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CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS 401k Plan overview

Plan NameCALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS
Plan identification number 513

CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

SUTTER BAY HOSPITALS has sponsored the creation of one or more 401k plans.

Company Name:SUTTER BAY HOSPITALS
Employer identification number (EIN):940562680
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5132023-01-01JENNIFER SUSNARA2024-10-10
5132022-01-01
5132022-01-01TRACY MESSINEO
5132021-01-01
5132021-01-01TRACY MESSINEO
5132020-01-01
5132019-01-01
5132017-01-01MAYNARD JENKINS
5132016-01-01MAYNARD JENKINS
5132015-01-01MAYNARD JENKINS
5132014-01-01JOHN GATES
5132013-01-01JOHN GATES
5132012-01-01JOHN B. GATES, CPA
5132011-01-01JOHN B. GATES, CPA
5132009-01-01GRANT DAVIES
5132009-01-01LINDA ISAACS GRANT DAVIES2010-10-12

Plan Statistics for CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS

401k plan membership statisitcs for CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS

Measure Date Value
2023: CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS 2023 401k membership
Total participants, beginning-of-year2023-01-011,172
Total number of active participants reported on line 7a of the Form 55002023-01-011,172
Number of retired or separated participants receiving benefits2023-01-010
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-011,172
Number of employers contributing to the scheme2023-01-010
2022: CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS 2022 401k membership
Total participants, beginning-of-year2022-01-011,177
Total number of active participants reported on line 7a of the Form 55002022-01-011,172
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-011,172
2021: CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS 2021 401k membership
Total participants, beginning-of-year2021-01-011,190
Total number of active participants reported on line 7a of the Form 55002021-01-011,177
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-011,177
2020: CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS 2020 401k membership
Total participants, beginning-of-year2020-01-011,198
Total number of active participants reported on line 7a of the Form 55002020-01-011,190
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-011,190
2019: CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS 2019 401k membership
Total participants, beginning-of-year2019-01-011,229
Total number of active participants reported on line 7a of the Form 55002019-01-011,198
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-011,198
2017: CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS 2017 401k membership
Total participants, beginning-of-year2017-01-014,798
Total number of active participants reported on line 7a of the Form 55002017-01-012,457
Total of all active and inactive participants2017-01-012,457
Total participants2017-01-012,457
2016: CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS 2016 401k membership
Total participants, beginning-of-year2016-01-015,101
Total number of active participants reported on line 7a of the Form 55002016-01-014,798
Total of all active and inactive participants2016-01-014,798
Total participants2016-01-014,798
2015: CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS 2015 401k membership
Total participants, beginning-of-year2015-01-014,973
Total number of active participants reported on line 7a of the Form 55002015-01-015,101
Total of all active and inactive participants2015-01-015,101
Total participants2015-01-015,101
2014: CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS 2014 401k membership
Total participants, beginning-of-year2014-01-015,109
Total number of active participants reported on line 7a of the Form 55002014-01-014,973
Total of all active and inactive participants2014-01-014,973
Total participants2014-01-014,973
2013: CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS 2013 401k membership
Total participants, beginning-of-year2013-01-015,203
Total number of active participants reported on line 7a of the Form 55002013-01-015,109
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-015,109
2012: CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS 2012 401k membership
Total participants, beginning-of-year2012-01-0111,296
Total number of active participants reported on line 7a of the Form 55002012-01-015,203
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 participants2012-01-015,203
2011: CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS 2011 401k membership
Total participants, beginning-of-year2011-01-0111,849
Total number of active participants reported on line 7a of the Form 55002011-01-0111,176
Number of retired or separated participants receiving benefits2011-01-01120
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-0111,296
2009: CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS 2009 401k membership
Total participants, beginning-of-year2009-01-015,150
Total number of active participants reported on line 7a of the Form 55002009-01-014,930
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 participants2009-01-014,930

Form 5500 Responses for CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS

2023: CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS 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 funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS 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 funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS 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 funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
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: CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS 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: CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS 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: CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS 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 funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: CALIFORNIA PACIFIC MEDICAL CENTER EMPLOYEE WELFARE AND FRINGE BENEFITS 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedYes
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 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

UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number28710
Policy instance 1
Insurance contract or identification number28710
Number of Individuals Covered1172
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedLONG TERM CARE
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number28710
Policy instance 1
Insurance contract or identification number28710
Number of Individuals Covered86
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
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
Other welfare benefits providedLONG TERM CARE
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 $159,077
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number28710
Policy instance 1
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number28710
Policy instance 1
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number28710
Policy instance 1
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0008708046
Policy instance 2
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number28710
Policy instance 1
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0008708046
Policy instance 1
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number28710
Policy instance 2
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0008708046
Policy instance 2
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number28710
Policy instance 1
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number8708046
Policy instance 2
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number28710
Policy instance 1
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number28710
Policy instance 1
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number2544
Policy instance 2
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number8708046
Policy instance 3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number30028614
Policy instance 4
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number28710
Policy instance 1
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number2544
Policy instance 2
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0144536
Policy instance 3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number138250/138258
Policy instance 4
FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 )
Policy contract number9708728/9709718
Policy instance 5
FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 )
Policy contract number9708728/9709718
Policy instance 5
JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )
Policy contract number28710
Policy instance 1
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number2544
Policy instance 2
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0144536
Policy instance 3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number138250
Policy instance 4

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