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BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL 401k Plan overview

Plan NameBROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL
Plan identification number 503

BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Vision

401k Sponsoring company profile

LICH AT NYU LANGONE HEALTH has sponsored the creation of one or more 401k plans.

Company Name:LICH AT NYU LANGONE HEALTH
Employer identification number (EIN):111704595
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032023-01-01
5032022-01-01
5032021-01-01THALIA ANTHONY2022-04-26
5032020-01-01JESSICA TERRANOVA2021-04-05
5032019-01-01PATRICIA WHITE2020-06-16
5032018-01-01
5032017-01-01
5032016-01-01
5032015-01-01
5032015-01-01PATRICIA M. WHITE2018-11-07
5032014-01-01BRENDA FARRELL
5032014-01-01PATRICIA M. WHITE2018-11-09
5032013-01-01BRENDA FARRELL
5032012-01-01BRENDA FARRELL
5032011-01-01BRENDA FARRELL
5032009-01-01VIRGINIA RAFFAELE

Plan Statistics for BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL

401k plan membership statisitcs for BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL

Measure Date Value
2023: BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL 2023 401k membership
Total participants, beginning-of-year2023-01-01557
Total number of active participants reported on line 7a of the Form 55002023-01-01563
Number of retired or separated participants receiving benefits2023-01-018
Number of other retired or separated participants entitled to future benefits2023-01-0126
Total of all active and inactive participants2023-01-01597
2022: BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL 2022 401k membership
Total participants, beginning-of-year2022-01-01617
Total number of active participants reported on line 7a of the Form 55002022-01-01534
Number of retired or separated participants receiving benefits2022-01-013
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01537
Total participants2022-01-01537
Number of employers contributing to the scheme2022-01-010
2021: BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL 2021 401k membership
Total participants, beginning-of-year2021-01-01721
Total number of active participants reported on line 7a of the Form 55002021-01-01619
Number of retired or separated participants receiving benefits2021-01-0111
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01630
Number of employers contributing to the scheme2021-01-010
2020: BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL 2020 401k membership
Total participants, beginning-of-year2020-01-01844
Total number of active participants reported on line 7a of the Form 55002020-01-01762
Number of retired or separated participants receiving benefits2020-01-017
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01769
Number of employers contributing to the scheme2020-01-010
2019: BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL 2019 401k membership
Total participants, beginning-of-year2019-01-011,385
Total number of active participants reported on line 7a of the Form 55002019-01-011,361
Number of retired or separated participants receiving benefits2019-01-013
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-011,364
Number of employers contributing to the scheme2019-01-010
2018: BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL 2018 401k membership
Total participants, beginning-of-year2018-01-011,365
Total number of active participants reported on line 7a of the Form 55002018-01-011,365
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-011,365
Number of employers contributing to the scheme2018-01-010
2017: BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL 2017 401k membership
Total participants, beginning-of-year2017-01-011,365
Total number of active participants reported on line 7a of the Form 55002017-01-011,365
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-011,365
2016: BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL 2016 401k membership
Total participants, beginning-of-year2016-01-011,290
Total number of active participants reported on line 7a of the Form 55002016-01-011,365
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 participants2016-01-011,365
2015: BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL 2015 401k membership
Total participants, beginning-of-year2015-01-011,384
Total number of active participants reported on line 7a of the Form 55002015-01-011,282
Number of retired or separated participants receiving benefits2015-01-018
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-011,290
2014: BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL 2014 401k membership
Total participants, beginning-of-year2014-01-011,450
Total number of active participants reported on line 7a of the Form 55002014-01-011,378
Number of retired or separated participants receiving benefits2014-01-016
Number of other retired or separated participants entitled to future benefits2014-01-011
Total of all active and inactive participants2014-01-011,385
2013: BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL 2013 401k membership
Total participants, beginning-of-year2013-01-011,441
Total number of active participants reported on line 7a of the Form 55002013-01-011,461
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 participants2013-01-011,461
2012: BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL 2012 401k membership
Total participants, beginning-of-year2012-01-011,444
Total number of active participants reported on line 7a of the Form 55002012-01-011,441
Total of all active and inactive participants2012-01-011,441
Total participants2012-01-011,441
2011: BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL 2011 401k membership
Total participants, beginning-of-year2011-01-011,512
Total number of active participants reported on line 7a of the Form 55002011-01-011,444
Total of all active and inactive participants2011-01-011,444
Total participants2011-01-011,444
2009: BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL 2009 401k membership
Total participants, beginning-of-year2009-01-011,468
Total number of active participants reported on line 7a of the Form 55002009-01-011,527
Total of all active and inactive participants2009-01-011,527
Total participants2009-01-011,527

Form 5500 Responses for BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL

2023: BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL 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 filingNo
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 – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL 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 – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL 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 – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
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 – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: BROOKHAVEN MEMORIAL HOSPITAL WELFARE PLAN GROUP MEDICAL 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 )
Policy contract numberG1922
Policy instance 1
Insurance contract or identification numberG1922
Number of Individuals Covered0
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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 BenefitYes
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
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 $8,930
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number721020
Policy instance 2
Insurance contract or identification number721020
Number of Individuals Covered3160
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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
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 $1,130,414
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 )
Policy contract numberG1922
Policy instance 1
Insurance contract or identification numberG1922
Number of Individuals Covered3509
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $229,909
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 BenefitYes
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
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 $11,362,481
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $98,734
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameEMERSON REID & COMPANY INC
WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 )
Policy contract numberG1922
Policy instance 1
Insurance contract or identification numberG1922
Number of Individuals Covered1461
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $319,766
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 BenefitYes
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
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $245,651
Insurance broker nameEMERSON REID & COMPANY INC
WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 )
Policy contract numberG1922
Policy instance 1
Insurance contract or identification numberG1922
Number of Individuals Covered1441
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $942,346
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,755,347
Commission paid to Insurance BrokerUSD $367,575
Insurance broker nameTSG FINANCIAL LLC
WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 )
Policy contract numberG1922
Policy instance 1
Insurance contract or identification numberG1922
Number of Individuals Covered1455
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $904,447
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,502,025
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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