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SHORT TERM AND LONG TERM DISABILITY INSURANCE 401k Plan overview

Plan NameSHORT TERM AND LONG TERM DISABILITY INSURANCE
Plan identification number 503

SHORT TERM AND LONG TERM DISABILITY INSURANCE Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Temporary disability (accident and sickness)
  • Long-term disability cover

401k Sponsoring company profile

PATHOLOGY MEDICAL SERVICES, P.C. has sponsored the creation of one or more 401k plans.

Company Name:PATHOLOGY MEDICAL SERVICES, P.C.
Employer identification number (EIN):470549869
NAIC Classification:621510
NAIC Description: Medical and Diagnostic Laboratories

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SHORT TERM AND LONG TERM DISABILITY INSURANCE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032016-01-01RYAN DEHAAN RYAN DEHAAN2017-10-03
5032015-01-01RYAN DEHAAN RYAN DEHAAN2016-09-06
5032014-01-01DEBORAH K. DAVIDSON DEBORAH K. DAVIDSON2015-10-03
5032013-01-01DEBORAH K. DAVIDSON DEBORAH K. DAVIDSON2014-10-06
5032012-01-01DEBORAH K. DAVIDSON DEBORAH K. DAVIDSON2013-10-09
5032011-01-01DEBORAH K. DAVIDSON DEBORAH K. DAVIDSON2012-10-11
5032009-01-01DEBORAH K. DAVIDSON DEBORAH K. DAVIDSON2010-10-12

Plan Statistics for SHORT TERM AND LONG TERM DISABILITY INSURANCE

401k plan membership statisitcs for SHORT TERM AND LONG TERM DISABILITY INSURANCE

Measure Date Value
2016: SHORT TERM AND LONG TERM DISABILITY INSURANCE 2016 401k membership
Total participants, beginning-of-year2016-01-01199
Total number of active participants reported on line 7a of the Form 55002016-01-0113
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-0113
2015: SHORT TERM AND LONG TERM DISABILITY INSURANCE 2015 401k membership
Total participants, beginning-of-year2015-01-01196
Total number of active participants reported on line 7a of the Form 55002015-01-01199
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01199
2014: SHORT TERM AND LONG TERM DISABILITY INSURANCE 2014 401k membership
Total participants, beginning-of-year2014-01-01198
Total number of active participants reported on line 7a of the Form 55002014-01-01196
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01196
2013: SHORT TERM AND LONG TERM DISABILITY INSURANCE 2013 401k membership
Total participants, beginning-of-year2013-01-01180
Total number of active participants reported on line 7a of the Form 55002013-01-01198
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 participants2013-01-01198
2012: SHORT TERM AND LONG TERM DISABILITY INSURANCE 2012 401k membership
Total participants, beginning-of-year2012-01-01171
Total number of active participants reported on line 7a of the Form 55002012-01-01180
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 participants2012-01-01180
2011: SHORT TERM AND LONG TERM DISABILITY INSURANCE 2011 401k membership
Total participants, beginning-of-year2011-01-01145
Total number of active participants reported on line 7a of the Form 55002011-01-01171
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01171
2009: SHORT TERM AND LONG TERM DISABILITY INSURANCE 2009 401k membership
Total participants, beginning-of-year2009-01-01145
Total number of active participants reported on line 7a of the Form 55002009-01-01145
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 participants2009-01-01145

Form 5500 Responses for SHORT TERM AND LONG TERM DISABILITY INSURANCE

2016: SHORT TERM AND LONG TERM DISABILITY INSURANCE 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01This submission is the final filingYes
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: SHORT TERM AND LONG TERM DISABILITY INSURANCE 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: SHORT TERM AND LONG TERM DISABILITY INSURANCE 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: SHORT TERM AND LONG TERM DISABILITY INSURANCE 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: SHORT TERM AND LONG TERM DISABILITY INSURANCE 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: SHORT TERM AND LONG TERM DISABILITY INSURANCE 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: SHORT TERM AND LONG TERM DISABILITY INSURANCE 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number038105G
Policy instance 1
Insurance contract or identification number038105G
Number of Individuals Covered199
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $10,861
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $108,607
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,861
Insurance broker organization code?3
Insurance broker nameFIRST INS GROUP LLC
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number038105G
Policy instance 1
Insurance contract or identification number038105G
Number of Individuals Covered196
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $10,441
Total amount of fees paid to insurance companyUSD $1,344
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $104,353
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,435
Insurance broker organization code?3
Amount paid for insurance broker fees1344
Additional information about fees paid to insurance brokerCONTINGENT COMPENSATION (BONUS) PAID TO BROKER BY HARTFORD
Insurance broker nameBENEFIT ADMINISTRATORS INC
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number038105G
Policy instance 1
Insurance contract or identification number038105G
Number of Individuals Covered198
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $10,749
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $107,487
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,749
Insurance broker organization code?3
Insurance broker nameFIRST INS GROUP LLC
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number038105G
Policy instance 1
Insurance contract or identification number038105G
Number of Individuals Covered180
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $17,172
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $176,401
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,995
Insurance broker organization code?3
Insurance broker nameFIRST INS GROUP LLC
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number038105G
Policy instance 1
Insurance contract or identification number038105G
Number of Individuals Covered171
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $15,787
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $153,193
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 number038105G
Policy instance 1
Insurance contract or identification number038105G
Number of Individuals Covered145
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $14,821
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $151,365
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,821
Insurance broker organization code?3
Insurance broker nameBENEFIT ADMIN INC

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