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MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE 401k Plan overview

Plan NameMEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE
Plan identification number 504

MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

MEMORIAL COMMUNITY HEALTH, INC. has sponsored the creation of one or more 401k plans.

Company Name:MEMORIAL COMMUNITY HEALTH, INC.
Employer identification number (EIN):470461859
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042022-01-01
5042021-01-01
5042020-01-01
5042019-09-01
5042018-09-01
5042017-09-01
5042016-09-01LAURA TEICHMEIER LAURA TEICHMEIER2018-06-11
5042015-09-01LAURA TEICHMEIER LAURA TEICHMEIER2017-06-07
5042014-09-01LAURA TEICHMEIER LAURA TEICHMEIER2016-05-16
5042013-09-01LAURIE ANDREWS LAURIE ANDREWS2015-06-11
5042012-09-01LAURIE ANDREWS LAURIE ANDREWS2014-06-02
5042011-09-01LAURIE ANDREWS LAURIE ANDREWS2013-06-10
5042009-10-01LAURIE ANDREWS

Plan Statistics for MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE

401k plan membership statisitcs for MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE

Measure Date Value
2022: MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE 2022 401k membership
Total participants, beginning-of-year2022-01-01155
Total number of active participants reported on line 7a of the Form 55002022-01-01149
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01149
Total participants2022-01-01149
2021: MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE 2021 401k membership
Total participants, beginning-of-year2021-01-01152
Total number of active participants reported on line 7a of the Form 55002021-01-01155
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01155
Total participants2021-01-01155
2020: MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE 2020 401k membership
Total participants, beginning-of-year2020-01-01162
Total number of active participants reported on line 7a of the Form 55002020-01-01152
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01152
Total participants2020-01-01152
2019: MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE 2019 401k membership
Total participants, beginning-of-year2019-09-01162
Total number of active participants reported on line 7a of the Form 55002019-09-01162
Number of retired or separated participants receiving benefits2019-09-010
Number of other retired or separated participants entitled to future benefits2019-09-010
Total of all active and inactive participants2019-09-01162
Total participants2019-09-01162
2018: MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE 2018 401k membership
Total participants, beginning-of-year2018-09-01155
Total number of active participants reported on line 7a of the Form 55002018-09-01162
Number of retired or separated participants receiving benefits2018-09-010
Number of other retired or separated participants entitled to future benefits2018-09-010
Total of all active and inactive participants2018-09-01162
Total participants2018-09-01162
2017: MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE 2017 401k membership
Total participants, beginning-of-year2017-09-01148
Total number of active participants reported on line 7a of the Form 55002017-09-01155
Number of retired or separated participants receiving benefits2017-09-010
Number of other retired or separated participants entitled to future benefits2017-09-010
Total of all active and inactive participants2017-09-01155
Total participants2017-09-01155
2016: MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE 2016 401k membership
Total participants, beginning-of-year2016-09-01142
Total number of active participants reported on line 7a of the Form 55002016-09-01148
Number of retired or separated participants receiving benefits2016-09-010
Number of other retired or separated participants entitled to future benefits2016-09-010
Total of all active and inactive participants2016-09-01148
Total participants2016-09-01148
2015: MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE 2015 401k membership
Total participants, beginning-of-year2015-09-01125
Total number of active participants reported on line 7a of the Form 55002015-09-01142
Number of retired or separated participants receiving benefits2015-09-010
Number of other retired or separated participants entitled to future benefits2015-09-010
Total of all active and inactive participants2015-09-01142
Total participants2015-09-01142
2014: MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE 2014 401k membership
Total participants, beginning-of-year2014-09-01115
Total number of active participants reported on line 7a of the Form 55002014-09-01125
Number of retired or separated participants receiving benefits2014-09-010
Number of other retired or separated participants entitled to future benefits2014-09-010
Total of all active and inactive participants2014-09-01125
Total participants2014-09-01125
2013: MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE 2013 401k membership
Total participants, beginning-of-year2013-09-01123
Total number of active participants reported on line 7a of the Form 55002013-09-01115
Number of retired or separated participants receiving benefits2013-09-010
Number of other retired or separated participants entitled to future benefits2013-09-010
Total of all active and inactive participants2013-09-01115
Total participants2013-09-01115
2012: MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE 2012 401k membership
Total participants, beginning-of-year2012-09-01132
Total number of active participants reported on line 7a of the Form 55002012-09-01123
Total of all active and inactive participants2012-09-01123
Total participants2012-09-01123
2011: MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE 2011 401k membership
Total participants, beginning-of-year2011-09-01125
Total number of active participants reported on line 7a of the Form 55002011-09-01132
Total of all active and inactive participants2011-09-01132
Total participants2011-09-01132
2009: MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE 2009 401k membership
Total participants, beginning-of-year2009-10-01115
Total number of active participants reported on line 7a of the Form 55002009-10-01123
Total of all active and inactive participants2009-10-01123
Total participants2009-10-01123

Form 5500 Responses for MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE

2022: MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE 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: MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE 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: MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE 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: MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE 2019 form 5500 responses
2019-09-01Type of plan entitySingle employer plan
2019-09-01This return/report is a short plan year return/report (less than 12 months)Yes
2019-09-01Plan funding arrangement – InsuranceYes
2019-09-01Plan funding arrangement – General assets of the sponsorYes
2019-09-01Plan benefit arrangement – InsuranceYes
2019-09-01Plan benefit arrangement – General assets of the sponsorYes
2018: MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE 2018 form 5500 responses
2018-09-01Type of plan entitySingle employer plan
2018-09-01Plan funding arrangement – InsuranceYes
2018-09-01Plan funding arrangement – General assets of the sponsorYes
2018-09-01Plan benefit arrangement – InsuranceYes
2018-09-01Plan benefit arrangement – General assets of the sponsorYes
2017: MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE 2017 form 5500 responses
2017-09-01Type of plan entitySingle employer plan
2017-09-01Plan funding arrangement – InsuranceYes
2017-09-01Plan funding arrangement – General assets of the sponsorYes
2017-09-01Plan benefit arrangement – InsuranceYes
2017-09-01Plan benefit arrangement – General assets of the sponsorYes
2016: MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE 2016 form 5500 responses
2016-09-01Type of plan entitySingle employer plan
2016-09-01Plan funding arrangement – InsuranceYes
2016-09-01Plan funding arrangement – General assets of the sponsorYes
2016-09-01Plan benefit arrangement – InsuranceYes
2016-09-01Plan benefit arrangement – General assets of the sponsorYes
2015: MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE 2015 form 5500 responses
2015-09-01Type of plan entitySingle employer plan
2015-09-01Plan funding arrangement – InsuranceYes
2015-09-01Plan funding arrangement – General assets of the sponsorYes
2015-09-01Plan benefit arrangement – InsuranceYes
2015-09-01Plan benefit arrangement – General assets of the sponsorYes
2014: MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE 2014 form 5500 responses
2014-09-01Type of plan entitySingle employer plan
2014-09-01Plan funding arrangement – InsuranceYes
2014-09-01Plan funding arrangement – General assets of the sponsorYes
2014-09-01Plan benefit arrangement – InsuranceYes
2014-09-01Plan benefit arrangement – General assets of the sponsorYes
2013: MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE 2013 form 5500 responses
2013-09-01Type of plan entitySingle employer plan
2013-09-01Plan funding arrangement – InsuranceYes
2013-09-01Plan funding arrangement – General assets of the sponsorYes
2013-09-01Plan benefit arrangement – InsuranceYes
2013-09-01Plan benefit arrangement – General assets of the sponsorYes
2012: MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE 2012 form 5500 responses
2012-09-01Type of plan entitySingle employer plan
2012-09-01Submission has been amendedNo
2012-09-01This submission is the final filingNo
2012-09-01This return/report is a short plan year return/report (less than 12 months)No
2012-09-01Plan is a collectively bargained planNo
2012-09-01Plan funding arrangement – InsuranceYes
2012-09-01Plan funding arrangement – General assets of the sponsorYes
2012-09-01Plan benefit arrangement – InsuranceYes
2012-09-01Plan benefit arrangement – General assets of the sponsorYes
2011: MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE 2011 form 5500 responses
2011-09-01Type of plan entitySingle employer plan
2011-09-01Submission has been amendedNo
2011-09-01This submission is the final filingNo
2011-09-01This return/report is a short plan year return/report (less than 12 months)No
2011-09-01Plan is a collectively bargained planNo
2011-09-01Plan funding arrangement – InsuranceYes
2011-09-01Plan funding arrangement – General assets of the sponsorYes
2011-09-01Plan benefit arrangement – InsuranceYes
2011-09-01Plan benefit arrangement – General assets of the sponsorYes
2009: MEMORIAL COMMUNITY HEALTH INC EMPLOYEE HEALTH CARE 2009 form 5500 responses
2009-10-01Type of plan entitySingle employer plan
2009-10-01Submission has been amendedNo
2009-10-01This submission is the final filingNo
2009-10-01This return/report is a short plan year return/report (less than 12 months)Yes
2009-10-01Plan is a collectively bargained planNo
2009-10-01Plan funding arrangement – InsuranceYes
2009-10-01Plan funding arrangement – General assets of the sponsorYes
2009-10-01Plan benefit arrangement – InsuranceYes
2009-10-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF NEBRASKA (National Association of Insurance Commissioners NAIC id number: 77780 )
Policy contract number305351
Policy instance 2
Insurance contract or identification number305351
Number of Individuals Covered285
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $18,060
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $389,400
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,060
Additional information about fees paid to insurance brokerBROKER
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0242264
Policy instance 1
Insurance contract or identification number0242264
Number of Individuals Covered102
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $8,431
Total amount of fees paid to insurance companyUSD $3,774
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $54,141
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,323
Amount paid for insurance broker fees89
Additional information about fees paid to insurance brokerBROKER
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF NEBRASKA (National Association of Insurance Commissioners NAIC id number: 77780 )
Policy contract number305351
Policy instance 2
Insurance contract or identification number305351
Number of Individuals Covered300
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $18,260
Health 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 $18,260
Additional information about fees paid to insurance brokerBROKER
Insurance broker organization code?3
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number4060930010
Policy instance 1
Insurance contract or identification number4060930010
Number of Individuals Covered155
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $409,485
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerAGGREGATE COVERAGE
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF NEBRASKA (National Association of Insurance Commissioners NAIC id number: 77780 )
Policy contract number305351
Policy instance 2
Insurance contract or identification number305351
Number of Individuals Covered301
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $18,763
Health 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 $18,763
Additional information about fees paid to insurance brokerBROKER
Insurance broker organization code?3
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number4060930010
Policy instance 1
Insurance contract or identification number4060930010
Number of Individuals Covered150
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $384,717
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerAGGREGATE COVERAGE
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF NEBRASKA (National Association of Insurance Commissioners NAIC id number: 77780 )
Policy contract number305351
Policy instance 2
Insurance contract or identification number305351
Number of Individuals Covered315
Insurance policy start date2019-09-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $6,307
Health 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 $6,307
Additional information about fees paid to insurance brokerBROKER
Insurance broker organization code?3
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number4060930010
Policy instance 1
Insurance contract or identification number4060930010
Number of Individuals Covered162
Insurance policy start date2019-09-01
Insurance policy end date2019-12-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $133,065
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerAGGREGATE COVERAGE
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF NEBRASKA (National Association of Insurance Commissioners NAIC id number: 77780 )
Policy contract number305351
Policy instance 2
Insurance contract or identification number305351
Number of Individuals Covered321
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $15,000
Health 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 $15,000
Additional information about fees paid to insurance brokerBROKER
Insurance broker organization code?3
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number4060930010
Policy instance 1
Insurance contract or identification number4060930010
Number of Individuals Covered162
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $368,715
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Additional information about fees paid to insurance brokerAGGREGATE COVERAGE
Insurance broker organization code?3
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number4060930010
Policy instance 1
Insurance contract or identification number4060930010
Number of Individuals Covered155
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $322,218
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF NEBRASKA (National Association of Insurance Commissioners NAIC id number: 77780 )
Policy contract number305351
Policy instance 2
Insurance contract or identification number305351
Number of Individuals Covered304
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $15,000
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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