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KINGSBROOK JEWISH MEDICAL CENTER MEDICAL INSURANCE PLAN 401k Plan overview

Plan NameKINGSBROOK JEWISH MEDICAL CENTER MEDICAL INSURANCE PLAN
Plan identification number 504

KINGSBROOK JEWISH MEDICAL CENTER MEDICAL INSURANCE PLAN Benefits

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

401k Sponsoring company profile

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

Company Name:KINGSBROOK JEWISH MEDICAL CENTER
Employer identification number (EIN):121631759
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KINGSBROOK JEWISH MEDICAL CENTER MEDICAL INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042020-06-01
5042020-06-01
5042019-06-01
5042017-06-01MICHELE FLOURNOY
5042016-06-01MICHELE FLOURNOY
5042015-06-01AMECIA GROOMSTER

Plan Statistics for KINGSBROOK JEWISH MEDICAL CENTER MEDICAL INSURANCE PLAN

401k plan membership statisitcs for KINGSBROOK JEWISH MEDICAL CENTER MEDICAL INSURANCE PLAN

Measure Date Value
2020: KINGSBROOK JEWISH MEDICAL CENTER MEDICAL INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year2020-06-01293
Total number of active participants reported on line 7a of the Form 55002020-06-01237
Number of retired or separated participants receiving benefits2020-06-0134
Number of other retired or separated participants entitled to future benefits2020-06-010
Total of all active and inactive participants2020-06-01271
2019: KINGSBROOK JEWISH MEDICAL CENTER MEDICAL INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year2019-06-01294
Total number of active participants reported on line 7a of the Form 55002019-06-01267
Number of retired or separated participants receiving benefits2019-06-0126
Number of other retired or separated participants entitled to future benefits2019-06-010
Total of all active and inactive participants2019-06-01293
2017: KINGSBROOK JEWISH MEDICAL CENTER MEDICAL INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-06-01307
Total number of active participants reported on line 7a of the Form 55002017-06-01282
Number of retired or separated participants receiving benefits2017-06-0117
Number of other retired or separated participants entitled to future benefits2017-06-010
Total of all active and inactive participants2017-06-01299
2016: KINGSBROOK JEWISH MEDICAL CENTER MEDICAL INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-06-01308
Total number of active participants reported on line 7a of the Form 55002016-06-01313
Number of retired or separated participants receiving benefits2016-06-0120
Number of other retired or separated participants entitled to future benefits2016-06-010
Total of all active and inactive participants2016-06-01333
2015: KINGSBROOK JEWISH MEDICAL CENTER MEDICAL INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-06-01309
Total number of active participants reported on line 7a of the Form 55002015-06-01290
Number of retired or separated participants receiving benefits2015-06-010
Number of other retired or separated participants entitled to future benefits2015-06-010
Total of all active and inactive participants2015-06-01290

Form 5500 Responses for KINGSBROOK JEWISH MEDICAL CENTER MEDICAL INSURANCE PLAN

2020: KINGSBROOK JEWISH MEDICAL CENTER MEDICAL INSURANCE PLAN 2020 form 5500 responses
2020-06-01Type of plan entitySingle employer plan
2020-06-01Submission has been amendedNo
2020-06-01This submission is the final filingNo
2020-06-01This return/report is a short plan year return/report (less than 12 months)No
2020-06-01Plan is a collectively bargained planNo
2020-06-01Plan funding arrangement – InsuranceYes
2020-06-01Plan benefit arrangement – InsuranceYes
2019: KINGSBROOK JEWISH MEDICAL CENTER MEDICAL INSURANCE PLAN 2019 form 5500 responses
2019-06-01Type of plan entitySingle employer plan
2019-06-01Submission has been amendedNo
2019-06-01This submission is the final filingNo
2019-06-01This return/report is a short plan year return/report (less than 12 months)No
2019-06-01Plan is a collectively bargained planNo
2019-06-01Plan funding arrangement – InsuranceYes
2019-06-01Plan benefit arrangement – InsuranceYes
2017: KINGSBROOK JEWISH MEDICAL CENTER MEDICAL INSURANCE PLAN 2017 form 5500 responses
2017-06-01Type of plan entitySingle employer plan
2017-06-01Submission has been amendedNo
2017-06-01This submission is the final filingNo
2017-06-01This return/report is a short plan year return/report (less than 12 months)No
2017-06-01Plan is a collectively bargained planNo
2017-06-01Plan funding arrangement – InsuranceYes
2017-06-01Plan benefit arrangement – InsuranceYes
2016: KINGSBROOK JEWISH MEDICAL CENTER MEDICAL INSURANCE PLAN 2016 form 5500 responses
2016-06-01Type of plan entitySingle employer plan
2016-06-01Submission has been amendedNo
2016-06-01This submission is the final filingNo
2016-06-01This return/report is a short plan year return/report (less than 12 months)No
2016-06-01Plan is a collectively bargained planNo
2016-06-01Plan funding arrangement – InsuranceYes
2016-06-01Plan benefit arrangement – InsuranceYes
2015: KINGSBROOK JEWISH MEDICAL CENTER MEDICAL INSURANCE PLAN 2015 form 5500 responses
2015-06-01Type of plan entitySingle employer plan
2015-06-01Submission has been amendedNo
2015-06-01This submission is the final filingNo
2015-06-01This return/report is a short plan year return/report (less than 12 months)No
2015-06-01Plan is a collectively bargained planNo
2015-06-01Plan funding arrangement – InsuranceYes
2015-06-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number197030
Policy instance 1
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 )
Policy contract number197030
Policy instance 1

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