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ST. PETERS HEALTHCARE SYSTEM MEDICAL, DENTAL AND VISION INSURANCE PLAN 401k Plan overview

Plan NameST. PETERS HEALTHCARE SYSTEM MEDICAL, DENTAL AND VISION INSURANCE PLAN
Plan identification number 502

ST. PETERS HEALTHCARE SYSTEM MEDICAL, DENTAL AND VISION INSURANCE PLAN Benefits

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

401k Sponsoring company profile

SAINT PETERS HEALTHCARE SYSTEM, INC has sponsored the creation of one or more 401k plans.

Company Name:SAINT PETERS HEALTHCARE SYSTEM, INC
Employer identification number (EIN):262019056
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ST. PETERS HEALTHCARE SYSTEM MEDICAL, DENTAL AND VISION INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022021-01-01ANNE BUSCAVAGE2022-06-27
5022020-01-01ANNE BUSCAVAGE2021-07-14
5022019-01-01ANNE BUSCAVAGE2020-07-09
5022019-01-01ANNE BUSCAVAGE2021-07-16
5022018-01-01
5022017-01-01
5022016-01-01ANNE BUSCAUAGE
5022015-01-01ANNE BUSCAVAGE
5022014-01-01ANNE BUSCAUGE
5022013-01-01ANNE BUSCAVAGE
5022012-01-01CHERYL N. DEFALCO
5022011-01-01CHERYL N DEFALCO

Plan Statistics for ST. PETERS HEALTHCARE SYSTEM MEDICAL, DENTAL AND VISION INSURANCE PLAN

401k plan membership statisitcs for ST. PETERS HEALTHCARE SYSTEM MEDICAL, DENTAL AND VISION INSURANCE PLAN

Measure Date Value
2021: ST. PETERS HEALTHCARE SYSTEM MEDICAL, DENTAL AND VISION INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-011,866
Total number of active participants reported on line 7a of the Form 55002021-01-01749
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 participants2021-01-01749
Number of employers contributing to the scheme2021-01-010
2020: ST. PETERS HEALTHCARE SYSTEM MEDICAL, DENTAL AND VISION INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-011,957
Total number of active participants reported on line 7a of the Form 55002020-01-011,826
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 participants2020-01-011,826
Number of employers contributing to the scheme2020-01-010
2019: ST. PETERS HEALTHCARE SYSTEM MEDICAL, DENTAL AND VISION INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-011,957
Total number of active participants reported on line 7a of the Form 55002019-01-011,957
Number of retired or separated participants receiving benefits2019-01-019
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-011,966
Number of employers contributing to the scheme2019-01-010
2018: ST. PETERS HEALTHCARE SYSTEM MEDICAL, DENTAL AND VISION INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-012,661
Total number of active participants reported on line 7a of the Form 55002018-01-012,715
Number of retired or separated participants receiving benefits2018-01-0115
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-012,730
Number of employers contributing to the scheme2018-01-010
2017: ST. PETERS HEALTHCARE SYSTEM MEDICAL, DENTAL AND VISION INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-012,075
Total number of active participants reported on line 7a of the Form 55002017-01-012,074
Number of retired or separated participants receiving benefits2017-01-0116
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-012,090
2016: ST. PETERS HEALTHCARE SYSTEM MEDICAL, DENTAL AND VISION INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-012,267
Total number of active participants reported on line 7a of the Form 55002016-01-012,034
Number of retired or separated participants receiving benefits2016-01-0115
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-012,049
2015: ST. PETERS HEALTHCARE SYSTEM MEDICAL, DENTAL AND VISION INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-012,118
Total number of active participants reported on line 7a of the Form 55002015-01-012,256
Number of retired or separated participants receiving benefits2015-01-0111
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-012,267
2014: ST. PETERS HEALTHCARE SYSTEM MEDICAL, DENTAL AND VISION INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-012,116
Total number of active participants reported on line 7a of the Form 55002014-01-012,116
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 participants2014-01-012,116
2013: ST. PETERS HEALTHCARE SYSTEM MEDICAL, DENTAL AND VISION INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-012,116
Total number of active participants reported on line 7a of the Form 55002013-01-012,116
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 participants2013-01-012,116
2012: ST. PETERS HEALTHCARE SYSTEM MEDICAL, DENTAL AND VISION INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-012,116
Total number of active participants reported on line 7a of the Form 55002012-01-012,116
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-012,116
2011: ST. PETERS HEALTHCARE SYSTEM MEDICAL, DENTAL AND VISION INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-012,145
Total number of active participants reported on line 7a of the Form 55002011-01-012,116
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-012,116

Form 5500 Responses for ST. PETERS HEALTHCARE SYSTEM MEDICAL, DENTAL AND VISION INSURANCE PLAN

2021: ST. PETERS HEALTHCARE SYSTEM MEDICAL, DENTAL AND VISION INSURANCE PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: ST. PETERS HEALTHCARE SYSTEM MEDICAL, DENTAL AND VISION INSURANCE PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: ST. PETERS HEALTHCARE SYSTEM MEDICAL, DENTAL AND VISION INSURANCE PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedYes
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: ST. PETERS HEALTHCARE SYSTEM MEDICAL, DENTAL AND VISION INSURANCE PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: ST. PETERS HEALTHCARE SYSTEM MEDICAL, DENTAL AND VISION INSURANCE PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: ST. PETERS HEALTHCARE SYSTEM MEDICAL, DENTAL AND VISION INSURANCE 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 – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: ST. PETERS HEALTHCARE SYSTEM MEDICAL, DENTAL AND VISION INSURANCE 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 – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: ST. PETERS HEALTHCARE SYSTEM MEDICAL, DENTAL AND VISION INSURANCE 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 – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: ST. PETERS HEALTHCARE SYSTEM MEDICAL, DENTAL AND VISION INSURANCE 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 – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: ST. PETERS HEALTHCARE SYSTEM MEDICAL, DENTAL AND VISION INSURANCE PLAN 2012 form 5500 responses
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 – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: ST. PETERS HEALTHCARE SYSTEM MEDICAL, DENTAL AND VISION INSURANCE 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 – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30069804
Policy instance 1
Insurance contract or identification number30069804
Number of Individuals Covered1759
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
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 $255,936
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FLAGSHIP HEALTH SYSTEMS (National Association of Insurance Commissioners NAIC id number: 11179 )
Policy contract number9564
Policy instance 2
Insurance contract or identification number9564
Number of Individuals Covered326
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
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: 39616 )
Policy contract number30069804
Policy instance 1
Insurance contract or identification number30069804
Number of Individuals Covered1810
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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 $256,577
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FLAGSHIP HEALTH SYSTEMS (National Association of Insurance Commissioners NAIC id number: 11179 )
Policy contract number9564-9001
Policy instance 2
Insurance contract or identification number9564-9001
Number of Individuals Covered397
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
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: 39616 )
Policy contract number30069804
Policy instance 1
Insurance contract or identification number30069804
Number of Individuals Covered1837
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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 $258,755
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FLAGSHIP HEALTH SYSTEMS (National Association of Insurance Commissioners NAIC id number: 11179 )
Policy contract number9564
Policy instance 2
Insurance contract or identification number9564
Number of Individuals Covered929
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
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: 39616 )
Policy contract number30069804
Policy instance 1
Insurance contract or identification number30069804
Number of Individuals Covered1779
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
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 $255,535
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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