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CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN 401k Plan overview

Plan NameCASEY COUNTY HOSPITAL LIFE INSURANCE PLAN
Plan identification number 503

CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

CASEY COUNTY HOSPITAL DISTRICT has sponsored the creation of one or more 401k plans.

Company Name:CASEY COUNTY HOSPITAL DISTRICT
Employer identification number (EIN):061705652
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032023-07-01
5032023-07-01RICHARD HENDERSHOT
5032022-07-01
5032022-07-01RICHARD HENDERSHOT
5032021-07-01
5032021-07-01RICHARD HENDERSHOT
5032019-07-01
5032019-07-01RICHARD HENDERSHOT
5032014-07-01RICHARD HENDERSHOT
5032013-07-01RICHARD HENDERSHOT
5032012-07-01REX TUNGATE
5032011-07-01RICHARD HENDERSHOT
5032009-07-01REX TUNGATE

Plan Statistics for CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN

401k plan membership statisitcs for CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN

Measure Date Value
2023: CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN 2023 401k membership
Total participants, beginning-of-year2023-07-01165
Total number of active participants reported on line 7a of the Form 55002023-07-01197
Number of retired or separated participants receiving benefits2023-07-010
Number of other retired or separated participants entitled to future benefits2023-07-010
Total of all active and inactive participants2023-07-01197
2022: CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN 2022 401k membership
Total participants, beginning-of-year2022-07-01180
Total number of active participants reported on line 7a of the Form 55002022-07-01194
Number of retired or separated participants receiving benefits2022-07-010
Number of other retired or separated participants entitled to future benefits2022-07-010
Total of all active and inactive participants2022-07-01194
Total participants2022-07-01194
2021: CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year2021-07-01179
Total number of active participants reported on line 7a of the Form 55002021-07-011,860
Number of retired or separated participants receiving benefits2021-07-010
Number of other retired or separated participants entitled to future benefits2021-07-010
Total of all active and inactive participants2021-07-011,860
2019: CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-01172
Total number of active participants reported on line 7a of the Form 55002019-07-01165
Number of retired or separated participants receiving benefits2019-07-010
Number of other retired or separated participants entitled to future benefits2019-07-010
Total of all active and inactive participants2019-07-01165
2014: CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-010
Total of all active and inactive participants2014-07-010
Total participants2014-07-010
2013: CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-01139
Total number of active participants reported on line 7a of the Form 55002013-07-01151
Number of retired or separated participants receiving benefits2013-07-010
Number of other retired or separated participants entitled to future benefits2013-07-010
Total of all active and inactive participants2013-07-01151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-07-010
Total participants2013-07-01151
Number of participants with account balances2013-07-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-07-010
2012: CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-07-01134
Total number of active participants reported on line 7a of the Form 55002012-07-01139
Number of retired or separated participants receiving benefits2012-07-010
Number of other retired or separated participants entitled to future benefits2012-07-010
Total of all active and inactive participants2012-07-01139
2011: CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-07-01127
Total number of active participants reported on line 7a of the Form 55002011-07-01134
Total of all active and inactive participants2011-07-01134
Total participants2011-07-01134
2009: CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-07-01103
Total number of active participants reported on line 7a of the Form 55002009-07-01111
Total of all active and inactive participants2009-07-01111
Total participants2009-07-01111

Financial Data on CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN

Measure Date Value
2024 : CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN 2024 401k financial data
Total income from all sources2024-06-30$58,925
Expenses. Total of all expenses incurred2024-06-30$58,925
Benefits paid (including direct rollovers)2024-06-30$58,925
Total plan assets at end of year2024-06-30$0
Total plan assets at beginning of year2024-06-30$0
Net plan assets at end of year (total assets less liabilities)2024-06-30$0
Net plan assets at beginning of year (total assets less liabilities)2024-06-30$0
Total contributions received or receivable from employer(s)2024-06-30$58,925
2023 : CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN 2023 401k financial data
Total income from all sources2023-06-30$0
Total plan assets at end of year2023-06-30$0
Total plan assets at beginning of year2023-06-30$0
Net plan assets at end of year (total assets less liabilities)2023-06-30$0
Net plan assets at beginning of year (total assets less liabilities)2023-06-30$0
2022 : CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN 2022 401k financial data
Total income from all sources2022-06-30$0
Total plan assets at end of year2022-06-30$0
Total plan assets at beginning of year2022-06-30$0
Net plan assets at end of year (total assets less liabilities)2022-06-30$0
Net plan assets at beginning of year (total assets less liabilities)2022-06-30$0
2020 : CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN 2020 401k financial data
Total income from all sources2020-06-30$0
Total plan assets at end of year2020-06-30$0
Total plan assets at beginning of year2020-06-30$0
Net plan assets at end of year (total assets less liabilities)2020-06-30$0
Net plan assets at beginning of year (total assets less liabilities)2020-06-30$0
2019 : CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN 2019 401k financial data
Total income from all sources2019-06-30$0
Total plan assets at end of year2019-06-30$0
Total plan assets at beginning of year2019-06-30$0
Net plan assets at end of year (total assets less liabilities)2019-06-30$0
Net plan assets at beginning of year (total assets less liabilities)2019-06-30$0
2015 : CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN 2015 401k financial data
Value of total assets at end of year2015-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-06-30No
Was this plan covered by a fidelity bond2015-06-30No
If this is an individual account plan, was there a blackout period2015-06-30No
Were there any nonexempt tranactions with any party-in-interest2015-06-30No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-06-30No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2015-06-30No
Were any leases to which the plan was party in default or uncollectible2015-06-30No
Value of interest in common/collective trusts at end of year2015-06-30$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-06-30No
Was there a failure to transmit to the plan any participant contributions2015-06-30No
Has the plan failed to provide any benefit when due under the plan2015-06-30No
Did the plan have assets held for investment2015-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-06-30No
2011 : CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN 2011 401k financial data
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-06-30No
Was this plan covered by a fidelity bond2011-06-30No
Were there any nonexempt tranactions with any party-in-interest2011-06-30No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-06-30No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2011-06-30No
Were any leases to which the plan was party in default or uncollectible2011-06-30No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-06-30No
Was there a failure to transmit to the plan any participant contributions2011-06-30No
Has the plan failed to provide any benefit when due under the plan2011-06-30No
Did the plan have assets held for investment2011-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-06-30No

Form 5500 Responses for CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN

2023: CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN 2023 form 5500 responses
2023-07-01Type of plan entitySingle employer plan
2023-07-01Plan funding arrangement – InsuranceYes
2023-07-01Plan benefit arrangement – InsuranceYes
2022: CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN 2022 form 5500 responses
2022-07-01Type of plan entitySingle employer plan
2022-07-01Plan funding arrangement – InsuranceYes
2022-07-01Plan benefit arrangement – InsuranceYes
2021: CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – InsuranceYes
2019: CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – InsuranceYes
2014: CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013: CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – InsuranceYes
2012: CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – InsuranceYes
2011: CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01First time form 5500 has been submittedYes
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – InsuranceYes
2009: CASEY COUNTY HOSPITAL LIFE INSURANCE PLAN 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan 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 number871206G
Policy instance 1
Insurance contract or identification number871206G
Number of Individuals Covered197
Insurance policy start date2023-07-01
Insurance policy end date2024-06-30
Total amount of commissions paid to insurance brokerUSD $6,100
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 number871206G
Policy instance 2
Insurance contract or identification number871206G
Number of Individuals Covered197
Insurance policy start date2023-07-01
Insurance policy end date2024-06-30
Long Term Disability Insurance Welfare BenefitYes
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 number871206G
Policy instance 1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number871206G
Policy instance 1
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number871206G
Policy instance 1
Insurance contract or identification number871206G
Number of Individuals Covered179
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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