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| Plan Name | COMMUNITY HEALTHCARE CENTER EMPLOYEE BENEFIT PLAN - LIFE INSURANCE |
| Plan identification number | 503 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | COMMUNITY HEALTHCARE CENTER |
| Employer identification number (EIN): | 752429644 |
| NAIC Classification: | 621111 |
| NAIC Description: | Offices of Physicians (except Mental Health Specialists) |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 503 | 2018-08-01 | KRISTI MCCASLAND, CFOO | 2020-02-27 | ||
| 503 | 2017-08-01 | KRISTI MCCASLAND, CFOO | 2019-02-28 |
| Measure | Date | Value |
|---|---|---|
| 2018: COMMUNITY HEALTHCARE CENTER EMPLOYEE BENEFIT PLAN - LIFE INSURANCE 2018 401k membership | ||
| Total participants, beginning-of-year | 2018-08-01 | 185 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-08-01 | 0 |
| Total of all active and inactive participants | 2018-08-01 | 0 |
| Total participants | 2018-08-01 | 0 |
| 2017: COMMUNITY HEALTHCARE CENTER EMPLOYEE BENEFIT PLAN - LIFE INSURANCE 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-08-01 | 176 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-08-01 | 185 |
| Total of all active and inactive participants | 2017-08-01 | 185 |
| Total participants | 2017-08-01 | 185 |
| 2018: COMMUNITY HEALTHCARE CENTER EMPLOYEE BENEFIT PLAN - LIFE INSURANCE 2018 form 5500 responses | ||
|---|---|---|
| 2018-08-01 | Type of plan entity | Single employer plan |
| 2018-08-01 | This submission is the final filing | Yes |
| 2018-08-01 | Plan funding arrangement – Insurance | Yes |
| 2018-08-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-08-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: COMMUNITY HEALTHCARE CENTER EMPLOYEE BENEFIT PLAN - LIFE INSURANCE 2017 form 5500 responses | ||
| 2017-08-01 | Type of plan entity | Single employer plan |
| 2017-08-01 | Plan funding arrangement – Insurance | Yes |
| 2017-08-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-08-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGD607011 |
| Policy instance | 1 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGM606760 |
| Policy instance | 2 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGM606761 |
| Policy instance | 3 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SOK604793 |
| Policy instance | 4 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGD607011 |
| Policy instance | 1 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGM606760 |
| Policy instance | 2 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SGM606761 |
| Policy instance | 3 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | SOK604793 |
| Policy instance | 4 |
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