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JEFFERSON HOSPITAL ASSOCIATION ACCIDENT PLAN 401k Plan overview

Plan NameJEFFERSON HOSPITAL ASSOCIATION ACCIDENT PLAN
Plan identification number 504

JEFFERSON HOSPITAL ASSOCIATION ACCIDENT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)

401k Sponsoring company profile

JEFFERSON HOSPITAL ASSOCIATION, INC has sponsored the creation of one or more 401k plans.

Company Name:JEFFERSON HOSPITAL ASSOCIATION, INC
Employer identification number (EIN):710329353
NAIC Classification:622000
NAIC Description: Hospitals

Additional information about JEFFERSON HOSPITAL ASSOCIATION, INC

Jurisdiction of Incorporation: Arkansas Secretary of State
Incorporation Date:
Company Identification Number: 100027932

More information about JEFFERSON HOSPITAL ASSOCIATION, INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JEFFERSON HOSPITAL ASSOCIATION ACCIDENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042017-01-01BRYAN JACKSON
5042016-01-01BRYAN JACKSON
5042015-01-01BRYAN JACKSON
5042014-01-01BRYAN JACKSON BRYAN JACKSON2015-10-14
5042013-01-01BRYAN JACKSON BRYAN JACKSON2014-10-15
5042012-01-01BRYAN JACKSON
5042011-01-01BRYAN JACKSON
5042010-01-01BRYAN JACKSON BRYAN JACKSON2011-10-04
5042009-01-01BROCK HOLMAN

Plan Statistics for JEFFERSON HOSPITAL ASSOCIATION ACCIDENT PLAN

401k plan membership statisitcs for JEFFERSON HOSPITAL ASSOCIATION ACCIDENT PLAN

Measure Date Value
2017: JEFFERSON HOSPITAL ASSOCIATION ACCIDENT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-011,050
Total number of active participants reported on line 7a of the Form 55002017-01-011,094
Total of all active and inactive participants2017-01-011,094
Total participants2017-01-011,094
2016: JEFFERSON HOSPITAL ASSOCIATION ACCIDENT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01982
Total number of active participants reported on line 7a of the Form 55002016-01-011,050
Total of all active and inactive participants2016-01-011,050
Total participants2016-01-011,050
2015: JEFFERSON HOSPITAL ASSOCIATION ACCIDENT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-011,314
Total number of active participants reported on line 7a of the Form 55002015-01-01982
Total of all active and inactive participants2015-01-01982
Total participants2015-01-01982
2014: JEFFERSON HOSPITAL ASSOCIATION ACCIDENT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-011,419
Total number of active participants reported on line 7a of the Form 55002014-01-011,314
Total of all active and inactive participants2014-01-011,314
Total participants2014-01-011,314
2013: JEFFERSON HOSPITAL ASSOCIATION ACCIDENT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01507
Total number of active participants reported on line 7a of the Form 55002013-01-011,419
Total of all active and inactive participants2013-01-011,419
Total participants2013-01-011,419
2012: JEFFERSON HOSPITAL ASSOCIATION ACCIDENT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01522
Total number of active participants reported on line 7a of the Form 55002012-01-01507
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01507
2011: JEFFERSON HOSPITAL ASSOCIATION ACCIDENT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01557
Total number of active participants reported on line 7a of the Form 55002011-01-01522
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01522
2010: JEFFERSON HOSPITAL ASSOCIATION ACCIDENT PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01562
Total number of active participants reported on line 7a of the Form 55002010-01-01557
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-01557
2009: JEFFERSON HOSPITAL ASSOCIATION ACCIDENT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01485
Total number of active participants reported on line 7a of the Form 55002009-01-01562
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01562

Form 5500 Responses for JEFFERSON HOSPITAL ASSOCIATION ACCIDENT PLAN

2017: JEFFERSON HOSPITAL ASSOCIATION ACCIDENT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: JEFFERSON HOSPITAL ASSOCIATION ACCIDENT 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 benefit arrangement – InsuranceYes
2015: JEFFERSON HOSPITAL ASSOCIATION ACCIDENT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: JEFFERSON HOSPITAL ASSOCIATION ACCIDENT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: JEFFERSON HOSPITAL ASSOCIATION ACCIDENT PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: JEFFERSON HOSPITAL ASSOCIATION ACCIDENT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: JEFFERSON HOSPITAL ASSOCIATION ACCIDENT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: JEFFERSON HOSPITAL ASSOCIATION ACCIDENT PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: JEFFERSON HOSPITAL ASSOCIATION ACCIDENT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberSA389045057909
Policy instance 1
Insurance contract or identification numberSA389045057909
Number of Individuals Covered1094
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Other welfare benefits providedBASIC, OPTION, & DEPENDENT AD&D
Welfare Benefit Premiums Paid to CarrierUSD $45,496
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberSA389045057901
Policy instance 1
Insurance contract or identification numberSA389045057901
Number of Individuals Covered982
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Other welfare benefits providedBASIC, OPTION, & DEPENDENT AD&D
Welfare Benefit Premiums Paid to CarrierUSD $44,487
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberSA389045057901
Policy instance 1
Insurance contract or identification numberSA389045057901
Number of Individuals Covered1314
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Other welfare benefits providedBASIC, OPTION, & DEPENDENT AD&D
Welfare Benefit Premiums Paid to CarrierUSD $47,526
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberSA389045057901
Policy instance 1
Insurance contract or identification numberSA389045057901
Number of Individuals Covered1419
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Other welfare benefits providedBASIC, OPTION, & DEPENDENT AD&D
Welfare Benefit Premiums Paid to CarrierUSD $50,865
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberGD3-890-450579
Policy instance 1
Insurance contract or identification numberGD3-890-450579
Number of Individuals Covered507
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $36,337
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $327,246
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,337
Insurance broker organization code?3
Insurance broker nameFIRST ARKANSAS INSURANCE
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberGD3-890-450579
Policy instance 1
Insurance contract or identification numberGD3-890-450579
Number of Individuals Covered522
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $48,870
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $334,362
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )
Policy contract numberGD3-890-450579
Policy instance 1
Insurance contract or identification numberGD3-890-450579
Number of Individuals Covered557
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $43,933
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $368,096
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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