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PRAIRIE LAKES HEALTHCARE SYSEM LTD PLAN 401k Plan overview

Plan NamePRAIRIE LAKES HEALTHCARE SYSEM LTD PLAN
Plan identification number 551

PRAIRIE LAKES HEALTHCARE SYSEM LTD PLAN Benefits

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

401k Sponsoring company profile

PRAIRIE LAKES HEALTHCARE SYSTEM has sponsored the creation of one or more 401k plans.

Company Name:PRAIRIE LAKES HEALTHCARE SYSTEM
Employer identification number (EIN):460391067
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PRAIRIE LAKES HEALTHCARE SYSEM LTD PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5512017-01-01DAWN MILLER
5512016-01-01DAWN MILLER
5512016-01-01
5512015-01-01DAWN MILLER
5512014-01-01DAWN MILLER
5512013-01-01DAWN MILLER
5512012-01-01DAWN MILLER

Plan Statistics for PRAIRIE LAKES HEALTHCARE SYSEM LTD PLAN

401k plan membership statisitcs for PRAIRIE LAKES HEALTHCARE SYSEM LTD PLAN

Measure Date Value
2017: PRAIRIE LAKES HEALTHCARE SYSEM LTD PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0127
Total number of active participants reported on line 7a of the Form 55002017-01-0127
Total of all active and inactive participants2017-01-0127
Total participants2017-01-0127
2016: PRAIRIE LAKES HEALTHCARE SYSEM LTD PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0153
Total number of active participants reported on line 7a of the Form 55002016-01-0153
Total of all active and inactive participants2016-01-0153
Total participants2016-01-0153
2015: PRAIRIE LAKES HEALTHCARE SYSEM LTD PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0127
Total number of active participants reported on line 7a of the Form 55002015-01-0126
Total of all active and inactive participants2015-01-0126
Total participants2015-01-0126
2014: PRAIRIE LAKES HEALTHCARE SYSEM LTD PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0130
Total number of active participants reported on line 7a of the Form 55002014-01-0127
Total of all active and inactive participants2014-01-0127
Total participants2014-01-0127
2013: PRAIRIE LAKES HEALTHCARE SYSEM LTD PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0129
Total number of active participants reported on line 7a of the Form 55002013-01-0130
Total of all active and inactive participants2013-01-0130
Total participants2013-01-0130
2012: PRAIRIE LAKES HEALTHCARE SYSEM LTD PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-010
Total number of active participants reported on line 7a of the Form 55002012-01-0129
Total of all active and inactive participants2012-01-0129
Total participants2012-01-0129

Form 5500 Responses for PRAIRIE LAKES HEALTHCARE SYSEM LTD PLAN

2017: PRAIRIE LAKES HEALTHCARE SYSEM LTD PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01First time form 5500 has been submittedYes
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: PRAIRIE LAKES HEALTHCARE SYSEM LTD PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01First time form 5500 has been submittedYes
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: PRAIRIE LAKES HEALTHCARE SYSEM LTD PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: PRAIRIE LAKES HEALTHCARE SYSEM LTD 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: PRAIRIE LAKES HEALTHCARE SYSEM LTD PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01First time form 5500 has been submittedYes
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: PRAIRIE LAKES HEALTHCARE SYSEM LTD PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01First time form 5500 has been submittedYes
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

Insurance Providers Used on plan

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0322420
Policy instance 1
Insurance contract or identification numberR0322420
Number of Individuals Covered27
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $2,508
Are there contracts with allocated funds for individual policies?0
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,508
Insurance broker nameFRIEMARK AND ASSOCIATES
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number905308
Policy instance 1
Insurance contract or identification number905308
Number of Individuals Covered26
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $4,775
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,775
Insurance broker nameFREIMARK AND ASSOCIATES INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0322420
Policy instance 1
Insurance contract or identification numberR0322420
Number of Individuals Covered27
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $2,073
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,073
Insurance broker nameFREINMARK AND ASSOCIATES INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0322420
Policy instance 1
Insurance contract or identification numberR0322420
Number of Individuals Covered30
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,953
Are there contracts with allocated funds for individual policies?Yes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,953
Insurance broker nameFREIMARK & ASSOCIATES INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0322420
Policy instance 1
Insurance contract or identification numberR0322420
Number of Individuals Covered29
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,869
Are there contracts with allocated funds for individual policies?Yes
Long Term Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,869
Insurance broker nameFREIMARK AND ASSOCIATES INC

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