401k Plan data: LUTHERAN MEDICAL CENTER LONG TERM DISABILITY PLAN plan

LUTHERAN MEDICAL CENTER LONG TERM DISABILITY PLAN 401k Plan overview

Plan Name	LUTHERAN MEDICAL CENTER LONG TERM DISABILITY PLAN
Plan identification number	518

LUTHERAN MEDICAL CENTER LONG TERM DISABILITY PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Long-term disability cover

401k Sponsoring company profile

NYU LANGONE HOSPITALS has sponsored the creation of one or more 401k plans.

Company Name: NYU LANGONE HOSPITALS

Employer identification number (EIN): 133971298

NAIC Classification: 622000
NAIC Description: Hospitals

Additional information about NYU LANGONE HOSPITALS

Jurisdiction of Incorporation: New York Department of State

Incorporation Date: 1997-11-24

Company Identification Number: 2202123

Legal Registered Office Address: OFFICE OF THE GENERAL COUNSEL
550 FIRST AVENUE - HCC 15
NEW YORK
United States of America (USA)
10016

More information about NYU LANGONE HOSPITALS

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LUTHERAN MEDICAL CENTER LONG TERM DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
518 2016-01-01 FRANK FRANZI
518 2015-01-01 FRANK FRANZI

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
518	2016-01-01	FRANK FRANZI
518	2015-01-01	FRANK FRANZI

Plan Statistics for LUTHERAN MEDICAL CENTER LONG TERM DISABILITY PLAN

401k plan membership statisitcs for LUTHERAN MEDICAL CENTER LONG TERM DISABILITY PLAN

Measure Date Value
2016: LUTHERAN MEDICAL CENTER LONG TERM DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 828
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
Total of all active and inactive participants 2016-01-01 0
2015: LUTHERAN MEDICAL CENTER LONG TERM DISABILITY PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 650
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 828
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 828

Measure	Date	Value
2016: LUTHERAN MEDICAL CENTER LONG TERM DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	828
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
Total of all active and inactive participants	2016-01-01	0
2015: LUTHERAN MEDICAL CENTER LONG TERM DISABILITY PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	650
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	828
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	828

Form 5500 Responses for LUTHERAN MEDICAL CENTER LONG TERM DISABILITY PLAN

2016: LUTHERAN MEDICAL CENTER LONG TERM DISABILITY PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	Yes
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: LUTHERAN MEDICAL CENTER LONG TERM DISABILITY PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )

Policy contract number

LTD123657

Policy instance

Insurance contract or identification number	LTD123657
Number of Individuals Covered	828
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $5,406
Total amount of fees paid to insurance company	USD $1,838
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $101,250
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,406
Amount paid for insurance broker fees	1838
Additional information about fees paid to insurance broker	ADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?	3
Insurance broker name	FRENKEL BENEFITS LLC

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Company Name:	NYU LANGONE HOSPITALS
Employer identification number (EIN):	133971298
NAIC Classification:	622000
NAIC Description:	Hospitals

Jurisdiction of Incorporation:	New York Department of State
Incorporation Date:	1997-11-24
Company Identification Number:	2202123
Legal Registered Office Address:	OFFICE OF THE GENERAL COUNSEL 550 FIRST AVENUE - HCC 15 NEW YORK United States of America (USA) 10016