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| Plan Name | SCPMG SHORT TERM DISABILITY PLAN |
| Plan identification number | 508 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP |
| Employer identification number (EIN): | 951750445 |
| NAIC Classification: | 621112 |
| NAIC Description: | Offices of Physicians, Mental Health Specialists |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 508 | 2014-01-01 | DOUGLAS KILLION | |||
| 508 | 2014-01-01 | DOUGLAS KILLION | |||
| 508 | 2013-01-01 | DOUGLAS KILLION | |||
| 508 | 2012-01-01 | DOUGLAS KILLION | |||
| 508 | 2011-01-01 | VIRGINIA AMBROSINI | |||
| 508 | 2009-01-01 | REGINALD CYRUS | |||
| 508 | 2009-01-01 | REGINALD CYRUS | 2010-10-08 |
| Measure | Date | Value |
|---|---|---|
| 2014: SCPMG SHORT TERM DISABILITY PLAN 2014 401k membership | ||
| Total participants, beginning-of-year | 2014-01-01 | 1,409 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 1,269 |
| Total of all active and inactive participants | 2014-01-01 | 1,269 |
| Total participants | 2014-01-01 | 1,269 |
| 2013: SCPMG SHORT TERM DISABILITY PLAN 2013 401k membership | ||
| Total participants, beginning-of-year | 2013-01-01 | 2,194 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 1,409 |
| Total of all active and inactive participants | 2013-01-01 | 1,409 |
| Total participants | 2013-01-01 | 1,409 |
| 2012: SCPMG SHORT TERM DISABILITY PLAN 2012 401k membership | ||
| Total participants, beginning-of-year | 2012-01-01 | 2,129 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 2,194 |
| Total of all active and inactive participants | 2012-01-01 | 2,194 |
| Total participants | 2012-01-01 | 2,194 |
| 2011: SCPMG SHORT TERM DISABILITY PLAN 2011 401k membership | ||
| Total participants, beginning-of-year | 2011-01-01 | 1,848 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 2,129 |
| Total of all active and inactive participants | 2011-01-01 | 2,129 |
| Total participants | 2011-01-01 | 2,129 |
| 2009: SCPMG SHORT TERM DISABILITY PLAN 2009 401k membership | ||
| Total participants, beginning-of-year | 2009-01-01 | 1,890 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 1,832 |
| Total of all active and inactive participants | 2009-01-01 | 1,832 |
| Total participants | 2009-01-01 | 1,832 |
| 2014: SCPMG SHORT TERM DISABILITY PLAN 2014 form 5500 responses | ||
|---|---|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Submission has been amended | No |
| 2014-01-01 | This submission is the final filing | No |
| 2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-01-01 | Plan is a collectively bargained plan | No |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: SCPMG SHORT TERM DISABILITY PLAN 2013 form 5500 responses | ||
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Submission has been amended | No |
| 2013-01-01 | This submission is the final filing | No |
| 2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-01-01 | Plan is a collectively bargained plan | No |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: SCPMG SHORT TERM DISABILITY PLAN 2012 form 5500 responses | ||
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Submission has been amended | No |
| 2012-01-01 | This submission is the final filing | No |
| 2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-01-01 | Plan is a collectively bargained plan | No |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: SCPMG SHORT TERM DISABILITY PLAN 2011 form 5500 responses | ||
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Submission has been amended | No |
| 2011-01-01 | This submission is the final filing | No |
| 2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-01-01 | Plan is a collectively bargained plan | No |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: SCPMG SHORT TERM DISABILITY PLAN 2009 form 5500 responses | ||
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Submission has been amended | Yes |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-01-01 | Plan is a collectively bargained plan | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | LK 020199 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | LK 020199 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | LK020199 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | LK020199 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | LK 020199 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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