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RS MEDICAL EMPLOYEE MEDICAL INSURANCE PLAN 401k Plan overview

Plan NameRS MEDICAL EMPLOYEE MEDICAL INSURANCE PLAN
Plan identification number 501

RS MEDICAL EMPLOYEE MEDICAL INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

INTERNATIONAL REHABILITATIVE SCIENC has sponsored the creation of one or more 401k plans.

Company Name:INTERNATIONAL REHABILITATIVE SCIENC
Employer identification number (EIN):911490213
NAIC Classification:454390
NAIC Description:Other Direct Selling Establishments

Form 5500 Filing Information

Submission information for form 5500 for 401k plan RS MEDICAL EMPLOYEE MEDICAL INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012014-01-01RICHARD M TERRELL
5012013-01-01DIANA MCCLENAHAN
5012012-01-01DIANA MCCLENAHAN
5012011-01-01MARY MANNING MARY MANNING2012-08-15
5012009-01-01THOMAS A PIERCE
5012009-01-01THOMAS A PIERCE

Plan Statistics for RS MEDICAL EMPLOYEE MEDICAL INSURANCE PLAN

401k plan membership statisitcs for RS MEDICAL EMPLOYEE MEDICAL INSURANCE PLAN

Measure Date Value
2014: RS MEDICAL EMPLOYEE MEDICAL INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01141
Total number of active participants reported on line 7a of the Form 55002014-01-01147
Total of all active and inactive participants2014-01-01147
Total participants2014-01-010
2013: RS MEDICAL EMPLOYEE MEDICAL INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01258
Total number of active participants reported on line 7a of the Form 55002013-01-01141
Total of all active and inactive participants2013-01-01141
Total participants2013-01-01141
2012: RS MEDICAL EMPLOYEE MEDICAL INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01413
Total number of active participants reported on line 7a of the Form 55002012-01-01258
Number of retired or separated participants receiving benefits2012-01-010
Total of all active and inactive participants2012-01-01258
Total participants2012-01-01258
2011: RS MEDICAL EMPLOYEE MEDICAL INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01441
Total number of active participants reported on line 7a of the Form 55002011-01-01539
Total of all active and inactive participants2011-01-01539
2009: RS MEDICAL EMPLOYEE MEDICAL INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01533
Total number of active participants reported on line 7a of the Form 55002009-01-01433
Total of all active and inactive participants2009-01-01433
Total participants2009-01-01433

Form 5500 Responses for RS MEDICAL EMPLOYEE MEDICAL INSURANCE PLAN

2014: RS MEDICAL EMPLOYEE MEDICAL INSURANCE 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: RS MEDICAL EMPLOYEE MEDICAL INSURANCE PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
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
2012: RS MEDICAL EMPLOYEE MEDICAL INSURANCE 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 funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: RS MEDICAL EMPLOYEE MEDICAL INSURANCE PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: RS MEDICAL EMPLOYEE MEDICAL INSURANCE PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberWA077925
Policy instance 2
Insurance contract or identification numberWA077925
Number of Individuals Covered147
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $52,403
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker nameBUTLER PARNERS & ASSOCIATES, LLC
QBE A&H (National Association of Insurance Commissioners NAIC id number: 10219 )
Policy contract numberLGS00928-13
Policy instance 3
Insurance contract or identification numberLGS00928-13
Number of Individuals Covered163
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of fees paid to insurance companyUSD $3,933
Welfare Benefit Premiums Paid to CarrierUSD $157,321
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees3933
Insurance broker organization code?0
Insurance broker nameREGENCE GROUP ADMINISTRATORS
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number33944
Policy instance 1
Insurance contract or identification number33944
Number of Individuals Covered1
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,691
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberWA077925
Policy instance 1
Insurance contract or identification numberWA077925
Number of Individuals Covered183
Insurance policy start date2012-06-01
Insurance policy end date2013-02-28
Total amount of commissions paid to insurance brokerUSD $4,133
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D VOLUNTARY AD&D
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 $71,499
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,864
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameBENEFIT SPECIALISTS INC.
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number33944
Policy instance 2
Insurance contract or identification number33944
Number of Individuals Covered1
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Total amount of commissions paid to insurance brokerUSD $0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
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 $5,615
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number417006410213
Policy instance 3
Insurance contract or identification number417006410213
Number of Individuals Covered184
Insurance policy start date2012-03-01
Insurance policy end date2013-03-01
Total amount of commissions paid to insurance brokerUSD $0
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 BenefitNo
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 $233,923
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number33944
Policy instance 2
Insurance contract or identification number33944
Number of Individuals Covered1
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Total amount of commissions paid to insurance brokerUSD $0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
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 $3,705
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberWA077925
Policy instance 3
Insurance contract or identification numberWA077925
Number of Individuals Covered295
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $5,560
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D VOLUNTARY AD&D
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 $119,702
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,560
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameBENEFIT SPECIALISTS INC.
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number417004410213
Policy instance 1
Insurance contract or identification number417004410213
Number of Individuals Covered346
Insurance policy start date2011-03-01
Insurance policy end date2012-03-01
Total amount of commissions paid to insurance brokerUSD $0
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 BenefitNo
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 $293,052
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number417004410213
Policy instance 1
Insurance contract or identification number417004410213
Number of Individuals Covered452
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Welfare Benefit Premiums Paid to CarrierUSD $237,119
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number33944-CS
Policy instance 2
Insurance contract or identification number33944-CS
Number of Individuals Covered4
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,254
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number417004410213
Policy instance 1
Insurance contract or identification number417004410213
Number of Individuals Covered436
Insurance policy start date2009-03-01
Insurance policy end date2010-03-01
Welfare Benefit Premiums Paid to CarrierUSD $270,141
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberVAR 203884
Policy instance 2
Insurance contract or identification numberVAR 203884
Number of Individuals Covered491
Insurance policy start date2009-03-01
Insurance policy end date2010-02-28
Total amount of commissions paid to insurance brokerUSD $586
Other welfare benefits providedVOLUNTARY AD&D
Welfare Benefit Premiums Paid to CarrierUSD $11,977
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $586
Insurance broker organization code?3
Insurance broker nameBENEFIT SPECIALISTS, INC.
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 142070
Policy instance 3
Insurance contract or identification numberGL 142070
Number of Individuals Covered426
Insurance policy start date2009-03-01
Insurance policy end date2010-02-28
Total amount of commissions paid to insurance brokerUSD $3,614
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $117,993
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,614
Insurance broker organization code?3
Insurance broker nameBENEFIT SPECIALISTS, INC.
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number33944-CS
Policy instance 4
Insurance contract or identification number33944-CS
Number of Individuals Covered2
Insurance policy start date2009-03-01
Insurance policy end date2010-02-28
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,709
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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