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| Plan Name | NEBRASKA MEDICINE PERMANENT LIFE |
| Plan identification number | 509 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | NEBRASKA MEDICINE |
| Employer identification number (EIN): | 911858433 |
| NAIC Classification: | 622000 |
| NAIC Description: | Hospitals |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 509 | 2018-01-01 | LAURIE L. WILLBURN | 2019-08-22 | ||
| 509 | 2017-09-01 | ||||
| 509 | 2017-09-01 |
| Measure | Date | Value |
|---|---|---|
| 2018: NEBRASKA MEDICINE PERMANENT LIFE 2018 401k membership | ||
| Total participants, beginning-of-year | 2018-01-01 | 426 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 0 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 0 |
| Number of employers contributing to the scheme | 2018-01-01 | 0 |
| 2017: NEBRASKA MEDICINE PERMANENT LIFE 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-09-01 | 426 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-09-01 | 0 |
| Number of retired or separated participants receiving benefits | 2017-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-09-01 | 0 |
| Total of all active and inactive participants | 2017-09-01 | 0 |
| Number of employers contributing to the scheme | 2017-09-01 | 0 |
| 2018: NEBRASKA MEDICINE PERMANENT LIFE 2018 form 5500 responses | ||
|---|---|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | This submission is the final filing | Yes |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: NEBRASKA MEDICINE PERMANENT LIFE 2017 form 5500 responses | ||
| 2017-09-01 | Type of plan entity | Single employer plan |
| 2017-09-01 | First time form 5500 has been submitted | Yes |
| 2017-09-01 | Submission has been amended | Yes |
| 2017-09-01 | This submission is the final filing | Yes |
| 2017-09-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2017-09-01 | Plan funding arrangement – Insurance | Yes |
| 2017-09-01 | Plan benefit arrangement – Insurance | Yes |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) | |||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 752199 | ||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||
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| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 ) | |||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 752199 | ||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||
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