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| Plan Name | ACADEMIC MEDICAL GROUP HOSPITAL INDEMNITY |
| Plan identification number | 512 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | Academic Medical Group Inc. Academic Medical Group Inc. |
| Employer identification number (EIN): | 863038188 |
| NAIC Classification: | 621399 |
| NAIC Description: | Offices of All Other Miscellaneous Health Practitioners |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 512 | 2023-01-01 | MEAGAN LANGDOC | 2024-07-16 | ||
| 512 | 2022-01-01 | MEAGAN LANGDOC | 2023-07-03 | ||
| 512 | 2022-01-01 | MEAGAN LANGDOC | 2024-04-25 |
| Measure | Date | Value |
|---|---|---|
| 2023: ACADEMIC MEDICAL GROUP HOSPITAL INDEMNITY 2023 401k membership | ||
| Total participants, beginning-of-year | 2023-01-01 | 266 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-01-01 | 0 |
| Number of retired or separated participants receiving benefits | 2023-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2023-01-01 | 0 |
| Total of all active and inactive participants | 2023-01-01 | 0 |
| Number of employers contributing to the scheme | 2023-01-01 | 0 |
| 2022: ACADEMIC MEDICAL GROUP HOSPITAL INDEMNITY 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-01-01 | 266 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 0 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 0 |
| Number of employers contributing to the scheme | 2022-01-01 | 0 |
| 2023: ACADEMIC MEDICAL GROUP HOSPITAL INDEMNITY 2023 form 5500 responses | ||
|---|---|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | This submission is the final filing | Yes |
| 2023-01-01 | Plan funding arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: ACADEMIC MEDICAL GROUP HOSPITAL INDEMNITY 2022 form 5500 responses | ||
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | First time form 5500 has been submitted | Yes |
| 2022-01-01 | Submission has been amended | Yes |
| 2022-01-01 | This submission is the final filing | Yes |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |||||||||||||||||||
| Policy contract number | HI-0000377053 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
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| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |||||||||||||||||||
| Policy contract number | 238668 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
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