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COFFEE REGIONAL MEDICAL CENTER, INC. BENEFIT PLAN 401k Plan overview

Plan NameCOFFEE REGIONAL MEDICAL CENTER, INC. BENEFIT PLAN
Plan identification number 501

COFFEE REGIONAL MEDICAL CENTER, INC. BENEFIT 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
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

COFFEE REGIONAL MEDICAL CENTER, INC. has sponsored the creation of one or more 401k plans.

Company Name:COFFEE REGIONAL MEDICAL CENTER, INC.
Employer identification number (EIN):650543088
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COFFEE REGIONAL MEDICAL CENTER, INC. BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01PEGGY KIRKLAND2024-09-17
5012022-01-01JOHN MCLEOD2023-10-10
5012021-01-01ROBERT FINCH2022-05-11
5012020-01-01ROBERT FINCH2021-07-08
5012019-01-01VICKI LEWIS2020-07-30
5012018-01-01VICKI LEWIS2020-07-30
5012017-01-01VICKI LEWIS2020-07-30
5012016-01-01VICKI LEWIS2020-07-30
5012015-01-01VICKI LEWIS2020-07-30
5012014-01-01VICKI LEWIS2020-07-30
5012013-01-01VICKI LEWIS2020-07-30

Plan Statistics for COFFEE REGIONAL MEDICAL CENTER, INC. BENEFIT PLAN

401k plan membership statisitcs for COFFEE REGIONAL MEDICAL CENTER, INC. BENEFIT PLAN

Measure Date Value
2023: COFFEE REGIONAL MEDICAL CENTER, INC. BENEFIT PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-01764
Total number of active participants reported on line 7a of the Form 55002023-01-01765
Number of retired or separated participants receiving benefits2023-01-010
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-01765
Number of employers contributing to the scheme2023-01-010
2022: COFFEE REGIONAL MEDICAL CENTER, INC. BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01746
Total number of active participants reported on line 7a of the Form 55002022-01-01764
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 participants2022-01-01764
Number of employers contributing to the scheme2022-01-010
2021: COFFEE REGIONAL MEDICAL CENTER, INC. BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01695
Total number of active participants reported on line 7a of the Form 55002021-01-01746
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 participants2021-01-01746
Number of employers contributing to the scheme2021-01-010
2020: COFFEE REGIONAL MEDICAL CENTER, INC. BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01499
Total number of active participants reported on line 7a of the Form 55002020-01-01695
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 participants2020-01-01695
Number of employers contributing to the scheme2020-01-010
2019: COFFEE REGIONAL MEDICAL CENTER, INC. BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01533
Total number of active participants reported on line 7a of the Form 55002019-01-01548
Total of all active and inactive participants2019-01-01548
2018: COFFEE REGIONAL MEDICAL CENTER, INC. BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01518
Total number of active participants reported on line 7a of the Form 55002018-01-01533
Total of all active and inactive participants2018-01-01533
2017: COFFEE REGIONAL MEDICAL CENTER, INC. BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01499
Total number of active participants reported on line 7a of the Form 55002017-01-01518
Total of all active and inactive participants2017-01-01518
2016: COFFEE REGIONAL MEDICAL CENTER, INC. BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01526
Total number of active participants reported on line 7a of the Form 55002016-01-01499
Total of all active and inactive participants2016-01-01499
2015: COFFEE REGIONAL MEDICAL CENTER, INC. BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01529
Total number of active participants reported on line 7a of the Form 55002015-01-01526
Total of all active and inactive participants2015-01-01526
2014: COFFEE REGIONAL MEDICAL CENTER, INC. BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01561
Total number of active participants reported on line 7a of the Form 55002014-01-01529
Total of all active and inactive participants2014-01-01529
2013: COFFEE REGIONAL MEDICAL CENTER, INC. BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01561
Total number of active participants reported on line 7a of the Form 55002013-01-01561
Total of all active and inactive participants2013-01-01561

Form 5500 Responses for COFFEE REGIONAL MEDICAL CENTER, INC. BENEFIT PLAN

2023: COFFEE REGIONAL MEDICAL CENTER, INC. BENEFIT PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: COFFEE REGIONAL MEDICAL CENTER, INC. BENEFIT 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: COFFEE REGIONAL MEDICAL CENTER, INC. BENEFIT 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: COFFEE REGIONAL MEDICAL CENTER, INC. BENEFIT 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: COFFEE REGIONAL MEDICAL CENTER, INC. BENEFIT 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
2018: COFFEE REGIONAL MEDICAL CENTER, INC. BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: COFFEE REGIONAL MEDICAL CENTER, INC. BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: COFFEE REGIONAL MEDICAL CENTER, INC. BENEFIT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
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: COFFEE REGIONAL MEDICAL CENTER, INC. BENEFIT 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: COFFEE REGIONAL MEDICAL CENTER, INC. BENEFIT 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: COFFEE REGIONAL MEDICAL CENTER, INC. BENEFIT 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

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number40000100026579
Policy instance 3
Insurance contract or identification number40000100026579
Number of Individuals Covered765
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $85,637
Total amount of fees paid to insurance companyUSD $90,478
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT,ACCIDENT, HOSPITAL,CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $584,994
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number663786
Policy instance 2
Insurance contract or identification number663786
Number of Individuals Covered765
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10023991001
Policy instance 1
Insurance contract or identification number10023991001
Number of Individuals Covered1381
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $6,606
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $83,590
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number40000100026579
Policy instance 3
AETNA EMPLOYEE ASSISTANCE PLAN (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number663786
Policy instance 2
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10023991001
Policy instance 1
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10023991001
Policy instance 1
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number400001000026579
Policy instance 2
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0BH9Q
Policy instance 3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number70003-7
Policy instance 2
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10023991001
Policy instance 1
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10023991001
Policy instance 1
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUDE0BH9Q
Policy instance 8
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number000000591457
Policy instance 2
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract numberEXRK
Policy instance 3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract numberACC
Policy instance 4
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract numberHCI
Policy instance 5
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BH9Q
Policy instance 6
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0BH9Q
Policy instance 10
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUPR0BH9Q
Policy instance 9
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUC 0BH9Q
Policy instance 7
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10023991001
Policy instance 1
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number000000591457
Policy instance 2
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract numberEXRK
Policy instance 3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract numberEXRK
Policy instance 3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10023991001
Policy instance 1
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number000000591457
Policy instance 2
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL31613
Policy instance 1

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