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GRAHAM HOSPITAL ASSOCIATION LONG TERM DISABILITY PLAN 401k Plan overview

Plan NameGRAHAM HOSPITAL ASSOCIATION LONG TERM DISABILITY PLAN
Plan identification number 505

GRAHAM HOSPITAL ASSOCIATION LONG TERM DISABILITY PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Long-term disability cover

401k Sponsoring company profile

GRAHAM HOSPITAL ASSOCIATION has sponsored the creation of one or more 401k plans.

Company Name:GRAHAM HOSPITAL ASSOCIATION
Employer identification number (EIN):370673506
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GRAHAM HOSPITAL ASSOCIATION LONG TERM DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5052014-01-01JULIE REEDER JULIE REEDER2015-06-08
5052014-01-01KYLE COOK2021-12-06
5052013-01-01MELISSA WILSON MELISSA WILSON2014-06-24
5052012-01-01MELISSA WILSON MELISSA WILSON2013-04-24
5052011-01-01MELISSA WILSON
5052009-01-01 MELISSA WILSON2010-07-29
5052009-01-01 MELISSA WILSON2010-08-08
5052009-01-01MELISSA WILSON

Plan Statistics for GRAHAM HOSPITAL ASSOCIATION LONG TERM DISABILITY PLAN

401k plan membership statisitcs for GRAHAM HOSPITAL ASSOCIATION LONG TERM DISABILITY PLAN

Measure Date Value
2014: GRAHAM HOSPITAL ASSOCIATION LONG TERM DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01193
Total number of active participants reported on line 7a of the Form 55002014-01-01188
Total of all active and inactive participants2014-01-01188
Total participants2014-01-01188
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Number of employers contributing to the scheme2014-01-010
2013: GRAHAM HOSPITAL ASSOCIATION LONG TERM DISABILITY PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01179
Total number of active participants reported on line 7a of the Form 55002013-01-01193
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 participants2013-01-01193
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01193
2012: GRAHAM HOSPITAL ASSOCIATION LONG TERM DISABILITY PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01200
Total number of active participants reported on line 7a of the Form 55002012-01-01179
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 participants2012-01-01179
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01179
2011: GRAHAM HOSPITAL ASSOCIATION LONG TERM DISABILITY PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01205
Total number of active participants reported on line 7a of the Form 55002011-01-01200
Total of all active and inactive participants2011-01-01200
Total participants2011-01-01200
2009: GRAHAM HOSPITAL ASSOCIATION LONG TERM DISABILITY PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01158
Total number of active participants reported on line 7a of the Form 55002009-01-01205
Total of all active and inactive participants2009-01-01205
Total participants2009-01-01205

Form 5500 Responses for GRAHAM HOSPITAL ASSOCIATION LONG TERM DISABILITY PLAN

2014: GRAHAM HOSPITAL ASSOCIATION LONG TERM DISABILITY 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 – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: GRAHAM HOSPITAL ASSOCIATION LONG TERM DISABILITY 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 – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: GRAHAM HOSPITAL ASSOCIATION LONG TERM DISABILITY 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 – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: GRAHAM HOSPITAL ASSOCIATION LONG TERM DISABILITY 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 – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: GRAHAM HOSPITAL ASSOCIATION LONG TERM DISABILITY PLAN 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 benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000APEM
Policy instance 1
Insurance contract or identification numberG000APEM
Number of Individuals Covered193
Insurance policy start date2013-07-01
Insurance policy end date2014-07-01
Total amount of commissions paid to insurance brokerUSD $8,646
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $59,629
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,646
Additional information about fees paid to insurance brokerAGENT OR BROKER OF RECORD
Insurance broker organization code?3
Total amount of fees paid to insurance companyUSD $0
Amount paid for insurance broker fees0
Insurance broker nameINSURANCEPOINT LLC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010158592
Policy instance 1
Insurance contract or identification number000010158592
Number of Individuals Covered200
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $7,105
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $70,554
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,105
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameVHA MID AMERICA INS SVCS
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number473200-LTD
Policy instance 1
Insurance contract or identification number473200-LTD
Number of Individuals Covered208
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $6,397
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,976
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,397
Amount paid for insurance broker fees0
Insurance broker nameVHA MID-AMERICA INS SERVICES INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number473200-LTD
Policy instance 1
Insurance contract or identification number473200-LTD
Number of Individuals Covered205
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $6,531
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $66,081
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number473200
Policy instance 1
Insurance contract or identification number473200
Number of Individuals Covered205
Insurance policy start date2009-07-01
Insurance policy end date2010-06-30
Total amount of commissions paid to insurance brokerUSD $2,208
Total amount of fees paid to insurance companyUSD $955
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $57,359
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,208
Amount paid for insurance broker fees955
Additional information about fees paid to insurance brokerNEW BUSINESS
Insurance broker organization code?3
Insurance broker nameVHA MID AMERICAN INSURANCE SERVICES

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