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MARSHALL MEDICAL CENTER HEALTH & WELFARE PLAN 401k Plan overview

Plan NameMARSHALL MEDICAL CENTER HEALTH & WELFARE PLAN
Plan identification number 507

MARSHALL MEDICAL CENTER HEALTH & WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

MARSHALL MEDICAL CENTER has sponsored the creation of one or more 401k plans.

Company Name:MARSHALL MEDICAL CENTER
Employer identification number (EIN):941450151
NAIC Classification:622000
NAIC Description: Hospitals

Additional information about MARSHALL MEDICAL CENTER

Jurisdiction of Incorporation: California Department of State
Incorporation Date: 1957-03-21
Company Identification Number: C0335489
Legal Registered Office Address: 1100 Marshall Way

Placerville
United States of America (USA)
95667

More information about MARSHALL MEDICAL CENTER

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MARSHALL MEDICAL CENTER HEALTH & WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5072022-01-01BRETT APPLEBERG2023-07-17
5072021-01-01SCOTT COMER2022-08-22
5072020-01-01SCOTT COMER2021-07-26
5072019-11-01SCOTT COMER2020-06-09
5072018-11-01SCOTT COMER2020-04-17
5072017-11-01SCOTT M. COMER2019-04-11

Plan Statistics for MARSHALL MEDICAL CENTER HEALTH & WELFARE PLAN

401k plan membership statisitcs for MARSHALL MEDICAL CENTER HEALTH & WELFARE PLAN

Measure Date Value
2022: MARSHALL MEDICAL CENTER HEALTH & WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-011,273
Total number of active participants reported on line 7a of the Form 55002022-01-011,247
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 participants2022-01-011,247
Number of employers contributing to the scheme2022-01-010
2021: MARSHALL MEDICAL CENTER HEALTH & WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-011,273
Total number of active participants reported on line 7a of the Form 55002021-01-011,247
Number of retired or separated participants receiving benefits2021-01-014
Number of other retired or separated participants entitled to future benefits2021-01-016
Total of all active and inactive participants2021-01-011,257
Number of employers contributing to the scheme2021-01-010
2020: MARSHALL MEDICAL CENTER HEALTH & WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-011,602
Total number of active participants reported on line 7a of the Form 55002020-01-011,588
Number of retired or separated participants receiving benefits2020-01-0112
Number of other retired or separated participants entitled to future benefits2020-01-0169
Total of all active and inactive participants2020-01-011,669
Number of employers contributing to the scheme2020-01-010
2019: MARSHALL MEDICAL CENTER HEALTH & WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year2019-11-011,602
Total number of active participants reported on line 7a of the Form 55002019-11-011,598
Number of retired or separated participants receiving benefits2019-11-014
Number of other retired or separated participants entitled to future benefits2019-11-010
Total of all active and inactive participants2019-11-011,602
Number of employers contributing to the scheme2019-11-010
2018: MARSHALL MEDICAL CENTER HEALTH & WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year2018-11-011,610
Total number of active participants reported on line 7a of the Form 55002018-11-011,598
Number of retired or separated participants receiving benefits2018-11-016
Number of other retired or separated participants entitled to future benefits2018-11-010
Total of all active and inactive participants2018-11-011,604
Number of employers contributing to the scheme2018-11-010
2017: MARSHALL MEDICAL CENTER HEALTH & WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year2017-11-011,413
Total number of active participants reported on line 7a of the Form 55002017-11-011,610
Number of retired or separated participants receiving benefits2017-11-016
Number of other retired or separated participants entitled to future benefits2017-11-010
Total of all active and inactive participants2017-11-011,616
Number of employers contributing to the scheme2017-11-010

Form 5500 Responses for MARSHALL MEDICAL CENTER HEALTH & WELFARE PLAN

2022: MARSHALL MEDICAL CENTER HEALTH & WELFARE PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
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: MARSHALL MEDICAL CENTER HEALTH & WELFARE PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
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: MARSHALL MEDICAL CENTER HEALTH & WELFARE PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
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: MARSHALL MEDICAL CENTER HEALTH & WELFARE PLAN 2019 form 5500 responses
2019-11-01Type of plan entitySingle employer plan
2019-11-01This return/report is a short plan year return/report (less than 12 months)Yes
2019-11-01Plan funding arrangement – InsuranceYes
2019-11-01Plan funding arrangement – General assets of the sponsorYes
2019-11-01Plan benefit arrangement – InsuranceYes
2019-11-01Plan benefit arrangement – General assets of the sponsorYes
2018: MARSHALL MEDICAL CENTER HEALTH & WELFARE PLAN 2018 form 5500 responses
2018-11-01Type of plan entitySingle employer plan
2018-11-01Plan funding arrangement – InsuranceYes
2018-11-01Plan funding arrangement – General assets of the sponsorYes
2018-11-01Plan benefit arrangement – InsuranceYes
2018-11-01Plan benefit arrangement – General assets of the sponsorYes
2017: MARSHALL MEDICAL CENTER HEALTH & WELFARE PLAN 2017 form 5500 responses
2017-11-01Type of plan entitySingle employer plan
2017-11-01First time form 5500 has been submittedYes
2017-11-01Plan funding arrangement – InsuranceYes
2017-11-01Plan funding arrangement – General assets of the sponsorYes
2017-11-01Plan benefit arrangement – InsuranceYes
2017-11-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract number280667
Policy instance 3
Insurance contract or identification number280667
Number of Individuals Covered1247
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $44,064
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number617058
Policy instance 2
Insurance contract or identification number617058
Number of Individuals Covered1001
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $157,242
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number402901G
Policy instance 1
Insurance contract or identification number402901G
Number of Individuals Covered1218
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $141,691
Total amount of fees paid to insurance companyUSD $28,607
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, CRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $979,515
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $90,031
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBONUS
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract number280667
Policy instance 3
Insurance contract or identification number280667
Number of Individuals Covered1700
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $41,820
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00617058
Policy instance 2
Insurance contract or identification number00617058
Number of Individuals Covered993
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $161,082
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number402901G
Policy instance 1
Insurance contract or identification number402901G
Number of Individuals Covered1240
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $149,240
Total amount of fees paid to insurance companyUSD $27,894
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, CRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $917,159
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $91,955
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBONUS
MANAGED HEALTH NETWORK (National Association of Insurance Commissioners NAIC id number: 52411 )
Policy contract number2333
Policy instance 3
Insurance contract or identification number2333
Number of Individuals Covered1588
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $35,806
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number617058
Policy instance 2
Insurance contract or identification number617058
Number of Individuals Covered1068
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $175,161
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number402901G
Policy instance 1
Insurance contract or identification number402901G
Number of Individuals Covered1250
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $156,743
Total amount of fees paid to insurance companyUSD $37,220
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, CRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $1,088,355
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $97,926
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBONUS
MANAGED HEALTH NETWORK (National Association of Insurance Commissioners NAIC id number: 52411 )
Policy contract number2333
Policy instance 3
Insurance contract or identification number2333
Number of Individuals Covered1598
Insurance policy start date2019-11-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $6,072
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number617058
Policy instance 2
Insurance contract or identification number617058
Number of Individuals Covered1131
Insurance policy start date2019-11-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $29,202
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number402901G
Policy instance 1
Insurance contract or identification number402901G
Number of Individuals Covered1257
Insurance policy start date2019-11-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $29,382
Total amount of fees paid to insurance companyUSD $21,976
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, CRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $88,349
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,506
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBONUS
MANAGED HEALTH NETWORK (National Association of Insurance Commissioners NAIC id number: 52411 )
Policy contract number2333
Policy instance 3
Insurance contract or identification number2333
Number of Individuals Covered1598
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $33,290
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number617058
Policy instance 2
Insurance contract or identification number617058
Number of Individuals Covered1108
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $174,576
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number402901G
Policy instance 1
Insurance contract or identification number402901G
Number of Individuals Covered1251
Insurance policy start date2018-11-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $86,651
Total amount of fees paid to insurance companyUSD $82,431
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $904,830
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees46415
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
MANAGED HEALTH NETWORK (National Association of Insurance Commissioners NAIC id number: 52411 )
Policy contract number005928
Policy instance 3
Insurance contract or identification number005928
Number of Individuals Covered1554
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $35,600
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00617058
Policy instance 2
Insurance contract or identification number00617058
Number of Individuals Covered1102
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $167,744
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number402901G
Policy instance 1
Insurance contract or identification number402901G
Number of Individuals Covered1236
Insurance policy start date2017-11-01
Insurance policy end date2018-10-31
Total amount of commissions paid to insurance brokerUSD $85,433
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $643,492
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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