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NORTHERN OSWEGO COUNTY HEALTH SERVICES INC. HEALTH & WELFARE BENEFITS PLAN 401k Plan overview

Plan NameNORTHERN OSWEGO COUNTY HEALTH SERVICES INC. HEALTH & WELFARE BENEFITS PLAN
Plan identification number 501

NORTHERN OSWEGO COUNTY HEALTH SERVICES INC. HEALTH & WELFARE BENEFITS PLAN Benefits

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

401k Sponsoring company profile

NORTHERN OSWEGO COUNTY HEALTH SERVICES INC has sponsored the creation of one or more 401k plans.

Company Name:NORTHERN OSWEGO COUNTY HEALTH SERVICES INC
Employer identification number (EIN):237036393
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Additional information about NORTHERN OSWEGO COUNTY HEALTH SERVICES INC

Jurisdiction of Incorporation: New York Department of State
Incorporation Date: 1969-02-24
Company Identification Number: 272967

More information about NORTHERN OSWEGO COUNTY HEALTH SERVICES INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTHERN OSWEGO COUNTY HEALTH SERVICES INC. HEALTH & WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012024-01-01TRICIA PETER-CLARK
5012023-01-01
5012023-01-01TRICIA PETER-CLARK
5012022-01-01
5012022-01-01TRICIA PETER-CLARK
5012021-01-01
5012021-01-01TRICIA PETER-CLARK
5012020-01-01
5012019-01-01
5012018-01-01TRICIA PETER-CLARK
5012017-01-01TRICIA PETER-CLARK
5012016-01-01TRICIA PETER-CLARK
5012015-01-01KAREN T. PATERNITI
5012014-01-01KAREN T. PATERNITI
5012013-01-01KAREN T. PATERNITI

Plan Statistics for NORTHERN OSWEGO COUNTY HEALTH SERVICES INC. HEALTH & WELFARE BENEFITS PLAN

401k plan membership statisitcs for NORTHERN OSWEGO COUNTY HEALTH SERVICES INC. HEALTH & WELFARE BENEFITS PLAN

Measure Date Value
2023: NORTHERN OSWEGO COUNTY HEALTH SERVICES INC. HEALTH & WELFARE BENEFITS PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-01265
Total number of active participants reported on line 7a of the Form 55002023-01-01268
Number of retired or separated participants receiving benefits2023-01-011
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-01269
2022: NORTHERN OSWEGO COUNTY HEALTH SERVICES INC. HEALTH & WELFARE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01252
Total number of active participants reported on line 7a of the Form 55002022-01-01268
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 participants2022-01-01268
2021: NORTHERN OSWEGO COUNTY HEALTH SERVICES INC. HEALTH & WELFARE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01228
Total number of active participants reported on line 7a of the Form 55002021-01-01239
Number of retired or separated participants receiving benefits2021-01-012
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01241
2020: NORTHERN OSWEGO COUNTY HEALTH SERVICES INC. HEALTH & WELFARE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01232
Total number of active participants reported on line 7a of the Form 55002020-01-01228
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01228
2019: NORTHERN OSWEGO COUNTY HEALTH SERVICES INC. HEALTH & WELFARE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01221
Total number of active participants reported on line 7a of the Form 55002019-01-01232
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01232
2018: NORTHERN OSWEGO COUNTY HEALTH SERVICES INC. HEALTH & WELFARE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01215
Total number of active participants reported on line 7a of the Form 55002018-01-01225
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01225
2017: NORTHERN OSWEGO COUNTY HEALTH SERVICES INC. HEALTH & WELFARE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01206
Total number of active participants reported on line 7a of the Form 55002017-01-01215
Number of retired or separated participants receiving benefits2017-01-011
Total of all active and inactive participants2017-01-01216
Total participants2017-01-01216
2016: NORTHERN OSWEGO COUNTY HEALTH SERVICES INC. HEALTH & WELFARE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01208
Total number of active participants reported on line 7a of the Form 55002016-01-01206
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 participants2016-01-01206
Total participants2016-01-01206
2015: NORTHERN OSWEGO COUNTY HEALTH SERVICES INC. HEALTH & WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01185
Total number of active participants reported on line 7a of the Form 55002015-01-01208
Number of retired or separated participants receiving benefits2015-01-011
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01209
Total participants2015-01-01209
2014: NORTHERN OSWEGO COUNTY HEALTH SERVICES INC. HEALTH & WELFARE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01180
Total number of active participants reported on line 7a of the Form 55002014-01-01187
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01187
Total participants2014-01-01187
2013: NORTHERN OSWEGO COUNTY HEALTH SERVICES INC. HEALTH & WELFARE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01102
Total number of active participants reported on line 7a of the Form 55002013-01-01102
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01102
Total participants2013-01-01102

Form 5500 Responses for NORTHERN OSWEGO COUNTY HEALTH SERVICES INC. HEALTH & WELFARE BENEFITS PLAN

2023: NORTHERN OSWEGO COUNTY HEALTH SERVICES INC. HEALTH & WELFARE BENEFITS PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – InsuranceYes
2022: NORTHERN OSWEGO COUNTY HEALTH SERVICES INC. HEALTH & WELFARE BENEFITS PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: NORTHERN OSWEGO COUNTY HEALTH SERVICES INC. HEALTH & WELFARE BENEFITS 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: NORTHERN OSWEGO COUNTY HEALTH SERVICES INC. HEALTH & WELFARE BENEFITS PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: NORTHERN OSWEGO COUNTY HEALTH SERVICES INC. HEALTH & WELFARE BENEFITS PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: NORTHERN OSWEGO COUNTY HEALTH SERVICES INC. HEALTH & WELFARE BENEFITS PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: NORTHERN OSWEGO COUNTY HEALTH SERVICES INC. HEALTH & WELFARE BENEFITS PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: NORTHERN OSWEGO COUNTY HEALTH SERVICES INC. HEALTH & WELFARE BENEFITS PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: NORTHERN OSWEGO COUNTY HEALTH SERVICES INC. HEALTH & WELFARE BENEFITS PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: NORTHERN OSWEGO COUNTY HEALTH SERVICES INC. HEALTH & WELFARE BENEFITS PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedYes
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: NORTHERN OSWEGO COUNTY HEALTH SERVICES INC. HEALTH & WELFARE BENEFITS PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01First time form 5500 has been submittedYes
2013-01-01Submission has been amendedYes
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

AMERITAS LIFE INSURANCE CORP OF NY (National Association of Insurance Commissioners NAIC id number: 80837 )
Policy contract number026202400
Policy instance 3
Insurance contract or identification number026202400
Number of Individuals Covered407
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $6,083
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $121,661
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberG000BSNR
Policy instance 2
Insurance contract or identification numberG000BSNR
Number of Individuals Covered269
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $10,039
Total amount of fees paid to insurance companyUSD $4,971
Health Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $126,329
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number00007747
Policy instance 1
Insurance contract or identification number00007747
Number of Individuals Covered168
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $88,841
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP OF NY (National Association of Insurance Commissioners NAIC id number: 80837 )
Policy contract number026202400
Policy instance 3
Insurance contract or identification number026202400
Number of Individuals Covered738
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $6,049
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $120,984
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberG000BSNR
Policy instance 2
Insurance contract or identification numberG000BSNR
Number of Individuals Covered268
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $4,088
Total amount of fees paid to insurance companyUSD $1,505
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $49,777
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number00007747
Policy instance 1
Insurance contract or identification number00007747
Number of Individuals Covered162
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $92,592
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number00007747
Policy instance 1
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 71412 )
Policy contract numberG000BSNR
Policy instance 2
AMERITAS LIFE INSURANCE CORP OF NY (National Association of Insurance Commissioners NAIC id number: 80837 )
Policy contract number026202400
Policy instance 3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number768629
Policy instance 4
AMERITAS LIFE INSURANCE CORP OF NY (National Association of Insurance Commissioners NAIC id number: 80837 )
Policy contract number026202400
Policy instance 3
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number681598
Policy instance 2
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number00007747
Policy instance 1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number768629
Policy instance 5
AMERITAS LIFE INSURANCE CORP OF NY (National Association of Insurance Commissioners NAIC id number: 80837 )
Policy contract number026202400
Policy instance 4
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number681598
Policy instance 3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00314369
Policy instance 2
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number00007747
Policy instance 1
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00314369
Policy instance 2
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number00007747
Policy instance 1
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00314369
Policy instance 2
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number00007747
Policy instance 1
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number00007747
Policy instance 1
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00314369
Policy instance 2
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number00007747
Policy instance 1
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00314369
Policy instance 2
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00314369
Policy instance 3
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number11117747
Policy instance 1
THE STANDARD LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 89009 )
Policy contract number445261
Policy instance 2

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