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UPSON REGIONAL MEDICAL CENTER FLEXIBLE BENEFITS PLAN 401k Plan overview

Plan NameUPSON REGIONAL MEDICAL CENTER FLEXIBLE BENEFITS PLAN
Plan identification number 503

UPSON REGIONAL MEDICAL CENTER FLEXIBLE BENEFITS PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Temporary disability (accident and sickness)
  • Other welfare benefit cover

401k Sponsoring company profile

UPSON COUNTY HOSPITAL, INC. DBA UPSON REGIONAL MEDICAL CENTER has sponsored the creation of one or more 401k plans.

Company Name:UPSON COUNTY HOSPITAL, INC. DBA UPSON REGIONAL MEDICAL CENTER
Employer identification number (EIN):581734026
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UPSON REGIONAL MEDICAL CENTER FLEXIBLE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032022-01-01LAURA STOKES2023-10-11 LAURA STOKES2023-10-11
5032021-01-01LAURA STOKES2022-10-12 LAURA STOKES2022-10-12
5032020-01-01LAURA STOKES2021-10-13 LAURA STOKES2021-10-13
5032019-01-01LAURA STOKES2020-10-12 LAURA STOKES2020-10-12
5032016-01-01
5032015-01-01
5032014-01-01RICH WILLIAMS
5032013-01-01RICH WILLIAMS
5032012-01-01RICH WILLIAMS
5032011-01-01RICH WILLIAMS
5032010-01-01RICH WILLIAMS
5032009-01-01RICH WILLIAMS

Plan Statistics for UPSON REGIONAL MEDICAL CENTER FLEXIBLE BENEFITS PLAN

401k plan membership statisitcs for UPSON REGIONAL MEDICAL CENTER FLEXIBLE BENEFITS PLAN

Measure Date Value
2022: UPSON REGIONAL MEDICAL CENTER FLEXIBLE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01218
Total number of active participants reported on line 7a of the Form 55002022-01-01218
Total of all active and inactive participants2022-01-01218
2021: UPSON REGIONAL MEDICAL CENTER FLEXIBLE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0127
Total number of active participants reported on line 7a of the Form 55002021-01-01218
Total of all active and inactive participants2021-01-01218
2020: UPSON REGIONAL MEDICAL CENTER FLEXIBLE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0127
Total number of active participants reported on line 7a of the Form 55002020-01-0127
Total of all active and inactive participants2020-01-0127
2019: UPSON REGIONAL MEDICAL CENTER FLEXIBLE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0127
Total number of active participants reported on line 7a of the Form 55002019-01-0127
Total of all active and inactive participants2019-01-0127
2016: UPSON REGIONAL MEDICAL CENTER FLEXIBLE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01298
Total number of active participants reported on line 7a of the Form 55002016-01-011
Total of all active and inactive participants2016-01-011
2015: UPSON REGIONAL MEDICAL CENTER FLEXIBLE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01322
Total number of active participants reported on line 7a of the Form 55002015-01-01298
Total of all active and inactive participants2015-01-01298
2014: UPSON REGIONAL MEDICAL CENTER FLEXIBLE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01373
Total number of active participants reported on line 7a of the Form 55002014-01-01322
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01322
2013: UPSON REGIONAL MEDICAL CENTER FLEXIBLE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01377
Total number of active participants reported on line 7a of the Form 55002013-01-01373
Total of all active and inactive participants2013-01-01373
2012: UPSON REGIONAL MEDICAL CENTER FLEXIBLE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01370
Total number of active participants reported on line 7a of the Form 55002012-01-01377
Total of all active and inactive participants2012-01-01377
2011: UPSON REGIONAL MEDICAL CENTER FLEXIBLE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01339
Total number of active participants reported on line 7a of the Form 55002011-01-01370
Total of all active and inactive participants2011-01-01370
2010: UPSON REGIONAL MEDICAL CENTER FLEXIBLE BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01368
Total number of active participants reported on line 7a of the Form 55002010-01-01339
Total of all active and inactive participants2010-01-01339
2009: UPSON REGIONAL MEDICAL CENTER FLEXIBLE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01353
Total number of active participants reported on line 7a of the Form 55002009-01-01368
Total of all active and inactive participants2009-01-01368

Form 5500 Responses for UPSON REGIONAL MEDICAL CENTER FLEXIBLE BENEFITS PLAN

2022: UPSON REGIONAL MEDICAL CENTER FLEXIBLE BENEFITS PLAN 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: UPSON REGIONAL MEDICAL CENTER FLEXIBLE BENEFITS PLAN 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: UPSON REGIONAL MEDICAL CENTER FLEXIBLE BENEFITS PLAN 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: UPSON REGIONAL MEDICAL CENTER FLEXIBLE BENEFITS PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: UPSON REGIONAL MEDICAL CENTER FLEXIBLE BENEFITS PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: UPSON REGIONAL MEDICAL CENTER FLEXIBLE BENEFITS PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: UPSON REGIONAL MEDICAL CENTER FLEXIBLE BENEFITS PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: UPSON REGIONAL MEDICAL CENTER FLEXIBLE BENEFITS PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: UPSON REGIONAL MEDICAL CENTER FLEXIBLE BENEFITS PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: UPSON REGIONAL MEDICAL CENTER FLEXIBLE BENEFITS PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: UPSON REGIONAL MEDICAL CENTER FLEXIBLE BENEFITS PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: UPSON REGIONAL MEDICAL CENTER FLEXIBLE BENEFITS PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number26270
Policy instance 1
Insurance contract or identification number26270
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Other welfare benefits providedCANCER, INTENSIVE CARE
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Insurance broker organization code?3
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number26270
Policy instance 1
Insurance contract or identification number26270
Number of Individuals Covered218
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $33,878
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Other welfare benefits providedCANCER, INTENSIVE CARE
Welfare Benefit Premiums Paid to CarrierUSD $117,395
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,766
Insurance broker organization code?3
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract number02282
Policy instance 1
Insurance contract or identification number02282
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Other welfare benefits providedCANCER, INTENSIVE CARE
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Insurance broker organization code?3
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract number02282
Policy instance 1
Insurance contract or identification number02282
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Other welfare benefits providedCANCER, INTENSIVE CARE
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3

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