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FISHERMEN'S HOSPITAL FLEXIBLE SPENDING ACCOUNT PLAN 401k Plan overview

Plan NameFISHERMEN'S HOSPITAL FLEXIBLE SPENDING ACCOUNT PLAN
Plan identification number 501

FISHERMEN'S HOSPITAL FLEXIBLE SPENDING ACCOUNT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover

401k Sponsoring company profile

FISHERMEN'S HOSPITAL INC has sponsored the creation of one or more 401k plans.

Company Name:FISHERMEN'S HOSPITAL INC
Employer identification number (EIN):590914771
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FISHERMEN'S HOSPITAL FLEXIBLE SPENDING ACCOUNT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012016-07-01
5012015-07-01
5012014-07-01
5012013-07-01
5012012-07-01HAL W. LEFTWICH
5012011-07-01HAL W. LEFTWICH

Plan Statistics for FISHERMEN'S HOSPITAL FLEXIBLE SPENDING ACCOUNT PLAN

401k plan membership statisitcs for FISHERMEN'S HOSPITAL FLEXIBLE SPENDING ACCOUNT PLAN

Measure Date Value
2016: FISHERMEN'S HOSPITAL FLEXIBLE SPENDING ACCOUNT PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-01250
Total number of active participants reported on line 7a of the Form 55002016-07-010
Total of all active and inactive participants2016-07-010
2015: FISHERMEN'S HOSPITAL FLEXIBLE SPENDING ACCOUNT PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-01265
Total number of active participants reported on line 7a of the Form 55002015-07-01250
Total of all active and inactive participants2015-07-01250
2014: FISHERMEN'S HOSPITAL FLEXIBLE SPENDING ACCOUNT PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-01187
Total number of active participants reported on line 7a of the Form 55002014-07-01265
Total of all active and inactive participants2014-07-01265
2013: FISHERMEN'S HOSPITAL FLEXIBLE SPENDING ACCOUNT PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-01188
Total number of active participants reported on line 7a of the Form 55002013-07-01187
Total of all active and inactive participants2013-07-01187
2012: FISHERMEN'S HOSPITAL FLEXIBLE SPENDING ACCOUNT PLAN 2012 401k membership
Total participants, beginning-of-year2012-07-01124
Total number of active participants reported on line 7a of the Form 55002012-07-01188
Total of all active and inactive participants2012-07-01188
2011: FISHERMEN'S HOSPITAL FLEXIBLE SPENDING ACCOUNT PLAN 2011 401k membership
Total participants, beginning-of-year2011-07-010
Total number of active participants reported on line 7a of the Form 55002011-07-01124
Number of retired or separated participants receiving benefits2011-07-010
Number of other retired or separated participants entitled to future benefits2011-07-010
Total of all active and inactive participants2011-07-01124

Form 5500 Responses for FISHERMEN'S HOSPITAL FLEXIBLE SPENDING ACCOUNT PLAN

2016: FISHERMEN'S HOSPITAL FLEXIBLE SPENDING ACCOUNT PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01This submission is the final filingYes
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – InsuranceYes
2015: FISHERMEN'S HOSPITAL FLEXIBLE SPENDING ACCOUNT PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – InsuranceYes
2014: FISHERMEN'S HOSPITAL FLEXIBLE SPENDING ACCOUNT PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013: FISHERMEN'S HOSPITAL FLEXIBLE SPENDING ACCOUNT PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – InsuranceYes
2012: FISHERMEN'S HOSPITAL FLEXIBLE SPENDING ACCOUNT PLAN 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – InsuranceYes
2011: FISHERMEN'S HOSPITAL FLEXIBLE SPENDING ACCOUNT PLAN 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01First time form 5500 has been submittedYes
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00497857
Policy instance 2
Insurance contract or identification number00497857
Number of Individuals Covered154
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Total amount of commissions paid to insurance brokerUSD $21,182
Total amount of fees paid to insurance companyUSD $6,638
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D, OPTIONAL AD&D, OPTIONAL LIFE
Welfare Benefit Premiums Paid to CarrierUSD $169,584
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,211
Insurance broker organization code?3
Amount paid for insurance broker fees6638
Insurance broker nameUSI BENEFIT CORP.
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0838182
Policy instance 1
Insurance contract or identification number0838182
Number of Individuals Covered250
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Total amount of commissions paid to insurance brokerUSD $3,300
Total amount of fees paid to insurance companyUSD $8,341
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,105,005
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees8341
Additional information about fees paid to insurance broker2014/2015 PPP ENGAGEMENT CREDIT
Insurance broker organization code?3
Commission paid to Insurance BrokerUSD $3,300
Insurance broker namePLANSOURCE HOLDINGS INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00497857
Policy instance 2
Insurance contract or identification number00497857
Number of Individuals Covered147
Insurance policy start date2014-04-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $20,682
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
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D, OPTIONAL AD&D, OPTIONAL LIFE
Welfare Benefit Premiums Paid to CarrierUSD $168,028
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,682
Insurance broker organization code?3
Insurance broker nameADAMS BENEFIT CORP.
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0838182
Policy instance 1
Insurance contract or identification number0838182
Number of Individuals Covered265
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $6,044
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,073,111
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees6044
Additional information about fees paid to insurance broker2013/2014 MM P3 BONUS
Insurance broker organization code?3
Insurance broker nameADAMS BENEFIT CORPORATION 600
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE4247961
Policy instance 3
Insurance contract or identification numberE4247961
Number of Individuals Covered72
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $26,899
Total amount of fees paid to insurance companyUSD $7,925
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 providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $46,500
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,339
Amount paid for insurance broker fees1876
Insurance broker organization code?3
Insurance broker nameSTACY MARIE FRADY
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00607926
Policy instance 1
Insurance contract or identification number00607926
Number of Individuals Covered187
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $57,070
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,780,670
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees57070
Additional information about fees paid to insurance brokerBENEFIT ADVISOR FEES
Insurance broker organization code?3
Insurance broker nameDEMOSS FINANCIAL INC
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 32395 )
Policy contract number30026517
Policy instance 2
Insurance contract or identification number30026517
Number of Individuals Covered0
Insurance policy start date2013-07-01
Insurance policy end date2014-04-01
Total amount of commissions paid to insurance brokerUSD $718
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 $9,353
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $718
Insurance broker organization code?3
Insurance broker nameMARLO W DEMOSS
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number0607926
Policy instance 3
Insurance contract or identification number0607926
Number of Individuals Covered121
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $7,402
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
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $74,872
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,402
Additional information about fees paid to insurance brokerCOMMISSIONS
Insurance broker organization code?3
Insurance broker nameDEMOSS FINANCIAL INC
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00607926
Policy instance 1
Insurance contract or identification number00607926
Number of Individuals Covered188
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $57,180
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,141,913
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees57180
Additional information about fees paid to insurance brokerBENEFIT ADVISOR FEES
Insurance broker organization code?3
Insurance broker nameDEMOSS FINANCIAL INC
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number0607926
Policy instance 3
Insurance contract or identification number0607926
Number of Individuals Covered120
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $8,805
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
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $89,058
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,805
Additional information about fees paid to insurance brokerCOMMISSIONS
Insurance broker organization code?3
Insurance broker nameDEMOSS FINANCIAL INC
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 32395 )
Policy contract number30026517
Policy instance 2
Insurance contract or identification number30026517
Number of Individuals Covered89
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $848
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 $12,750
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $848
Insurance broker organization code?3
Insurance broker nameMARLO W DEMOSS
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract number81967
Policy instance 1
Insurance contract or identification number81967
Number of Individuals Covered124
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $121,167
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
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 32395 )
Policy contract number30026517
Policy instance 2
Insurance contract or identification number30026517
Number of Individuals Covered86
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $34
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 $11,322
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 )
Policy contract number25X0242
Policy instance 3
Insurance contract or identification number25X0242
Number of Individuals Covered81
Insurance policy start date2012-01-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,975
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,403
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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