401k Plan data: SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES plan

SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES 401k Plan overview

Plan Name	SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES
Plan identification number	507

SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Dental

401k Sponsoring company profile

SCHUYLKILL MEDICAL CENTER SOUTH JACKSON STREET has sponsored the creation of one or more 401k plans.

Company Name: SCHUYLKILL MEDICAL CENTER SOUTH JACKSON STREET

Employer identification number (EIN): 231352202

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
507 2017-01-01 THOMAS MCPHILLIPS DIANE BORIS 2018-10-11
507 2016-01-01 THOMAS MCPHILLIPS DIANE BORIS 2017-07-27
507 2015-01-01 THOMAS MCPHILLIPS DIANE BORIS 2016-09-09
507 2014-01-01 THOMAS MCPHILLIPS DIANE BORIS 2015-07-20
507 2013-01-01 MARTIN G. TREASURE JOHN SIMODEJKA 2014-07-11
507 2012-01-01 MARTIN G. TREASURE JOHN SIMODEJKA 2013-09-11
507 2011-01-01 MARTIN G. TREASURE JOHN SIMODEJKA 2012-09-25
507 2009-01-01 MARTIN G. TREASURE JOHN SIMODEJKA 2010-09-27

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
507	2017-01-01	THOMAS MCPHILLIPS	DIANE BORIS	2018-10-11
507	2016-01-01	THOMAS MCPHILLIPS	DIANE BORIS	2017-07-27
507	2015-01-01	THOMAS MCPHILLIPS	DIANE BORIS	2016-09-09
507	2014-01-01	THOMAS MCPHILLIPS	DIANE BORIS	2015-07-20
507	2013-01-01	MARTIN G. TREASURE	JOHN SIMODEJKA	2014-07-11
507	2012-01-01	MARTIN G. TREASURE	JOHN SIMODEJKA	2013-09-11
507	2011-01-01	MARTIN G. TREASURE	JOHN SIMODEJKA	2012-09-25
507	2009-01-01	MARTIN G. TREASURE	JOHN SIMODEJKA	2010-09-27

Plan Statistics for SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES

401k plan membership statisitcs for SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES

Measure Date Value
2017: SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES 2017 401k membership
Total participants, beginning-of-year 2017-01-01 193
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 192
Number of retired or separated participants receiving benefits 2017-01-01 1
Number of other retired or separated participants entitled to future benefits 2017-01-01 1
Total of all active and inactive participants 2017-01-01 194
2016: SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES 2016 401k membership
Total participants, beginning-of-year 2016-01-01 209
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 191
Number of retired or separated participants receiving benefits 2016-01-01 2
Number of other retired or separated participants entitled to future benefits 2016-01-01 2
Total of all active and inactive participants 2016-01-01 195
2015: SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES 2015 401k membership
Total participants, beginning-of-year 2015-01-01 237
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 234
Number of retired or separated participants receiving benefits 2015-01-01 2
Number of other retired or separated participants entitled to future benefits 2015-01-01 2
Total of all active and inactive participants 2015-01-01 238
2014: SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES 2014 401k membership
Total participants, beginning-of-year 2014-01-01 243
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 236
Number of retired or separated participants receiving benefits 2014-01-01 3
Number of other retired or separated participants entitled to future benefits 2014-01-01 2
Total of all active and inactive participants 2014-01-01 241
2013: SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES 2013 401k membership
Total participants, beginning-of-year 2013-01-01 239
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 238
Number of retired or separated participants receiving benefits 2013-01-01 3
Number of other retired or separated participants entitled to future benefits 2013-01-01 22
Total of all active and inactive participants 2013-01-01 263
2012: SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES 2012 401k membership
Total participants, beginning-of-year 2012-01-01 239
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 236
Number of retired or separated participants receiving benefits 2012-01-01 2
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 238
2011: SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES 2011 401k membership
Total participants, beginning-of-year 2011-01-01 252
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 237
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 237
2009: SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES 2009 401k membership
Total participants, beginning-of-year 2009-01-01 210
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 448
Number of retired or separated participants receiving benefits 2009-01-01 1
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 449

Measure	Date	Value
2017: SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES 2017 401k membership
Total participants, beginning-of-year	2017-01-01	193
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	192
Number of retired or separated participants receiving benefits	2017-01-01	1
Number of other retired or separated participants entitled to future benefits	2017-01-01	1
Total of all active and inactive participants	2017-01-01	194
2016: SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES 2016 401k membership
Total participants, beginning-of-year	2016-01-01	209
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	191
Number of retired or separated participants receiving benefits	2016-01-01	2
Number of other retired or separated participants entitled to future benefits	2016-01-01	2
Total of all active and inactive participants	2016-01-01	195
2015: SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES 2015 401k membership
Total participants, beginning-of-year	2015-01-01	237
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	234
Number of retired or separated participants receiving benefits	2015-01-01	2
Number of other retired or separated participants entitled to future benefits	2015-01-01	2
Total of all active and inactive participants	2015-01-01	238
2014: SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES 2014 401k membership
Total participants, beginning-of-year	2014-01-01	243
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	236
Number of retired or separated participants receiving benefits	2014-01-01	3
Number of other retired or separated participants entitled to future benefits	2014-01-01	2
Total of all active and inactive participants	2014-01-01	241
2013: SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES 2013 401k membership
Total participants, beginning-of-year	2013-01-01	239
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	238
Number of retired or separated participants receiving benefits	2013-01-01	3
Number of other retired or separated participants entitled to future benefits	2013-01-01	22
Total of all active and inactive participants	2013-01-01	263
2012: SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES 2012 401k membership
Total participants, beginning-of-year	2012-01-01	239
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	236
Number of retired or separated participants receiving benefits	2012-01-01	2
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	238
2011: SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES 2011 401k membership
Total participants, beginning-of-year	2011-01-01	252
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	237
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	237
2009: SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES 2009 401k membership
Total participants, beginning-of-year	2009-01-01	210
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	448
Number of retired or separated participants receiving benefits	2009-01-01	1
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	449

Form 5500 Responses for SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES

2017: SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	Yes
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES 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	No
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	Yes
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES 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	Yes
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	Yes
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	Yes
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	Yes
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	Yes
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: SCHUYLKILL MEDICAL CENTER SJS DENTAL PLAN FOR TECHS, LPNS, S & M EMPLOYEES 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	Yes
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number	4505
Policy instance	1
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number	4505
Policy instance	1
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number	4505
Policy instance	1
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number	4505
Policy instance	1
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number	4505
Policy instance	1
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number	4505
Policy instance	1
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number	4505
Policy instance	1

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Company Name:	SCHUYLKILL MEDICAL CENTER SOUTH JACKSON STREET
Employer identification number (EIN):	231352202
NAIC Classification:	622000
NAIC Description:	Hospitals