401k Plan data: MAYO REGIONAL HOSPITAL HEALTH PLAN plan

MAYO REGIONAL HOSPITAL HEALTH PLAN 401k Plan overview

Plan Name	MAYO REGIONAL HOSPITAL HEALTH PLAN
Plan identification number	506

MAYO REGIONAL HOSPITAL HEALTH PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision)

401k Sponsoring company profile

MRH CORP has sponsored the creation of one or more 401k plans.

Company Name: MRH CORP

Employer identification number (EIN): 843689003

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MAYO REGIONAL HOSPITAL HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
506 2020-03-01

Plan Statistics for MAYO REGIONAL HOSPITAL HEALTH PLAN

401k plan membership statisitcs for MAYO REGIONAL HOSPITAL HEALTH PLAN

Measure Date Value
2020: MAYO REGIONAL HOSPITAL HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year 2020-03-01 317
Total of all active and inactive participants 2020-03-01 0
Total participants 2020-03-01 0

Measure	Date	Value
2020: MAYO REGIONAL HOSPITAL HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year	2020-03-01	317
Total of all active and inactive participants	2020-03-01	0
Total participants	2020-03-01	0

Form 5500 Responses for MAYO REGIONAL HOSPITAL HEALTH PLAN

2020: MAYO REGIONAL HOSPITAL HEALTH PLAN 2020 form 5500 responses
2020-03-01	Type of plan entity	Single employer plan
2020-03-01	First time form 5500 has been submitted	Yes
2020-03-01	This submission is the final filing	Yes
2020-03-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2020-03-01	Plan funding arrangement – Insurance	Yes
2020-03-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )

Policy contract number

016861

Policy instance

Insurance contract or identification number	016861
Number of Individuals Covered	247
Insurance policy start date	2020-03-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $25,107
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,568,945
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $25,107
Insurance broker organization code?	3

HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )

Policy contract number

016862

Policy instance

Insurance contract or identification number	016862
Number of Individuals Covered	150
Insurance policy start date	2020-03-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $17,057
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,061,659
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $17,057
Insurance broker organization code?	3

HPHC INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 18975 )

Policy contract number

022918

Policy instance

Insurance contract or identification number	022918
Number of Individuals Covered	74
Insurance policy start date	2020-03-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $9,338
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $581,204
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,338
Insurance broker organization code?	3

HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )

Policy contract number

080786

Policy instance

Insurance contract or identification number	080786
Number of Individuals Covered	103
Insurance policy start date	2020-03-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $14,353
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $895,469
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,353
Insurance broker organization code?	3

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Company Name:	MRH CORP
Employer identification number (EIN):	843689003
NAIC Classification:	622000
NAIC Description:	Hospitals