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MIDSTATE RADIOLOGY ASSOCIATES, LLC WELFARE BENEFIT PLAN 401k Plan overview

Plan NameMIDSTATE RADIOLOGY ASSOCIATES, LLC WELFARE BENEFIT PLAN
Plan identification number 501

MIDSTATE RADIOLOGY ASSOCIATES, LLC WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

MIDSTATE RADIOLOGY ASSOCIATES, LLC has sponsored the creation of one or more 401k plans.

Company Name:MIDSTATE RADIOLOGY ASSOCIATES, LLC
Employer identification number (EIN):061522306
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MIDSTATE RADIOLOGY ASSOCIATES, LLC WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-07-01SANDY FREDERICK2024-02-26
5012021-07-01SANDY FREDERICK2022-11-01
5012020-07-01SANDY FREDERICK2021-11-15
5012019-07-01SANDY FREDERICK2020-12-30
5012018-07-01SANDY FREDERICK2019-10-29
5012017-07-01
5012016-07-01
5012015-07-01
5012014-07-01
5012013-07-01MATHEW KRUKOSKI MATHEW KRUKOSKI2017-01-23
5012012-07-01MATHEW KRUKOSKI MATHEW KRUKOSKI2017-01-17

Plan Statistics for MIDSTATE RADIOLOGY ASSOCIATES, LLC WELFARE BENEFIT PLAN

401k plan membership statisitcs for MIDSTATE RADIOLOGY ASSOCIATES, LLC WELFARE BENEFIT PLAN

Measure Date Value
2022: MIDSTATE RADIOLOGY ASSOCIATES, LLC WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-07-01376
Total number of active participants reported on line 7a of the Form 55002022-07-01375
Number of retired or separated participants receiving benefits2022-07-010
Number of other retired or separated participants entitled to future benefits2022-07-010
Total of all active and inactive participants2022-07-01375
2021: MIDSTATE RADIOLOGY ASSOCIATES, LLC WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-07-01342
Total number of active participants reported on line 7a of the Form 55002021-07-01376
Number of retired or separated participants receiving benefits2021-07-010
Number of other retired or separated participants entitled to future benefits2021-07-010
Total of all active and inactive participants2021-07-01376
2020: MIDSTATE RADIOLOGY ASSOCIATES, LLC WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-07-01354
Total number of active participants reported on line 7a of the Form 55002020-07-01342
Number of retired or separated participants receiving benefits2020-07-010
Number of other retired or separated participants entitled to future benefits2020-07-010
Total of all active and inactive participants2020-07-01342
2019: MIDSTATE RADIOLOGY ASSOCIATES, LLC WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-01313
Total number of active participants reported on line 7a of the Form 55002019-07-01354
Number of retired or separated participants receiving benefits2019-07-010
Number of other retired or separated participants entitled to future benefits2019-07-010
Total of all active and inactive participants2019-07-01354
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-07-010
Total participants2019-07-01354
2018: MIDSTATE RADIOLOGY ASSOCIATES, LLC WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-07-01271
Total number of active participants reported on line 7a of the Form 55002018-07-01313
Total of all active and inactive participants2018-07-01313
2017: MIDSTATE RADIOLOGY ASSOCIATES, LLC WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-07-01200
Total number of active participants reported on line 7a of the Form 55002017-07-01271
Number of retired or separated participants receiving benefits2017-07-010
Number of other retired or separated participants entitled to future benefits2017-07-010
Total of all active and inactive participants2017-07-01271
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-07-010
Total participants2017-07-01271
2016: MIDSTATE RADIOLOGY ASSOCIATES, LLC WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-01143
Total number of active participants reported on line 7a of the Form 55002016-07-01200
Number of retired or separated participants receiving benefits2016-07-010
Number of other retired or separated participants entitled to future benefits2016-07-010
Total of all active and inactive participants2016-07-01200
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-07-010
Total participants2016-07-01200
2015: MIDSTATE RADIOLOGY ASSOCIATES, LLC WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-01138
Total number of active participants reported on line 7a of the Form 55002015-07-01143
Number of retired or separated participants receiving benefits2015-07-010
Number of other retired or separated participants entitled to future benefits2015-07-010
Total of all active and inactive participants2015-07-01143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-07-010
Total participants2015-07-01143
2014: MIDSTATE RADIOLOGY ASSOCIATES, LLC WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-01126
Total number of active participants reported on line 7a of the Form 55002014-07-01138
Number of retired or separated participants receiving benefits2014-07-010
Number of other retired or separated participants entitled to future benefits2014-07-010
Total of all active and inactive participants2014-07-01138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-07-010
Total participants2014-07-01138
2013: MIDSTATE RADIOLOGY ASSOCIATES, LLC WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-01143
Total number of active participants reported on line 7a of the Form 55002013-07-01126
Number of retired or separated participants receiving benefits2013-07-010
Number of other retired or separated participants entitled to future benefits2013-07-010
Total of all active and inactive participants2013-07-01126
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-07-010
Total participants2013-07-01126
2012: MIDSTATE RADIOLOGY ASSOCIATES, LLC WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-07-0199
Total number of active participants reported on line 7a of the Form 55002012-07-01144
Number of retired or separated participants receiving benefits2012-07-010
Number of other retired or separated participants entitled to future benefits2012-07-010
Total of all active and inactive participants2012-07-01144
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-07-010
Total participants2012-07-01144

Form 5500 Responses for MIDSTATE RADIOLOGY ASSOCIATES, LLC WELFARE BENEFIT PLAN

2022: MIDSTATE RADIOLOGY ASSOCIATES, LLC WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-07-01Type of plan entitySingle employer plan
2022-07-01Plan funding arrangement – InsuranceYes
2022-07-01Plan benefit arrangement – InsuranceYes
2021: MIDSTATE RADIOLOGY ASSOCIATES, LLC WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – InsuranceYes
2020: MIDSTATE RADIOLOGY ASSOCIATES, LLC WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – InsuranceYes
2019: MIDSTATE RADIOLOGY ASSOCIATES, LLC WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – InsuranceYes
2018: MIDSTATE RADIOLOGY ASSOCIATES, LLC WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – InsuranceYes
2017: MIDSTATE RADIOLOGY ASSOCIATES, LLC WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – InsuranceYes
2016: MIDSTATE RADIOLOGY ASSOCIATES, LLC WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – InsuranceYes
2015: MIDSTATE RADIOLOGY ASSOCIATES, LLC WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – InsuranceYes
2014: MIDSTATE RADIOLOGY ASSOCIATES, LLC WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013: MIDSTATE RADIOLOGY ASSOCIATES, LLC WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – InsuranceYes
2012: MIDSTATE RADIOLOGY ASSOCIATES, LLC WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01First time form 5500 has been submittedYes
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract number1108519
Policy instance 2
Insurance contract or identification number1108519
Number of Individuals Covered375
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $99,255
Total amount of fees paid to insurance companyUSD $25,586
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,610,804
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $99,255
Amount paid for insurance broker fees25586
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number676350G,681817G
Policy instance 1
Insurance contract or identification number676350G,681817G
Number of Individuals Covered353
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $7,407
Total amount of fees paid to insurance companyUSD $11,370
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $311,682
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 fees11370
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract number1108519
Policy instance 2
Insurance contract or identification number1108519
Number of Individuals Covered376
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $90,667
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,021,442
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $90,667
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number676350G,681817G
Policy instance 1
Insurance contract or identification number676350G,681817G
Number of Individuals Covered345
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $6,051
Total amount of fees paid to insurance companyUSD $11,488
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $259,715
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 fees11488
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract number1108519
Policy instance 2
Insurance contract or identification number1108519
Number of Individuals Covered342
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $78,204
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,599,070
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $78,204
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number676350G,681817G
Policy instance 1
Insurance contract or identification number676350G,681817G
Number of Individuals Covered287
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $6,336
Total amount of fees paid to insurance companyUSD $4,397
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $288,268
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,336
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract number1748
Policy instance 2
Insurance contract or identification number1748
Number of Individuals Covered354
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $98,744
Total amount of fees paid to insurance companyUSD $24,626
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,633,181
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $81,922
Amount paid for insurance broker fees24626
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number676350G
Policy instance 1
Insurance contract or identification number676350G
Number of Individuals Covered290
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $29,301
Total amount of fees paid to insurance companyUSD $3,987
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $293,008
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,139
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract number1748
Policy instance 2
Insurance contract or identification number1748
Number of Individuals Covered313
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $57,335
Total amount of fees paid to insurance companyUSD $10,383
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,266,776
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $57,335
Amount paid for insurance broker fees10383
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number676350G
Policy instance 1
Insurance contract or identification number676350G
Number of Individuals Covered253
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $23,534
Total amount of fees paid to insurance companyUSD $3,639
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $235,331
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,534
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerN/A
Insurance broker organization code?3
CONNECTICARE, INC. (National Association of Insurance Commissioners NAIC id number: 95675 )
Policy contract number1748
Policy instance 2
Insurance contract or identification number1748
Number of Individuals Covered271
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $51,439
Total amount of fees paid to insurance companyUSD $11,116
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,795,143
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number676350G
Policy instance 1
Insurance contract or identification number676350G
Number of Individuals Covered207
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $16,375
Total amount of fees paid to insurance companyUSD $2,385
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $175,378
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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