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NYACK HOSPITAL HEALTH & DENTAL PLAN 401k Plan overview

Plan NameNYACK HOSPITAL HEALTH & DENTAL PLAN
Plan identification number 502

NYACK HOSPITAL HEALTH & DENTAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Vision

401k Sponsoring company profile

MONTEFIORE NYACK HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name:MONTEFIORE NYACK HOSPITAL
Employer identification number (EIN):131740119
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NYACK HOSPITAL HEALTH & DENTAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-01-01JOHN BURKE2023-06-23
5022021-01-01MARY SHINICK2022-09-18
5022020-01-01
5022019-01-01
5022018-01-01
5022017-01-01MARY SHINICK JOHN BURKE2018-06-19
5022016-01-01MARY SHINICK JOHN BURKE2017-10-03
5022015-01-01MARY SHINICK JOHN BURKE2016-10-13
5022014-01-01MARY SHINICK JOHN BURKE2015-09-09
5022013-01-01MARY SHINICK JOHN BURKE2014-09-05
5022012-01-01MARY SHINICK JOHN BURKE2013-12-05
5022011-01-01MARY SHINICK JOHN BURKE2012-09-18
5022010-01-01MARY SHINICK JOHN BURKE2011-10-12
5022009-01-01JOHN BURKE MARY SHINICK2010-10-14
5022009-01-01 JOHN BURKE2010-10-13

Plan Statistics for NYACK HOSPITAL HEALTH & DENTAL PLAN

401k plan membership statisitcs for NYACK HOSPITAL HEALTH & DENTAL PLAN

Measure Date Value
2022: NYACK HOSPITAL HEALTH & DENTAL PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01520
Total number of active participants reported on line 7a of the Form 55002022-01-010
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 participants2022-01-010
Number of employers contributing to the scheme2022-01-010
2021: NYACK HOSPITAL HEALTH & DENTAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-011,211
Total number of active participants reported on line 7a of the Form 55002021-01-01520
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 participants2021-01-01520
Number of employers contributing to the scheme2021-01-010
2020: NYACK HOSPITAL HEALTH & DENTAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-011,181
Total number of active participants reported on line 7a of the Form 55002020-01-011,211
Total of all active and inactive participants2020-01-011,211
Total participants2020-01-011,211
2019: NYACK HOSPITAL HEALTH & DENTAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-011,111
Total number of active participants reported on line 7a of the Form 55002019-01-011,181
Total of all active and inactive participants2019-01-011,181
Total participants2019-01-011,181
2018: NYACK HOSPITAL HEALTH & DENTAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-011,150
Total number of active participants reported on line 7a of the Form 55002018-01-011,111
Total of all active and inactive participants2018-01-011,111
Total participants2018-01-011,111
2017: NYACK HOSPITAL HEALTH & DENTAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-011,028
Total number of active participants reported on line 7a of the Form 55002017-01-011,150
Total of all active and inactive participants2017-01-011,150
Total participants2017-01-011,150
2016: NYACK HOSPITAL HEALTH & DENTAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01969
Total number of active participants reported on line 7a of the Form 55002016-01-011,028
Total of all active and inactive participants2016-01-011,028
Total participants2016-01-011,028
2015: NYACK HOSPITAL HEALTH & DENTAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01863
Total number of active participants reported on line 7a of the Form 55002015-01-01969
Total of all active and inactive participants2015-01-01969
Total participants2015-01-01969
2014: NYACK HOSPITAL HEALTH & DENTAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-011,616
Total number of active participants reported on line 7a of the Form 55002014-01-01863
Total of all active and inactive participants2014-01-01863
Total participants2014-01-01863
2013: NYACK HOSPITAL HEALTH & DENTAL PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-011,707
Total number of active participants reported on line 7a of the Form 55002013-01-011,616
Total of all active and inactive participants2013-01-011,616
Total participants2013-01-011,616
2012: NYACK HOSPITAL HEALTH & DENTAL PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-011,586
Total number of active participants reported on line 7a of the Form 55002012-01-011,707
Total of all active and inactive participants2012-01-011,707
Total participants2012-01-011,707
2011: NYACK HOSPITAL HEALTH & DENTAL PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-011,491
Total number of active participants reported on line 7a of the Form 55002011-01-011,586
Total of all active and inactive participants2011-01-011,586
Total participants2011-01-011,586
2010: NYACK HOSPITAL HEALTH & DENTAL PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-011,417
Total number of active participants reported on line 7a of the Form 55002010-01-011,491
Total of all active and inactive participants2010-01-011,491
Total participants2010-01-011,491
2009: NYACK HOSPITAL HEALTH & DENTAL PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-011,355
Total number of active participants reported on line 7a of the Form 55002009-01-011,417
Total of all active and inactive participants2009-01-011,417
Total participants2009-01-011,417

Form 5500 Responses for NYACK HOSPITAL HEALTH & DENTAL PLAN

2022: NYACK HOSPITAL HEALTH & DENTAL PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01This submission is the final filingYes
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: NYACK HOSPITAL HEALTH & DENTAL PLAN 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: NYACK HOSPITAL HEALTH & DENTAL PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: NYACK HOSPITAL HEALTH & DENTAL PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: NYACK HOSPITAL HEALTH & DENTAL PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: NYACK HOSPITAL HEALTH & DENTAL PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: NYACK HOSPITAL HEALTH & DENTAL PLAN 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: NYACK HOSPITAL HEALTH & DENTAL PLAN 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: NYACK HOSPITAL HEALTH & DENTAL PLAN 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: NYACK HOSPITAL HEALTH & DENTAL PLAN 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: NYACK HOSPITAL HEALTH & DENTAL PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedYes
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
2011: NYACK HOSPITAL HEALTH & DENTAL PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: NYACK HOSPITAL HEALTH & DENTAL PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: NYACK HOSPITAL HEALTH & DENTAL PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedYes
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number12102422
Policy instance 2
Insurance contract or identification number12102422
Number of Individuals Covered480
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $57,678
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number869838
Policy instance 1
Insurance contract or identification number869838
Number of Individuals Covered1202
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $31,688
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $581,221
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number12102422
Policy instance 3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number869838
Policy instance 2
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number300544
Policy instance 1
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0869838
Policy instance 2
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number0242435
Policy instance 1
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number12102422
Policy instance 3
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 78026 )
Policy contract numberNH10948
Policy instance 1
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0869838
Policy instance 2
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number12102422
Policy instance 3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0869838
Policy instance 1
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number12102422
Policy instance 3
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 78026 )
Policy contract numberNH10948
Policy instance 2
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number12102422
Policy instance 2
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 78026 )
Policy contract numberNH10948
Policy instance 1
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0869838
Policy instance 3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0144259
Policy instance 4
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number12102422
Policy instance 3
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number720509
Policy instance 1
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 78026 )
Policy contract numberNH10948
Policy instance 2
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0144259
Policy instance 3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number12102422
Policy instance 2
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number720509
Policy instance 1
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number720509
Policy instance 1
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0144259
Policy instance 2
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number12102422
Policy instance 3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number12102422
Policy instance 2
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0144259
Policy instance 3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number12102422
Policy instance 3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0144259
Policy instance 2
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number720509
Policy instance 1
OXFORD HEALTH INSURANCE, INC (National Association of Insurance Commissioners NAIC id number: 78026 )
Policy contract numberNH1101
Policy instance 1
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number720509
Policy instance 2
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0144259
Policy instance 3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number12102422
Policy instance 4

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