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ATHOL MEMORIAL HOSPITAL GROUP LIFE AND ADD 401k Plan overview

Plan NameATHOL MEMORIAL HOSPITAL GROUP LIFE AND ADD
Plan identification number 507

ATHOL MEMORIAL HOSPITAL GROUP LIFE AND ADD Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

ATHOL MEMORIAL HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name:ATHOL MEMORIAL HOSPITAL
Employer identification number (EIN):042126583
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ATHOL MEMORIAL HOSPITAL GROUP LIFE AND ADD

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5072022-01-01TOM SULLIVAN2023-05-24
5072021-01-01MIKE ABBATIELLO2022-07-18
5072020-01-01MIKE ABBATIELLO2021-05-14
5072019-01-01PAUL HEFFERNAN2020-07-14
5072018-01-01ROBERT CROSBY2019-07-26
5072017-01-01
5072016-01-01ROBERT CROSBY
5072015-01-01DONALD J BLOUD
5072014-01-01DONALD J. BLOOD
5072013-01-01ROBERT CROSBY
5072012-01-01ROBERT CROSBY

Plan Statistics for ATHOL MEMORIAL HOSPITAL GROUP LIFE AND ADD

401k plan membership statisitcs for ATHOL MEMORIAL HOSPITAL GROUP LIFE AND ADD

Measure Date Value
2022: ATHOL MEMORIAL HOSPITAL GROUP LIFE AND ADD 2022 401k membership
Total participants, beginning-of-year2022-01-01163
Total number of active participants reported on line 7a of the Form 55002022-01-01150
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01150
Number of employers contributing to the scheme2022-01-010
2021: ATHOL MEMORIAL HOSPITAL GROUP LIFE AND ADD 2021 401k membership
Total participants, beginning-of-year2021-01-01168
Total number of active participants reported on line 7a of the Form 55002021-01-01165
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01165
Number of employers contributing to the scheme2021-01-010
2020: ATHOL MEMORIAL HOSPITAL GROUP LIFE AND ADD 2020 401k membership
Total participants, beginning-of-year2020-01-01159
Total number of active participants reported on line 7a of the Form 55002020-01-01169
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01169
Number of employers contributing to the scheme2020-01-010
2019: ATHOL MEMORIAL HOSPITAL GROUP LIFE AND ADD 2019 401k membership
Total participants, beginning-of-year2019-01-01159
Total number of active participants reported on line 7a of the Form 55002019-01-01160
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01160
Number of employers contributing to the scheme2019-01-010
2018: ATHOL MEMORIAL HOSPITAL GROUP LIFE AND ADD 2018 401k membership
Total participants, beginning-of-year2018-01-01158
Total number of active participants reported on line 7a of the Form 55002018-01-01170
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01170
Number of employers contributing to the scheme2018-01-010
2017: ATHOL MEMORIAL HOSPITAL GROUP LIFE AND ADD 2017 401k membership
Total participants, beginning-of-year2017-01-010
Total number of active participants reported on line 7a of the Form 55002017-01-010
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-010
2016: ATHOL MEMORIAL HOSPITAL GROUP LIFE AND ADD 2016 401k membership
Total participants, beginning-of-year2016-01-01117
Total number of active participants reported on line 7a of the Form 55002016-01-01130
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01130
2015: ATHOL MEMORIAL HOSPITAL GROUP LIFE AND ADD 2015 401k membership
Total participants, beginning-of-year2015-01-01901
Total number of active participants reported on line 7a of the Form 55002015-01-01927
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01927
2014: ATHOL MEMORIAL HOSPITAL GROUP LIFE AND ADD 2014 401k membership
Total participants, beginning-of-year2014-01-01168
Total number of active participants reported on line 7a of the Form 55002014-01-01901
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01901
2013: ATHOL MEMORIAL HOSPITAL GROUP LIFE AND ADD 2013 401k membership
Total participants, beginning-of-year2013-01-01183
Total number of active participants reported on line 7a of the Form 55002013-01-01168
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01168
2012: ATHOL MEMORIAL HOSPITAL GROUP LIFE AND ADD 2012 401k membership
Total participants, beginning-of-year2012-01-01183
Total number of active participants reported on line 7a of the Form 55002012-01-01183
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01183

Form 5500 Responses for ATHOL MEMORIAL HOSPITAL GROUP LIFE AND ADD

2022: ATHOL MEMORIAL HOSPITAL GROUP LIFE AND ADD 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: ATHOL MEMORIAL HOSPITAL GROUP LIFE AND ADD 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: ATHOL MEMORIAL HOSPITAL GROUP LIFE AND ADD 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: ATHOL MEMORIAL HOSPITAL GROUP LIFE AND ADD 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: ATHOL MEMORIAL HOSPITAL GROUP LIFE AND ADD 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: ATHOL MEMORIAL HOSPITAL GROUP LIFE AND ADD 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: ATHOL MEMORIAL HOSPITAL GROUP LIFE AND ADD 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: ATHOL MEMORIAL HOSPITAL GROUP LIFE AND ADD 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: ATHOL MEMORIAL HOSPITAL GROUP LIFE AND ADD 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: ATHOL MEMORIAL HOSPITAL GROUP LIFE AND ADD 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: ATHOL MEMORIAL HOSPITAL GROUP LIFE AND ADD 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01First time form 5500 has been submittedYes
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number53600
Policy instance 1
Insurance contract or identification number53600
Number of Individuals Covered1254
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $4,943
Total amount of fees paid to insurance companyUSD $8,278
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $197,701
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees8278
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMMISSIONS
Insurance broker organization code?3
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number53600
Policy instance 1
Insurance contract or identification number53600
Number of Individuals Covered1222
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $18,695
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $167,757
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,501
Amount paid for insurance broker fees0
Insurance broker organization code?3
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number53600
Policy instance 1
Insurance contract or identification number53600
Number of Individuals Covered1208
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $18,104
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $195,767
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,210
Amount paid for insurance broker fees0
Insurance broker organization code?3
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number53600
Policy instance 1
Insurance contract or identification number53600
Number of Individuals Covered1160
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $4,684
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $187,369
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,684
Amount paid for insurance broker fees0
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number233080
Policy instance 1
Insurance contract or identification number233080
Number of Individuals Covered954
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $10,167
Total amount of fees paid to insurance companyUSD $2,470
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $161,761
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,167
Amount paid for insurance broker fees2470
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameMARSH AND MCLENNAN AGENCY

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