GEORGIA HIGHLANDS MEDICAL SERVICES DISABILITY PLANS 401k Plan overview
| Plan Name | GEORGIA HIGHLANDS MEDICAL SERVICES DISABILITY PLANS |
| Plan identification number | 504 |
GEORGIA HIGHLANDS MEDICAL SERVICES DISABILITY PLANS Benefits
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits | - Life insurance
- Temporary disability (accident and sickness)
- Long-term disability cover
- Death benefits (include travel accident but not life insurance)
|
401k Sponsoring company profile
GEORGIA HIGHLANDS MEDICAL SERVICES, INC has sponsored the creation of one or more 401k plans.
Additional information about GEORGIA HIGHLANDS MEDICAL SERVICES, INC
| Jurisdiction of Incorporation: | Georgia Department of States Corporations Division |
| Incorporation Date: | |
| Company Identification Number: | 576814 |
More information about GEORGIA HIGHLANDS MEDICAL SERVICES, INC
Form 5500 Filing Information
Submission information for form 5500 for 401k plan GEORGIA HIGHLANDS MEDICAL SERVICES DISABILITY PLANS
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|
| 504 | 2022-01-01 | TODD SHIFFLET | 2023-10-02 | | |
| 504 | 2021-01-01 | TODD SHIFFLET | 2023-10-02 | | |
Plan Statistics for GEORGIA HIGHLANDS MEDICAL SERVICES DISABILITY PLANS
401k plan membership statisitcs for GEORGIA HIGHLANDS MEDICAL SERVICES DISABILITY PLANS
| Measure | Date | Value |
|---|
| 2022: GEORGIA HIGHLANDS MEDICAL SERVICES DISABILITY PLANS 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 119 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 141 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 141 |
| Number of employers contributing to the scheme | 2022-01-01 | 0 |
| 2021: GEORGIA HIGHLANDS MEDICAL SERVICES DISABILITY PLANS 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 110 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 119 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
| Total of all active and inactive participants | 2021-01-01 | 119 |
| Number of employers contributing to the scheme | 2021-01-01 | 0 |
Form 5500 Responses for GEORGIA HIGHLANDS MEDICAL SERVICES DISABILITY PLANS
| 2022: GEORGIA HIGHLANDS MEDICAL SERVICES DISABILITY PLANS 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: GEORGIA HIGHLANDS MEDICAL SERVICES DISABILITY PLANS 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | First time form 5500 has been submitted | Yes |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
Insurance Providers Used on plan
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 920519 |
| Policy instance | 1 |
| Insurance contract or identification number | 920519 | | Number of Individuals Covered | 141 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $14,235 | | Total amount of fees paid to insurance company | USD $0 | | Life Insurance Welfare Benefit | Yes | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | | Welfare Benefit Premiums Paid to Carrier | USD $84,174 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $11,670 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
|
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) |
| Policy contract number | 920519 |
| Policy instance | 1 |
| Insurance contract or identification number | 920519 | | Number of Individuals Covered | 119 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $10,304 | | Total amount of fees paid to insurance company | USD $0 | | Temporary Disability Insurance Welfare Benefit | Yes | | Long Term Disability Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $61,832 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $10,304 | | Amount paid for insurance broker fees | 0 | | Insurance broker organization code? | 3 |
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