401k Plan data: JOINT TOWNSHIP DISTRICT MEMORIAL EMPLOYEE FRINGE BENEFIT PLAN plan

JOINT TOWNSHIP DISTRICT MEMORIAL EMPLOYEE FRINGE BENEFIT PLAN 401k Plan overview

Plan Name	JOINT TOWNSHIP DISTRICT MEMORIAL EMPLOYEE FRINGE BENEFIT PLAN
Plan identification number	504

JOINT TOWNSHIP DISTRICT MEMORIAL EMPLOYEE FRINGE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Temporary disability (accident and sickness) Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name: JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL

Employer identification number (EIN): 341623770

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JOINT TOWNSHIP DISTRICT MEMORIAL EMPLOYEE FRINGE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
504 2000-01-01 SHELLY RUPPERT 2020-10-13

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
504	2000-01-01	SHELLY RUPPERT	2020-10-13

Plan Statistics for JOINT TOWNSHIP DISTRICT MEMORIAL EMPLOYEE FRINGE BENEFIT PLAN

401k plan membership statisitcs for JOINT TOWNSHIP DISTRICT MEMORIAL EMPLOYEE FRINGE BENEFIT PLAN

Measure Date Value
2000: JOINT TOWNSHIP DISTRICT MEMORIAL EMPLOYEE FRINGE BENEFIT PLAN 2000 401k membership
Total participants, beginning-of-year 2000-01-01 352
Total number of active participants reported on line 7a of the Form 5500 2000-01-01 238
Number of retired or separated participants receiving benefits 2000-01-01 0
Number of other retired or separated participants entitled to future benefits 2000-01-01 0
Total of all active and inactive participants 2000-01-01 238
Number of employers contributing to the scheme 2000-01-01 0

Measure	Date	Value
2000: JOINT TOWNSHIP DISTRICT MEMORIAL EMPLOYEE FRINGE BENEFIT PLAN 2000 401k membership
Total participants, beginning-of-year	2000-01-01	352
Total number of active participants reported on line 7a of the Form 5500	2000-01-01	238
Number of retired or separated participants receiving benefits	2000-01-01	0
Number of other retired or separated participants entitled to future benefits	2000-01-01	0
Total of all active and inactive participants	2000-01-01	238
Number of employers contributing to the scheme	2000-01-01	0

Form 5500 Responses for JOINT TOWNSHIP DISTRICT MEMORIAL EMPLOYEE FRINGE BENEFIT PLAN

2000: JOINT TOWNSHIP DISTRICT MEMORIAL EMPLOYEE FRINGE BENEFIT PLAN 2000 form 5500 responses
2000-01-01	Type of plan entity	Single employer plan
2000-01-01	Submission has been amended	Yes
2000-01-01	Plan funding arrangement – Insurance	Yes
2000-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )

Policy contract number

7189772

Policy instance

Insurance contract or identification number	7189772
Number of Individuals Covered	1231
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $13,552
Total amount of fees paid to insurance company	USD $0
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $13,552
Amount paid for insurance broker fees	0
Insurance broker organization code?	4

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Company Name:	JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL
Employer identification number (EIN):	341623770
NAIC Classification:	622000
NAIC Description:	Hospitals