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NORTHWESTERN MEDICAL CENTER, INC. ACCIDENT PLAN 401k Plan overview

Plan NameNORTHWESTERN MEDICAL CENTER, INC. ACCIDENT PLAN
Plan identification number 507

NORTHWESTERN MEDICAL CENTER, INC. ACCIDENT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Other welfare benefit cover

401k Sponsoring company profile

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

Company Name:NORTHWESTERN MEDICAL CENTER
Employer identification number (EIN):030266986
NAIC Classification:621491
NAIC Description:HMO Medical Centers

Additional information about NORTHWESTERN MEDICAL CENTER

Jurisdiction of Incorporation: Vermont Secretary of State Corporations Division
Incorporation Date: 1977-09-30
Company Identification Number: 43873
Legal Registered Office Address: 133 FAIRFIELD ST

ST. ALBANS
United States of America (USA)
05478

More information about NORTHWESTERN MEDICAL CENTER

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTHWESTERN MEDICAL CENTER, INC. ACCIDENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5072015-01-01CHRISTOPHER HICKEY CHRISTOPHER HICKEY2016-05-26
5072014-01-01TED SIROTTA TED SIROTTA2015-07-09
5072013-01-01TED SIROTTA TED SIROTTA2014-07-29
5072012-01-01TED SIROTTA

Plan Statistics for NORTHWESTERN MEDICAL CENTER, INC. ACCIDENT PLAN

401k plan membership statisitcs for NORTHWESTERN MEDICAL CENTER, INC. ACCIDENT PLAN

Measure Date Value
2015: NORTHWESTERN MEDICAL CENTER, INC. ACCIDENT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01137
Total number of active participants reported on line 7a of the Form 55002015-01-010
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 participants2015-01-010
2014: NORTHWESTERN MEDICAL CENTER, INC. ACCIDENT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01142
Total number of active participants reported on line 7a of the Form 55002014-01-01137
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 participants2014-01-01137
2013: NORTHWESTERN MEDICAL CENTER, INC. ACCIDENT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01158
Total number of active participants reported on line 7a of the Form 55002013-01-01142
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 participants2013-01-01142
2012: NORTHWESTERN MEDICAL CENTER, INC. ACCIDENT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-010
Total number of active participants reported on line 7a of the Form 55002012-01-01158
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 participants2012-01-01158

Form 5500 Responses for NORTHWESTERN MEDICAL CENTER, INC. ACCIDENT PLAN

2015: NORTHWESTERN MEDICAL CENTER, INC. ACCIDENT PLAN 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 filingYes
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 benefit arrangement – InsuranceYes
2014: NORTHWESTERN MEDICAL CENTER, INC. ACCIDENT PLAN 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 benefit arrangement – InsuranceYes
2013: NORTHWESTERN MEDICAL CENTER, INC. ACCIDENT PLAN 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 benefit arrangement – InsuranceYes
2012: NORTHWESTERN MEDICAL CENTER, INC. ACCIDENT PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01First time form 5500 has been submittedYes
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

Insurance Providers Used on plan

PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0001935093
Policy instance 1
Insurance contract or identification number0001935093
Number of Individuals Covered121
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $850
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $35,391
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $850
Insurance broker organization code?3
Insurance broker nameTHE RICHARDS GROUP
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0001935093
Policy instance 1
Insurance contract or identification number0001935093
Number of Individuals Covered137
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $2,387
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $40,410
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,387
Insurance broker organization code?3
Insurance broker nameTHE RICHARDS GROUP
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0001935093
Policy instance 1
Insurance contract or identification number0001935093
Number of Individuals Covered142
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,561
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $38,726
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,561
Insurance broker organization code?3
Insurance broker nameTHE RICHARDS GROUP
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number1935093
Policy instance 1
Insurance contract or identification number1935093
Number of Individuals Covered158
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $6,677
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 providedACCIDENT
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 $46,871
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,677
Insurance broker organization code?3
Insurance broker nameRICHARDS INC

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