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STONEWALL JACKSON MEMORIAL HOSPITAL WELFARE BENEFIT PLAN 401k Plan overview

Plan NameSTONEWALL JACKSON MEMORIAL HOSPITAL WELFARE BENEFIT PLAN
Plan identification number 503

STONEWALL JACKSON MEMORIAL HOSPITAL WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

STONEWALL JACKSON MEMORIAL HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name:STONEWALL JACKSON MEMORIAL HOSPITAL
Employer identification number (EIN):550422958
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan STONEWALL JACKSON MEMORIAL HOSPITAL WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032017-08-01
5032016-08-01RHONDA HAGER RHONDA HAGER2018-05-15
5032015-08-01RHONDA HAGER RHONDA HAGER2017-05-11
5032014-08-01RHONDA HAGER RHONDA HAGER2016-02-24
5032013-08-01RHONDA HAGER RHONDA HAGER2015-02-24
5032012-08-01RHONDA HAGER RHONDA HAGER2014-02-17
5032011-08-01RHONDA HAGER RHONDA HAGER2013-02-18
5032010-08-01RHONDA M. HAGER RHONDA M. HAGER2012-02-24
5032009-08-01RHONDA M. HAGER RHONDA M. HAGER2011-02-24
5032008-08-01RHONDA M. HAGER RHONDA M. HAGER2011-02-28

Plan Statistics for STONEWALL JACKSON MEMORIAL HOSPITAL WELFARE BENEFIT PLAN

401k plan membership statisitcs for STONEWALL JACKSON MEMORIAL HOSPITAL WELFARE BENEFIT PLAN

Measure Date Value
2017: STONEWALL JACKSON MEMORIAL HOSPITAL WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-08-01356
Total number of active participants reported on line 7a of the Form 55002017-08-010
Number of retired or separated participants receiving benefits2017-08-010
Total of all active and inactive participants2017-08-010
2016: STONEWALL JACKSON MEMORIAL HOSPITAL WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-08-01376
Total number of active participants reported on line 7a of the Form 55002016-08-01356
Number of retired or separated participants receiving benefits2016-08-011
Total of all active and inactive participants2016-08-01357
2015: STONEWALL JACKSON MEMORIAL HOSPITAL WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-08-01373
Total number of active participants reported on line 7a of the Form 55002015-08-01311
Number of other retired or separated participants entitled to future benefits2015-08-011
Total of all active and inactive participants2015-08-01312
2014: STONEWALL JACKSON MEMORIAL HOSPITAL WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-08-01358
Total number of active participants reported on line 7a of the Form 55002014-08-01372
Number of retired or separated participants receiving benefits2014-08-011
Total of all active and inactive participants2014-08-01373
2013: STONEWALL JACKSON MEMORIAL HOSPITAL WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-08-01343
Total number of active participants reported on line 7a of the Form 55002013-08-01315
Number of retired or separated participants receiving benefits2013-08-012
Total of all active and inactive participants2013-08-01317
2012: STONEWALL JACKSON MEMORIAL HOSPITAL WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-08-01334
Total number of active participants reported on line 7a of the Form 55002012-08-01343
Total of all active and inactive participants2012-08-01343
2011: STONEWALL JACKSON MEMORIAL HOSPITAL WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-08-01338
Total number of active participants reported on line 7a of the Form 55002011-08-01334
Number of retired or separated participants receiving benefits2011-08-010
Total of all active and inactive participants2011-08-01334
2010: STONEWALL JACKSON MEMORIAL HOSPITAL WELFARE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-08-01331
Total number of active participants reported on line 7a of the Form 55002010-08-01337
Number of retired or separated participants receiving benefits2010-08-011
Total of all active and inactive participants2010-08-01338
2009: STONEWALL JACKSON MEMORIAL HOSPITAL WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-08-01288
Total number of active participants reported on line 7a of the Form 55002009-08-01331
Total of all active and inactive participants2009-08-01331
2008: STONEWALL JACKSON MEMORIAL HOSPITAL WELFARE BENEFIT PLAN 2008 401k membership
Total participants, beginning-of-year2008-08-01284
Total number of active participants reported on line 7a of the Form 55002008-08-01288
Total of all active and inactive participants2008-08-01288

Form 5500 Responses for STONEWALL JACKSON MEMORIAL HOSPITAL WELFARE BENEFIT PLAN

2017: STONEWALL JACKSON MEMORIAL HOSPITAL WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-08-01Type of plan entitySingle employer plan
2017-08-01This submission is the final filingYes
2017-08-01Plan funding arrangement – InsuranceYes
2017-08-01Plan benefit arrangement – InsuranceYes
2016: STONEWALL JACKSON MEMORIAL HOSPITAL WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-08-01Type of plan entitySingle employer plan
2016-08-01Plan funding arrangement – InsuranceYes
2016-08-01Plan benefit arrangement – InsuranceYes
2015: STONEWALL JACKSON MEMORIAL HOSPITAL WELFARE BENEFIT PLAN 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: STONEWALL JACKSON MEMORIAL HOSPITAL WELFARE BENEFIT PLAN 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: STONEWALL JACKSON MEMORIAL HOSPITAL WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-08-01Type of plan entitySingle employer plan
2013-08-01Plan funding arrangement – InsuranceYes
2013-08-01Plan benefit arrangement – InsuranceYes
2012: STONEWALL JACKSON MEMORIAL HOSPITAL WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-08-01Type of plan entitySingle employer plan
2012-08-01Plan funding arrangement – InsuranceYes
2012-08-01Plan benefit arrangement – InsuranceYes
2011: STONEWALL JACKSON MEMORIAL HOSPITAL WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-08-01Type of plan entitySingle employer plan
2011-08-01Plan funding arrangement – InsuranceYes
2011-08-01Plan benefit arrangement – InsuranceYes
2010: STONEWALL JACKSON MEMORIAL HOSPITAL WELFARE BENEFIT PLAN 2010 form 5500 responses
2010-08-01Type of plan entitySingle employer plan
2010-08-01Plan funding arrangement – InsuranceYes
2010-08-01Plan benefit arrangement – InsuranceYes
2009: STONEWALL JACKSON MEMORIAL HOSPITAL WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-08-01Type of plan entitySingle employer plan
2009-08-01This submission is the final filingNo
2009-08-01Plan funding arrangement – InsuranceYes
2009-08-01Plan benefit arrangement – InsuranceYes
2008: STONEWALL JACKSON MEMORIAL HOSPITAL WELFARE BENEFIT PLAN 2008 form 5500 responses
2008-08-01Type of plan entitySingle employer plan
2008-08-01Submission has been amendedYes
2008-08-01This submission is the final filingNo
2008-08-01Plan funding arrangement – InsuranceYes
2008-08-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30027714
Policy instance 2
Insurance contract or identification number30027714
Number of Individuals Covered229
Insurance policy start date2013-09-01
Insurance policy end date2014-08-13
Total amount of commissions paid to insurance brokerUSD $1,558
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,552
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,336
Insurance broker organization code?3
Insurance broker nameUSI INSURANCE SERVICES LLC
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0005871684
Policy instance 4
Insurance contract or identification number0005871684
Number of Individuals Covered158
Insurance policy start date2013-09-01
Insurance policy end date2014-09-01
Total amount of commissions paid to insurance brokerUSD $18,748
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedSHORT TERM DISABILITY
Welfare Benefit Premiums Paid to CarrierUSD $36,856
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,399
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERVICES
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number434715
Policy instance 1
Insurance contract or identification number434715
Number of Individuals Covered348
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $20,004
Total amount of fees paid to insurance companyUSD $12,155
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $363,964
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,215
Insurance broker organization code?3
Amount paid for insurance broker fees12155
Insurance broker nameWELLS FARGO INSURANCE SERVICES
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0437301
Policy instance 3
Insurance contract or identification numberR0437301
Number of Individuals Covered225
Insurance policy start date2013-09-01
Insurance policy end date2014-09-01
Total amount of commissions paid to insurance brokerUSD $30,446
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedGROUP ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $64,979
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,098
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERVICES OF W
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number434715
Policy instance 1
Insurance contract or identification number434715
Number of Individuals Covered360
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $17,565
Total amount of fees paid to insurance companyUSD $9,848
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $334,669
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,221
Amount paid for insurance broker fees9848
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERVICES
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30027714
Policy instance 2
Insurance contract or identification number30027714
Number of Individuals Covered245
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Total amount of commissions paid to insurance brokerUSD $1,213
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,514
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,213
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERVICES OF W
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number434715
Policy instance 1
Insurance contract or identification number434715
Number of Individuals Covered360
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $17,565
Total amount of fees paid to insurance companyUSD $9,848
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $334,669
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,221
Amount paid for insurance broker fees9848
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERVICES
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30027714
Policy instance 2
Insurance contract or identification number30027714
Number of Individuals Covered245
Insurance policy start date2012-10-01
Insurance policy end date2013-09-30
Total amount of commissions paid to insurance brokerUSD $1,213
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,514
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,213
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERVICES OF W
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number434715
Policy instance 1
Insurance contract or identification number434715
Number of Individuals Covered352
Insurance policy start date2011-02-01
Insurance policy end date2012-01-31
Total amount of commissions paid to insurance brokerUSD $17,233
Total amount of fees paid to insurance companyUSD $11,952
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $311,488
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number37591
Policy instance 1
Insurance contract or identification number37591
Number of Individuals Covered337
Insurance policy start date2010-02-01
Insurance policy end date2011-01-31
Total amount of commissions paid to insurance brokerUSD $20,078
Total amount of fees paid to insurance companyUSD $6,850
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $308,538
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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