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401k Plan overview

Plan NameMONTEFIORE MEDICAL CENTER INSURED WELFARE BENEFITS PLAN
Plan identification number 508

MONTEFIORE MEDICAL CENTER INSURED WELFARE BENEFITS PLAN Benefits

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

401k Sponsoring company profile

MONTEFIORE MEDICAL CENTER has sponsored the creation of one or more 401k plans.

Company Name:MONTEFIORE MEDICAL CENTER
Employer identification number (EIN):131740114
NAIC Classification:622000
NAIC Description: Hospitals

Additional information about MONTEFIORE MEDICAL CENTER

Jurisdiction of Incorporation: New York Department of State
Incorporation Date: 1884-07-23
Company Identification Number: 19807
Legal Registered Office Address: C/O GENERAL COUNSEL
111 EAST 210TH STREET
BRONX
United States of America (USA)
10467

More information about MONTEFIORE MEDICAL CENTER

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MONTEFIORE MEDICAL CENTER INSURED WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5082016-01-01PAUL KELLER
5082015-01-01
5082014-01-01WILLIAM SHANAHAN
5082012-01-01WILLIAM SHANAHAN WILLIAM SHANAHAN2013-10-11

Plan Statistics for MONTEFIORE MEDICAL CENTER INSURED WELFARE BENEFITS PLAN

401k plan membership statisitcs for MONTEFIORE MEDICAL CENTER INSURED WELFARE BENEFITS PLAN

Measure Date Value
Total participants, beginning-of-year2016-01-010
Total number of active participants reported on line 7a of the Form 55002016-01-010
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 participants2016-01-010
Total participants, beginning-of-year2015-01-0122,518
Total number of active participants reported on line 7a of the Form 55002015-01-0122,089
Number of retired or separated participants receiving benefits2015-01-011,127
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-0123,216
Total participants, beginning-of-year2014-01-0122,436
Total number of active participants reported on line 7a of the Form 55002014-01-0121,443
Number of retired or separated participants receiving benefits2014-01-011,075
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-0122,518
Total participants, beginning-of-year2012-01-0118,506
Total number of active participants reported on line 7a of the Form 55002012-01-0118,082
Number of retired or separated participants receiving benefits2012-01-01980
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-0119,062
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-0119,062
Number of participants with account balances2012-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010

Form 5500 Responses

2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingYes
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 – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
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
2012-01-01Type of plan entitySingle employer plan
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

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH52238-1
Policy instance 1
Number of Individuals Covered11715
Total amount of commissions paid to insurance brokerUSD $328,851
Total amount of fees paid to insurance companyUSD $147,245
Welfare Benefit Premiums Paid to CarrierUSD $6,948,941
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Life Insurance Welfare BenefitYes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Commission paid to Insurance BrokerUSD $328,851
Insurance contract or identification numberH52238-1
Amount paid for insurance broker fees147245
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Additional information about fees paid to insurance brokerSERVICE FEE BONUS
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
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Insurance broker organization code?3
Insurance broker nameHAVENS & COMPANY INC

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