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THE BELLEVUE HOSPITAL EMPLOYEES' GROUP VISION INSURANCE PLAN 401k Plan overview

Plan NameTHE BELLEVUE HOSPITAL EMPLOYEES' GROUP VISION INSURANCE PLAN
Plan identification number 509

THE BELLEVUE HOSPITAL EMPLOYEES' GROUP VISION INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Vision

401k Sponsoring company profile

THE BELLEVUE HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name:THE BELLEVUE HOSPITAL
Employer identification number (EIN):344428205
NAIC Classification:622000
NAIC Description: Hospitals

Additional information about THE BELLEVUE HOSPITAL

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division
Incorporation Date: 1914-08-03
Company Identification Number: 34957
Legal Registered Office Address: 1400 W. MAIN ST.
-
BELLEVUE
United States of America (USA)
44811

More information about THE BELLEVUE HOSPITAL

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE BELLEVUE HOSPITAL EMPLOYEES' GROUP VISION INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5092017-05-01
5092017-05-01LISA SARTAIN2019-05-01
5092016-05-01
5092015-05-01LISA SARTAIN
5092014-05-01LISA SARTAIN
5092013-05-01LISA SARTAIN
5092012-05-01LISA SARTAIN
5092011-05-01DEBORAH GANCI
5092009-05-01DEBORAH GANCI

Plan Statistics for THE BELLEVUE HOSPITAL EMPLOYEES' GROUP VISION INSURANCE PLAN

401k plan membership statisitcs for THE BELLEVUE HOSPITAL EMPLOYEES' GROUP VISION INSURANCE PLAN

Measure Date Value
2017: THE BELLEVUE HOSPITAL EMPLOYEES' GROUP VISION INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-05-01305
Total number of active participants reported on line 7a of the Form 55002017-05-01308
Number of retired or separated participants receiving benefits2017-05-010
Number of other retired or separated participants entitled to future benefits2017-05-010
Total of all active and inactive participants2017-05-01308
2016: THE BELLEVUE HOSPITAL EMPLOYEES' GROUP VISION INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-05-01297
Total number of active participants reported on line 7a of the Form 55002016-05-01305
Number of retired or separated participants receiving benefits2016-05-011
Number of other retired or separated participants entitled to future benefits2016-05-010
Total of all active and inactive participants2016-05-01306
2015: THE BELLEVUE HOSPITAL EMPLOYEES' GROUP VISION INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-05-01290
Total number of active participants reported on line 7a of the Form 55002015-05-01296
Number of retired or separated participants receiving benefits2015-05-011
Number of other retired or separated participants entitled to future benefits2015-05-010
Total of all active and inactive participants2015-05-01297
2014: THE BELLEVUE HOSPITAL EMPLOYEES' GROUP VISION INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-05-01293
Total number of active participants reported on line 7a of the Form 55002014-05-01292
Number of retired or separated participants receiving benefits2014-05-013
Number of other retired or separated participants entitled to future benefits2014-05-010
Total of all active and inactive participants2014-05-01295
2013: THE BELLEVUE HOSPITAL EMPLOYEES' GROUP VISION INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-05-01309
Total number of active participants reported on line 7a of the Form 55002013-05-01292
Number of retired or separated participants receiving benefits2013-05-012
Total of all active and inactive participants2013-05-01294
2012: THE BELLEVUE HOSPITAL EMPLOYEES' GROUP VISION INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-05-01313
Total number of active participants reported on line 7a of the Form 55002012-05-01306
Number of retired or separated participants receiving benefits2012-05-013
Total of all active and inactive participants2012-05-01309
2011: THE BELLEVUE HOSPITAL EMPLOYEES' GROUP VISION INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-05-01311
Total number of active participants reported on line 7a of the Form 55002011-05-01313
Total of all active and inactive participants2011-05-01313
2009: THE BELLEVUE HOSPITAL EMPLOYEES' GROUP VISION INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-05-01349
Total number of active participants reported on line 7a of the Form 55002009-05-01324
Total of all active and inactive participants2009-05-01324

Form 5500 Responses for THE BELLEVUE HOSPITAL EMPLOYEES' GROUP VISION INSURANCE PLAN

2017: THE BELLEVUE HOSPITAL EMPLOYEES' GROUP VISION INSURANCE PLAN 2017 form 5500 responses
2017-05-01Type of plan entitySingle employer plan
2017-05-01Submission has been amendedYes
2017-05-01This submission is the final filingYes
2017-05-01This return/report is a short plan year return/report (less than 12 months)Yes
2017-05-01Plan funding arrangement – InsuranceYes
2017-05-01Plan benefit arrangement – InsuranceYes
2016: THE BELLEVUE HOSPITAL EMPLOYEES' GROUP VISION INSURANCE PLAN 2016 form 5500 responses
2016-05-01Type of plan entitySingle employer plan
2016-05-01Plan funding arrangement – InsuranceYes
2016-05-01Plan benefit arrangement – InsuranceYes
2015: THE BELLEVUE HOSPITAL EMPLOYEES' GROUP VISION INSURANCE PLAN 2015 form 5500 responses
2015-05-01Type of plan entitySingle employer plan
2015-05-01Plan funding arrangement – InsuranceYes
2015-05-01Plan benefit arrangement – InsuranceYes
2014: THE BELLEVUE HOSPITAL EMPLOYEES' GROUP VISION INSURANCE PLAN 2014 form 5500 responses
2014-05-01Type of plan entitySingle employer plan
2014-05-01Plan funding arrangement – InsuranceYes
2014-05-01Plan benefit arrangement – InsuranceYes
2013: THE BELLEVUE HOSPITAL EMPLOYEES' GROUP VISION INSURANCE PLAN 2013 form 5500 responses
2013-05-01Type of plan entitySingle employer plan
2013-05-01Plan funding arrangement – InsuranceYes
2013-05-01Plan benefit arrangement – InsuranceYes
2012: THE BELLEVUE HOSPITAL EMPLOYEES' GROUP VISION INSURANCE PLAN 2012 form 5500 responses
2012-05-01Type of plan entitySingle employer plan
2012-05-01Plan funding arrangement – InsuranceYes
2012-05-01Plan benefit arrangement – InsuranceYes
2011: THE BELLEVUE HOSPITAL EMPLOYEES' GROUP VISION INSURANCE PLAN 2011 form 5500 responses
2011-05-01Type of plan entitySingle employer plan
2011-05-01Plan funding arrangement – InsuranceYes
2011-05-01Plan benefit arrangement – InsuranceYes
2009: THE BELLEVUE HOSPITAL EMPLOYEES' GROUP VISION INSURANCE PLAN 2009 form 5500 responses
2009-05-01Type of plan entitySingle employer plan
2009-05-01This submission is the final filingNo
2009-05-01Plan funding arrangement – InsuranceYes
2009-05-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number12237729
Policy instance 1
Insurance contract or identification number12237729
Number of Individuals Covered308
Insurance policy start date2017-05-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $2,200
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,659
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,200
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES INC
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number12237729
Policy instance 1
Insurance contract or identification number12237729
Number of Individuals Covered297
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
Total amount of commissions paid to insurance brokerUSD $3,362
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $56,030
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,362
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES INC
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number12237729
Policy instance 1
Insurance contract or identification number12237729
Number of Individuals Covered294
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $3,366
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $56,098
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,366
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES INC
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number12237729
Policy instance 1
Insurance contract or identification number12237729
Number of Individuals Covered294
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $3,783
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,052
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,549
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES INC
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number12237729
Policy instance 1
Insurance contract or identification number12237729
Number of Individuals Covered309
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $3,843
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $64,048
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,843
Insurance broker organization code?3
Insurance broker nameGARDNER & WHITE CORPORATION
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 )
Policy contract number12237729
Policy instance 1
Insurance contract or identification number12237729
Number of Individuals Covered313
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $3,910
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $65,168
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: 47029 )
Policy contract number12237729
Policy instance 1
Insurance contract or identification number12237729
Number of Individuals Covered311
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $3,826
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,760
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,826
Insurance broker organization code?3
Insurance broker nameGARDNER & WHITE

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