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SHORT TERM DISABILITY INS. FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC 401k Plan overview

Plan NameSHORT TERM DISABILITY INS. FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC
Plan identification number 511

SHORT TERM DISABILITY INS. FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Temporary disability (accident and sickness)

401k Sponsoring company profile

FLAMBEAU HOSPITAL INC has sponsored the creation of one or more 401k plans.

Company Name:FLAMBEAU HOSPITAL INC
Employer identification number (EIN):390973724
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SHORT TERM DISABILITY INS. FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5112016-08-01
5112015-08-01
5112014-08-01
5112013-08-01
5112012-08-01PAUL RYBAK
5112011-08-01PAUL RYBAK
5112009-08-01BARBARA J MICHALSKI

Plan Statistics for SHORT TERM DISABILITY INS. FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC

401k plan membership statisitcs for SHORT TERM DISABILITY INS. FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC

Measure Date Value
2016: SHORT TERM DISABILITY INS. FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC 2016 401k membership
Total participants, beginning-of-year2016-08-01143
Total number of active participants reported on line 7a of the Form 55002016-08-010
Total of all active and inactive participants2016-08-010
Total participants2016-08-010
2015: SHORT TERM DISABILITY INS. FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC 2015 401k membership
Total participants, beginning-of-year2015-08-01128
Total number of active participants reported on line 7a of the Form 55002015-08-01143
Total of all active and inactive participants2015-08-01143
Total participants2015-08-01143
2014: SHORT TERM DISABILITY INS. FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC 2014 401k membership
Total participants, beginning-of-year2014-08-01128
Total number of active participants reported on line 7a of the Form 55002014-08-01128
Total of all active and inactive participants2014-08-01128
Total participants2014-08-01128
2013: SHORT TERM DISABILITY INS. FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC 2013 401k membership
Total participants, beginning-of-year2013-08-01124
Total number of active participants reported on line 7a of the Form 55002013-08-01128
Total of all active and inactive participants2013-08-01128
Total participants2013-08-01128
2012: SHORT TERM DISABILITY INS. FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC 2012 401k membership
Total participants, beginning-of-year2012-08-01129
Total number of active participants reported on line 7a of the Form 55002012-08-01124
Total of all active and inactive participants2012-08-01124
Total participants2012-08-01124
2011: SHORT TERM DISABILITY INS. FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC 2011 401k membership
Total participants, beginning-of-year2011-08-01134
Total number of active participants reported on line 7a of the Form 55002011-08-01129
Total of all active and inactive participants2011-08-01129
Total participants2011-08-01129
2009: SHORT TERM DISABILITY INS. FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC 2009 401k membership
Total participants, beginning-of-year2009-08-01153
Total number of active participants reported on line 7a of the Form 55002009-08-01153
Total of all active and inactive participants2009-08-01153
Total participants2009-08-01153

Form 5500 Responses for SHORT TERM DISABILITY INS. FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC

2016: SHORT TERM DISABILITY INS. FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC 2016 form 5500 responses
2016-08-01Type of plan entitySingle employer plan
2016-08-01This submission is the final filingYes
2016-08-01This return/report is a short plan year return/report (less than 12 months)Yes
2016-08-01Plan funding arrangement – InsuranceYes
2016-08-01Plan benefit arrangement – InsuranceYes
2015: SHORT TERM DISABILITY INS. FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC 2015 form 5500 responses
2015-08-01Type of plan entitySingle employer plan
2015-08-01Plan funding arrangement – InsuranceYes
2015-08-01Plan benefit arrangement – InsuranceYes
2014: SHORT TERM DISABILITY INS. FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC 2014 form 5500 responses
2014-08-01Type of plan entitySingle employer plan
2014-08-01Plan funding arrangement – InsuranceYes
2014-08-01Plan benefit arrangement – InsuranceYes
2013: SHORT TERM DISABILITY INS. FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC 2013 form 5500 responses
2013-08-01Type of plan entitySingle employer plan
2013-08-01Plan funding arrangement – InsuranceYes
2013-08-01Plan funding arrangement – General assets of the sponsorYes
2013-08-01Plan benefit arrangement – InsuranceYes
2013-08-01Plan benefit arrangement – General assets of the sponsorYes
2012: SHORT TERM DISABILITY INS. FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC 2012 form 5500 responses
2012-08-01Type of plan entitySingle employer plan
2012-08-01Plan funding arrangement – InsuranceYes
2012-08-01Plan funding arrangement – General assets of the sponsorYes
2012-08-01Plan benefit arrangement – InsuranceYes
2012-08-01Plan benefit arrangement – General assets of the sponsorYes
2011: SHORT TERM DISABILITY INS. FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC 2011 form 5500 responses
2011-08-01Type of plan entitySingle employer plan
2011-08-01Plan funding arrangement – InsuranceYes
2011-08-01Plan funding arrangement – General assets of the sponsorYes
2011-08-01Plan benefit arrangement – InsuranceYes
2011-08-01Plan benefit arrangement – General assets of the sponsorYes
2009: SHORT TERM DISABILITY INS. FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC 2009 form 5500 responses
2009-08-01Type of plan entityMulti-employer plan
2009-08-01Plan funding arrangement – InsuranceYes
2009-08-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number214554
Policy instance 1
Insurance contract or identification number214554
Number of Individuals Covered143
Insurance policy start date2015-08-01
Insurance policy end date2016-07-31
Total amount of commissions paid to insurance brokerUSD $12,017
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $80,115
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,017
Insurance broker organization code?3
Insurance broker nameISG ADVISORS LLC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number214554
Policy instance 1
Insurance contract or identification number214554
Number of Individuals Covered128
Insurance policy start date2014-08-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $8,946
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $59,641
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,946
Insurance broker organization code?4
Insurance broker nameISG ADVISORS LLC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number214554
Policy instance 1
Insurance contract or identification number214554
Number of Individuals Covered128
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
Total amount of commissions paid to insurance brokerUSD $7,743
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $51,617
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,743
Insurance broker organization code?3
Insurance broker nameISG ADVISORS LLC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number214554
Policy instance 1
Insurance contract or identification number214554
Number of Individuals Covered124
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Total amount of commissions paid to insurance brokerUSD $7,575
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $50,500
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,575
Insurance broker organization code?3
Insurance broker nameISG ADVISORS LLC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number214554
Policy instance 1
Insurance contract or identification number214554
Number of Individuals Covered129
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Total amount of commissions paid to insurance brokerUSD $7,775
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $51,836
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 number214554
Policy instance 1
Insurance contract or identification number214554
Number of Individuals Covered134
Insurance policy start date2011-01-01
Insurance policy end date2011-07-31
Total amount of commissions paid to insurance brokerUSD $4,691
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,271
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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