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SULLIVAN COUNTY COMMUNITY HOSPITAL WELFARE BENEFIT 401k Plan overview

Plan NameSULLIVAN COUNTY COMMUNITY HOSPITAL WELFARE BENEFIT
Plan identification number 501

SULLIVAN COUNTY COMMUNITY HOSPITAL WELFARE BENEFIT Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover

401k Sponsoring company profile

SULLIVAN COUNTY COMMUNITY HOSPITAL WELFARE BENEFIT PLAN has sponsored the creation of one or more 401k plans.

Company Name:SULLIVAN COUNTY COMMUNITY HOSPITAL WELFARE BENEFIT PLAN
Employer identification number (EIN):351164250
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SULLIVAN COUNTY COMMUNITY HOSPITAL WELFARE BENEFIT

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012024-01-01MICHELLE FRANKLIN
5012023-01-01
5012023-01-01MICHELLE FRANKLIN
5012022-01-01
5012022-01-01MICHELLE FRANKLIN
5012021-01-01
5012021-01-01MICHELLE FRANKLIN
5012020-01-01
5012019-01-01
5012018-01-01MICHELLE FRANKLIN
5012017-01-01MICHELLE FRANKLIN
5012016-01-01MICHELLE FRANKLIN
5012015-01-01MICHELLE FRANKLIN
5012014-01-01MICHELLE FRANKLIN
5012013-01-01ALAN MONTELLA
5012012-01-01ALAN MONTELLA
5012011-01-01ALAN MONTELLA
5012010-01-01ALAN MONTELLA
5012009-01-01ALAN MONTELLA

Form 5500 Responses for SULLIVAN COUNTY COMMUNITY HOSPITAL WELFARE BENEFIT

2023: SULLIVAN COUNTY COMMUNITY HOSPITAL WELFARE BENEFIT 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: SULLIVAN COUNTY COMMUNITY HOSPITAL WELFARE BENEFIT 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: SULLIVAN COUNTY COMMUNITY HOSPITAL WELFARE BENEFIT 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: SULLIVAN COUNTY COMMUNITY HOSPITAL WELFARE BENEFIT 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: SULLIVAN COUNTY COMMUNITY HOSPITAL WELFARE BENEFIT 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
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: SULLIVAN COUNTY COMMUNITY HOSPITAL WELFARE BENEFIT 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: SULLIVAN COUNTY COMMUNITY HOSPITAL WELFARE BENEFIT 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: SULLIVAN COUNTY COMMUNITY HOSPITAL WELFARE BENEFIT 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: SULLIVAN COUNTY COMMUNITY HOSPITAL WELFARE BENEFIT 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: SULLIVAN COUNTY COMMUNITY HOSPITAL WELFARE BENEFIT 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: SULLIVAN COUNTY COMMUNITY HOSPITAL WELFARE BENEFIT 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: SULLIVAN COUNTY COMMUNITY HOSPITAL WELFARE BENEFIT 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: SULLIVAN COUNTY COMMUNITY HOSPITAL WELFARE BENEFIT 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 – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: SULLIVAN COUNTY COMMUNITY HOSPITAL WELFARE BENEFIT 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: SULLIVAN COUNTY COMMUNITY HOSPITAL WELFARE BENEFIT 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract number00228492
Policy instance 3
Insurance contract or identification number00228492
Number of Individuals Covered426
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $4,026
Total amount of fees paid to insurance companyUSD $283
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )
Policy contract number80621301SCCC
Policy instance 2
Insurance contract or identification number80621301SCCC
Number of Individuals Covered481
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $6,045
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number417004411058
Policy instance 1
Insurance contract or identification number417004411058
Insurance policy start date2022-10-01
Insurance policy end date2023-10-01
Total amount of commissions paid to insurance brokerUSD $146,044
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG 00604736 0002
Policy instance 4
Insurance contract or identification numberG 00604736 0002
Number of Individuals Covered297
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $12,256
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG 00604736-0001
Policy instance 4
Insurance contract or identification numberG 00604736-0001
Number of Individuals Covered293
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $8,588
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )
Policy contract number80621301SCCC
Policy instance 2
Insurance contract or identification number80621301SCCC
Number of Individuals Covered1
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract number00228492
Policy instance 3
Insurance contract or identification number00228492
Number of Individuals Covered299
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $3,724
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG 00604736 0002
Policy instance 5
Insurance contract or identification numberG 00604736 0002
Number of Individuals Covered301
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $7,255
Long Term Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number417006411058
Policy instance 6
Insurance contract or identification number417006411058
Insurance policy start date2021-11-01
Insurance policy end date2022-11-01
Total amount of commissions paid to insurance brokerUSD $127,777
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )
Policy contract number806215891510
Policy instance 7
Insurance contract or identification number806215891510
Number of Individuals Covered435
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $5,213
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number417004411058
Policy instance 1
Insurance contract or identification number417004411058
Number of Individuals Covered83
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number417004411058
Policy instance 1
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG 00604736-0001
Policy instance 4
HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )
Policy contract number806215891510
Policy instance 2
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract number00228492
Policy instance 3
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG 00604736 0002
Policy instance 5
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract number00228492
Policy instance 4
HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )
Policy contract number806215891510
Policy instance 3
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG 00604736
Policy instance 2
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number417004411058
Policy instance 1
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number417004411058
Policy instance 1
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG 00604736
Policy instance 2
HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )
Policy contract number806215891510
Policy instance 3
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract number00228492
Policy instance 4
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG 00604736-002
Policy instance 5
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract number00228492
Policy instance 4
HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )
Policy contract number806215891510
Policy instance 3
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG 00604736 0001
Policy instance 2
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number417004411058
Policy instance 1
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract number00228492
Policy instance 4
HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )
Policy contract number806215891510
Policy instance 3
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG 00604736
Policy instance 2
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number417004411058
Policy instance 1
HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )
Policy contract number806215891510
Policy instance 3
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract number00228492
Policy instance 4
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number417004411058
Policy instance 1
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG 00604736
Policy instance 2
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract number00228492
Policy instance 4
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number417004411058
Policy instance 1
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG 00604736
Policy instance 2
HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )
Policy contract number806215891510
Policy instance 3
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number417004411058
Policy instance 1
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG 00604736
Policy instance 2
HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )
Policy contract number806215891510
Policy instance 3
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract number00228492
Policy instance 4
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG 00604736-0001
Policy instance 5
HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96887 )
Policy contract number806215891510
Policy instance 2
ANTHEM INSURANCE COMPANIES, INC (National Association of Insurance Commissioners NAIC id number: 28207 )
Policy contract number00228492
Policy instance 1
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG 00604736
Policy instance 3
AUL (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract number417003411058
Policy instance 6
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG 00604736-0002
Policy instance 4
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG006047360002
Policy instance 2
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG00604736
Policy instance 1
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract number5010-9001-818
Policy instance 2
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG00604736
Policy instance 1

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