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PROMISE HEALTHCARE, INC. MEDICAL PLAN 401k Plan overview

Plan NamePROMISE HEALTHCARE, INC. MEDICAL PLAN
Plan identification number 512

PROMISE HEALTHCARE, INC. MEDICAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Temporary disability (accident and sickness)
  • Other welfare benefit cover

401k Sponsoring company profile

PROMISE HEALTHCARE, INC. has sponsored the creation of one or more 401k plans.

Company Name:PROMISE HEALTHCARE, INC.
Employer identification number (EIN):141887953
NAIC Classification:622000
NAIC Description: Hospitals

Additional information about PROMISE HEALTHCARE, INC.

Jurisdiction of Incorporation: Florida Department of State Division of Corporations
Incorporation Date: 2003-05-30
Company Identification Number: P03000059552
Legal Registered Office Address: 1201 HAYS STREET

TALLAHASSEE

32301

More information about PROMISE HEALTHCARE, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PROMISE HEALTHCARE, INC. MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5122014-06-01DAVID ARMSTRONG
5122013-06-01DAVID ARMSTRONG
5122012-06-01DAVID J. ARMSTRONG, ESQ.
5122012-01-01DAVID J. ARMSTRONG, ESQ.
5122011-01-01DAVID J. ARMSTRONG, ESQ.

Plan Statistics for PROMISE HEALTHCARE, INC. MEDICAL PLAN

401k plan membership statisitcs for PROMISE HEALTHCARE, INC. MEDICAL PLAN

Measure Date Value
2014: PROMISE HEALTHCARE, INC. MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-06-011,320
Total number of active participants reported on line 7a of the Form 55002014-06-010
Number of retired or separated participants receiving benefits2014-06-010
Number of other retired or separated participants entitled to future benefits2014-06-010
Total of all active and inactive participants2014-06-010
2013: PROMISE HEALTHCARE, INC. MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year2013-06-011,320
Total number of active participants reported on line 7a of the Form 55002013-06-011,327
Number of retired or separated participants receiving benefits2013-06-010
Number of other retired or separated participants entitled to future benefits2013-06-010
Total of all active and inactive participants2013-06-011,327
2012: PROMISE HEALTHCARE, INC. MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year2012-06-01773
Total number of active participants reported on line 7a of the Form 55002012-06-011,320
Total of all active and inactive participants2012-06-011,320
Total participants2012-06-011,320
Total participants, beginning-of-year2012-01-01859
Total number of active participants reported on line 7a of the Form 55002012-01-01773
Total of all active and inactive participants2012-01-01773
2011: PROMISE HEALTHCARE, INC. MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01859
Total number of active participants reported on line 7a of the Form 55002011-01-01859
Total of all active and inactive participants2011-01-01859

Form 5500 Responses for PROMISE HEALTHCARE, INC. MEDICAL PLAN

2014: PROMISE HEALTHCARE, INC. MEDICAL PLAN 2014 form 5500 responses
2014-06-01Type of plan entitySingle employer plan
2014-06-01Submission has been amendedNo
2014-06-01This submission is the final filingYes
2014-06-01This return/report is a short plan year return/report (less than 12 months)No
2014-06-01Plan is a collectively bargained planNo
2014-06-01Plan funding arrangement – InsuranceYes
2014-06-01Plan benefit arrangement – InsuranceYes
2013: PROMISE HEALTHCARE, INC. MEDICAL PLAN 2013 form 5500 responses
2013-06-01Type of plan entitySingle employer plan
2013-06-01Submission has been amendedYes
2013-06-01This submission is the final filingNo
2013-06-01This return/report is a short plan year return/report (less than 12 months)No
2013-06-01Plan is a collectively bargained planNo
2013-06-01Plan funding arrangement – InsuranceYes
2013-06-01Plan benefit arrangement – InsuranceYes
2012: PROMISE HEALTHCARE, INC. MEDICAL PLAN 2012 form 5500 responses
2012-06-01Type of plan entitySingle employer plan
2012-06-01Plan funding arrangement – InsuranceYes
2012-06-01Plan benefit arrangement – InsuranceYes
2012-01-01Type of plan entitySingle employer plan
2012-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: PROMISE HEALTHCARE, INC. MEDICAL PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01First time form 5500 has been submittedYes
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3651890
Policy instance 1
Insurance contract or identification numberE3651890
Number of Individuals Covered1312
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $242,047
Total amount of fees paid to insurance companyUSD $75,934
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 BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedCANCER, CRITICAL ILLNESS HOSPITAL CONFINMENT
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 $888,589
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $85,107
Amount paid for insurance broker fees19803
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameMELAINE LOU ROBBINS
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3651890
Policy instance 1
Insurance contract or identification numberE3651890
Number of Individuals Covered578
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $101,551
Total amount of fees paid to insurance companyUSD $38,139
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 BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedCANCER/CI/HOSP CONFIN
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 $380,513
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $77,810
Amount paid for insurance broker fees18659
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker organization code?3
Insurance broker nameMELAINE LOU ROBBINS
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3638806
Policy instance 2
Insurance contract or identification numberE3638806
Number of Individuals Covered749
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $110,196
Total amount of fees paid to insurance companyUSD $43,784
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 BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedCANCER/CI/HOSP CONFIN
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 $403,338
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3651890
Policy instance 1
Insurance contract or identification numberE3651890
Number of Individuals Covered693
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Total amount of commissions paid to insurance brokerUSD $112,187
Total amount of fees paid to insurance companyUSD $36,084
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedCANCER/CI/HOSP CONFIN
Welfare Benefit Premiums Paid to CarrierUSD $309,964
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $45,883
Amount paid for insurance broker fees9777
Insurance broker organization code?3
Insurance broker nameLISA LAWSON
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3638806
Policy instance 2
Insurance contract or identification numberE3638806
Number of Individuals Covered627
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Total amount of commissions paid to insurance brokerUSD $128,963
Total amount of fees paid to insurance companyUSD $43,723
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedCANCER/CI/HOSP CONFIN
Welfare Benefit Premiums Paid to CarrierUSD $354,016
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $54,954
Amount paid for insurance broker fees11710
Insurance broker nameANN ASCANI
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3651890
Policy instance 1
Insurance contract or identification numberE3651890
Number of Individuals Covered392
Insurance policy start date2012-01-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $36,561
Total amount of fees paid to insurance companyUSD $8,870
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedCANCER/CI/HOSP CONFIN
Welfare Benefit Premiums Paid to CarrierUSD $170,357
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,388
Amount paid for insurance broker fees4082
Insurance broker organization code?3
Insurance broker nameANDRE JONATHAN TODD
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3638806
Policy instance 2
Insurance contract or identification numberE3638806
Number of Individuals Covered381
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $58,346
Total amount of fees paid to insurance companyUSD $8,607
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedCANCER/CI/HOSP CONFIN
Welfare Benefit Premiums Paid to CarrierUSD $199,811
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,559
Amount paid for insurance broker fees1343
Insurance broker nameDAVID ARTHUR RACKLIFFE
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3651890
Policy instance 1
Insurance contract or identification numberE3651890
Number of Individuals Covered426
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $72,926
Total amount of fees paid to insurance companyUSD $53,396
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedCANCER
Welfare Benefit Premiums Paid to CarrierUSD $159,781
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3638806
Policy instance 2
Insurance contract or identification numberE3638806
Number of Individuals Covered433
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $80,280
Total amount of fees paid to insurance companyUSD $62,960
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedCANCER
Welfare Benefit Premiums Paid to CarrierUSD $214,970
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes

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