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MASSACHUSETTS GENERAL HOSPITAL TRAVEL ACCIDENT PLAN 401k Plan overview

Plan NameMASSACHUSETTS GENERAL HOSPITAL TRAVEL ACCIDENT PLAN
Plan identification number 504

MASSACHUSETTS GENERAL HOSPITAL TRAVEL ACCIDENT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

THE GENERAL HOSPITAL CORPORATION FRUIT STREET has sponsored the creation of one or more 401k plans.

Company Name:THE GENERAL HOSPITAL CORPORATION FRUIT STREET
Employer identification number (EIN):042697983
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MASSACHUSETTS GENERAL HOSPITAL TRAVEL ACCIDENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042016-09-15CHRISTINE ZOTTOLI
5042015-09-15PAUL CHANEY
5042014-09-15PAUL CHANEY DONNA CLANCY2016-04-18
5042013-09-15PAUL CHANEY PAUL CHANEY2015-06-09
5042012-09-15PAUL CHANEY AMY VACCHINA2014-04-08
5042011-09-15PAUL CHANEY AMY VACCHINA2013-04-29
5042010-09-15PAUL CHANEY AMY VACCHINA2012-04-17
5042009-09-15PAUL CHANEY AMY VACCHINA2011-04-15

Plan Statistics for MASSACHUSETTS GENERAL HOSPITAL TRAVEL ACCIDENT PLAN

401k plan membership statisitcs for MASSACHUSETTS GENERAL HOSPITAL TRAVEL ACCIDENT PLAN

Measure Date Value
2016: MASSACHUSETTS GENERAL HOSPITAL TRAVEL ACCIDENT PLAN 2016 401k membership
Total participants, beginning-of-year2016-09-1570,066
Total number of active participants reported on line 7a of the Form 55002016-09-150
Number of retired or separated participants receiving benefits2016-09-150
Number of other retired or separated participants entitled to future benefits2016-09-150
Total of all active and inactive participants2016-09-150
2015: MASSACHUSETTS GENERAL HOSPITAL TRAVEL ACCIDENT PLAN 2015 401k membership
Total participants, beginning-of-year2015-09-1566,818
Total number of active participants reported on line 7a of the Form 55002015-09-1570,066
Total of all active and inactive participants2015-09-1570,066
2014: MASSACHUSETTS GENERAL HOSPITAL TRAVEL ACCIDENT PLAN 2014 401k membership
Total participants, beginning-of-year2014-09-1562,780
Total number of active participants reported on line 7a of the Form 55002014-09-1566,818
Total of all active and inactive participants2014-09-1566,818
2013: MASSACHUSETTS GENERAL HOSPITAL TRAVEL ACCIDENT PLAN 2013 401k membership
Total participants, beginning-of-year2013-09-1545,594
Total number of active participants reported on line 7a of the Form 55002013-09-1562,780
Total of all active and inactive participants2013-09-1562,780
2012: MASSACHUSETTS GENERAL HOSPITAL TRAVEL ACCIDENT PLAN 2012 401k membership
Total participants, beginning-of-year2012-09-1545,594
Total number of active participants reported on line 7a of the Form 55002012-09-1545,594
Number of retired or separated participants receiving benefits2012-09-150
Number of other retired or separated participants entitled to future benefits2012-09-150
Total of all active and inactive participants2012-09-1545,594
2011: MASSACHUSETTS GENERAL HOSPITAL TRAVEL ACCIDENT PLAN 2011 401k membership
Total participants, beginning-of-year2011-09-1545,594
Total number of active participants reported on line 7a of the Form 55002011-09-1545,594
Number of retired or separated participants receiving benefits2011-09-150
Number of other retired or separated participants entitled to future benefits2011-09-150
Total of all active and inactive participants2011-09-1545,594
2010: MASSACHUSETTS GENERAL HOSPITAL TRAVEL ACCIDENT PLAN 2010 401k membership
Total participants, beginning-of-year2010-09-1545,594
Total number of active participants reported on line 7a of the Form 55002010-09-1545,594
Number of retired or separated participants receiving benefits2010-09-150
Number of other retired or separated participants entitled to future benefits2010-09-150
Total of all active and inactive participants2010-09-1545,594
2009: MASSACHUSETTS GENERAL HOSPITAL TRAVEL ACCIDENT PLAN 2009 401k membership
Total participants, beginning-of-year2009-09-1545,594
Total number of active participants reported on line 7a of the Form 55002009-09-1545,594
Number of retired or separated participants receiving benefits2009-09-150
Number of other retired or separated participants entitled to future benefits2009-09-150
Total of all active and inactive participants2009-09-1545,594

Form 5500 Responses for MASSACHUSETTS GENERAL HOSPITAL TRAVEL ACCIDENT PLAN

2016: MASSACHUSETTS GENERAL HOSPITAL TRAVEL ACCIDENT PLAN 2016 form 5500 responses
2016-09-15Type of plan entitySingle employer plan
2016-09-15Submission has been amendedNo
2016-09-15This submission is the final filingYes
2016-09-15This return/report is a short plan year return/report (less than 12 months)No
2016-09-15Plan is a collectively bargained planNo
2016-09-15Plan funding arrangement – InsuranceYes
2016-09-15Plan benefit arrangement – InsuranceYes
2015: MASSACHUSETTS GENERAL HOSPITAL TRAVEL ACCIDENT PLAN 2015 form 5500 responses
2015-09-15Type of plan entitySingle employer plan
2015-09-15Submission has been amendedNo
2015-09-15This submission is the final filingNo
2015-09-15This return/report is a short plan year return/report (less than 12 months)No
2015-09-15Plan is a collectively bargained planNo
2015-09-15Plan funding arrangement – InsuranceYes
2015-09-15Plan benefit arrangement – InsuranceYes
2014: MASSACHUSETTS GENERAL HOSPITAL TRAVEL ACCIDENT PLAN 2014 form 5500 responses
2014-09-15Type of plan entitySingle employer plan
2014-09-15Submission has been amendedNo
2014-09-15This submission is the final filingNo
2014-09-15This return/report is a short plan year return/report (less than 12 months)No
2014-09-15Plan is a collectively bargained planNo
2014-09-15Plan funding arrangement – InsuranceYes
2014-09-15Plan benefit arrangement – InsuranceYes
2013: MASSACHUSETTS GENERAL HOSPITAL TRAVEL ACCIDENT PLAN 2013 form 5500 responses
2013-09-15Type of plan entitySingle employer plan
2013-09-15Submission has been amendedNo
2013-09-15This submission is the final filingNo
2013-09-15This return/report is a short plan year return/report (less than 12 months)No
2013-09-15Plan is a collectively bargained planNo
2013-09-15Plan funding arrangement – InsuranceYes
2013-09-15Plan benefit arrangement – InsuranceYes
2012: MASSACHUSETTS GENERAL HOSPITAL TRAVEL ACCIDENT PLAN 2012 form 5500 responses
2012-09-15Type of plan entitySingle employer plan
2012-09-15Submission has been amendedNo
2012-09-15This submission is the final filingNo
2012-09-15This return/report is a short plan year return/report (less than 12 months)No
2012-09-15Plan is a collectively bargained planNo
2012-09-15Plan funding arrangement – InsuranceYes
2012-09-15Plan benefit arrangement – InsuranceYes
2011: MASSACHUSETTS GENERAL HOSPITAL TRAVEL ACCIDENT PLAN 2011 form 5500 responses
2011-09-15Type of plan entitySingle employer plan
2011-09-15Submission has been amendedNo
2011-09-15This submission is the final filingNo
2011-09-15This return/report is a short plan year return/report (less than 12 months)No
2011-09-15Plan is a collectively bargained planNo
2011-09-15Plan funding arrangement – InsuranceYes
2011-09-15Plan benefit arrangement – InsuranceYes
2010: MASSACHUSETTS GENERAL HOSPITAL TRAVEL ACCIDENT PLAN 2010 form 5500 responses
2010-09-15Type of plan entitySingle employer plan
2010-09-15Submission has been amendedNo
2010-09-15This submission is the final filingNo
2010-09-15This return/report is a short plan year return/report (less than 12 months)No
2010-09-15Plan is a collectively bargained planNo
2010-09-15Plan funding arrangement – InsuranceYes
2010-09-15Plan benefit arrangement – InsuranceYes
2009: MASSACHUSETTS GENERAL HOSPITAL TRAVEL ACCIDENT PLAN 2009 form 5500 responses
2009-09-15Type of plan entitySingle employer plan
2009-09-15Submission has been amendedNo
2009-09-15This submission is the final filingNo
2009-09-15This return/report is a short plan year return/report (less than 12 months)No
2009-09-15Plan is a collectively bargained planNo
2009-09-15Plan funding arrangement – InsuranceYes
2009-09-15Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )
Policy contract numberADD N01173108
Policy instance 1
Insurance contract or identification numberADD N01173108
Number of Individuals Covered70066
Insurance policy start date2015-09-15
Insurance policy end date2016-09-14
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )
Policy contract numberADD N01173108
Policy instance 1
Insurance contract or identification numberADD N01173108
Number of Individuals Covered66818
Insurance policy start date2014-09-15
Insurance policy end date2015-09-14
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $90,379
ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )
Policy contract numberADDN01173108
Policy instance 1
Insurance contract or identification numberADDN01173108
Number of Individuals Covered2000
Insurance policy start date2013-09-15
Insurance policy end date2014-09-14
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $25,123
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )
Policy contract numberADDN01173108
Policy instance 1
Insurance contract or identification numberADDN01173108
Number of Individuals Covered45594
Insurance policy start date2012-09-15
Insurance policy end date2013-09-14
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $76,370
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 fees0
Insurance broker organization code?3
Insurance broker nameWILLIS GROUP HOLDINGS
ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )
Policy contract numberADDN01173108
Policy instance 1
Insurance contract or identification numberADDN01173108
Number of Individuals Covered45594
Insurance policy start date2011-09-15
Insurance policy end date2012-09-14
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $76,370
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )
Policy contract numberADDN01173108
Policy instance 1
Insurance contract or identification numberADDN01173108
Number of Individuals Covered45594
Insurance policy start date2010-09-15
Insurance policy end date2011-09-14
Total amount of commissions paid to insurance brokerUSD $15,911
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $79,553
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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