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Plan Name | ATHOL MEMORIAL HOSPITAL GROUP HEALTH PLAN |
Plan identification number | 506 |
401k Plan Type | Welfare Benefit |
Plan Features/Benefits |
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Company Name: | ATHOL MEMORIAL HOSPITAL |
Employer identification number (EIN): | 042126583 |
NAIC Classification: | 622000 |
NAIC Description: | Hospitals |
Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
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506 | 2016-01-01 | ROBERT CROSBY | |||
506 | 2015-01-01 | DONALD J BLOUD | |||
506 | 2014-01-01 | ROBERT CROSBY JR | |||
506 | 2014-01-01 | DONALD J. BLOOD | |||
506 | 2013-01-01 | ROBERT CROSBY | |||
506 | 2012-01-01 | ROBERT CROSBY |
Measure | Date | Value |
---|---|---|
2016: ATHOL MEMORIAL HOSPITAL GROUP HEALTH PLAN 2016 401k membership | ||
Total participants, beginning-of-year | 2016-01-01 | 104 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 96 |
Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
Total of all active and inactive participants | 2016-01-01 | 96 |
2015: ATHOL MEMORIAL HOSPITAL GROUP HEALTH PLAN 2015 401k membership | ||
Total participants, beginning-of-year | 2015-01-01 | 104 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 104 |
Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
Total of all active and inactive participants | 2015-01-01 | 104 |
2014: ATHOL MEMORIAL HOSPITAL GROUP HEALTH PLAN 2014 401k membership | ||
Total participants, beginning-of-year | 2014-01-01 | 104 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 104 |
Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 0 |
Total of all active and inactive participants | 2014-01-01 | 104 |
2013: ATHOL MEMORIAL HOSPITAL GROUP HEALTH PLAN 2013 401k membership | ||
Total participants, beginning-of-year | 2013-01-01 | 115 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 104 |
Number of retired or separated participants receiving benefits | 2013-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2013-01-01 | 0 |
Total of all active and inactive participants | 2013-01-01 | 104 |
2012: ATHOL MEMORIAL HOSPITAL GROUP HEALTH PLAN 2012 401k membership | ||
Total participants, beginning-of-year | 2012-01-01 | 115 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 115 |
Number of retired or separated participants receiving benefits | 2012-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 0 |
Total of all active and inactive participants | 2012-01-01 | 115 |
2016: ATHOL MEMORIAL HOSPITAL GROUP HEALTH PLAN 2016 form 5500 responses | ||
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2016-01-01 | Type of plan entity | Single employer plan |
2016-01-01 | Submission has been amended | No |
2016-01-01 | This submission is the final filing | No |
2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-01-01 | Plan is a collectively bargained plan | No |
2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2015: ATHOL MEMORIAL HOSPITAL GROUP HEALTH PLAN 2015 form 5500 responses | ||
2015-01-01 | Type of plan entity | Single employer plan |
2015-01-01 | Submission has been amended | No |
2015-01-01 | This submission is the final filing | No |
2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-01-01 | Plan is a collectively bargained plan | No |
2015-01-01 | Plan funding arrangement – Insurance | Yes |
2015-01-01 | Plan benefit arrangement – Insurance | Yes |
2014: ATHOL MEMORIAL HOSPITAL GROUP HEALTH PLAN 2014 form 5500 responses | ||
2014-01-01 | Type of plan entity | Single employer plan |
2014-01-01 | Submission has been amended | Yes |
2014-01-01 | This submission is the final filing | No |
2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-01-01 | Plan is a collectively bargained plan | No |
2014-01-01 | Plan funding arrangement – Insurance | Yes |
2014-01-01 | Plan benefit arrangement – Insurance | Yes |
2013: ATHOL MEMORIAL HOSPITAL GROUP HEALTH PLAN 2013 form 5500 responses | ||
2013-01-01 | Type of plan entity | Single employer plan |
2013-01-01 | Submission has been amended | No |
2013-01-01 | This submission is the final filing | No |
2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-01-01 | Plan is a collectively bargained plan | No |
2013-01-01 | Plan funding arrangement – Insurance | Yes |
2013-01-01 | Plan benefit arrangement – Insurance | Yes |
2012: ATHOL MEMORIAL HOSPITAL GROUP HEALTH PLAN 2012 form 5500 responses | ||
2012-01-01 | Type of plan entity | Single employer plan |
2012-01-01 | First time form 5500 has been submitted | Yes |
2012-01-01 | Submission has been amended | No |
2012-01-01 | This submission is the final filing | No |
2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-01-01 | Plan is a collectively bargained plan | No |
2012-01-01 | Plan funding arrangement – Insurance | Yes |
2012-01-01 | Plan benefit arrangement – Insurance | Yes |
MHN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy contract number | 16252300 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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MHN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy contract number | 00 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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MHN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy contract number | 16252300 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy contract number | 4956837 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy contract number | 4956837 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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