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CARRIER CLINIC EMPLOYEES LIFE INSURANCE PLAN 401k Plan overview

Plan NameCARRIER CLINIC EMPLOYEES LIFE INSURANCE PLAN
Plan identification number 510

CARRIER CLINIC EMPLOYEES 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

HMH CARRIER CLINIC has sponsored the creation of one or more 401k plans.

Company Name:HMH CARRIER CLINIC
Employer identification number (EIN):221714106
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CARRIER CLINIC EMPLOYEES LIFE INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5102019-01-01MATTHEW POLIZZOTTO2020-09-08
5102018-01-01MATTHEW POLIZZOTTO2019-08-27
5102017-01-01
5102016-01-01MATTHEW POLIZZOTTO
5102015-01-01MATTHEW POLIZZOTTO
5102014-01-01DONNA MOZET
5102013-01-01DONNA MOZET
5102012-01-01DONNA MOZET
5102011-01-01DONNA MOZET
5102009-01-01DONNA MOZET

Plan Statistics for CARRIER CLINIC EMPLOYEES LIFE INSURANCE PLAN

401k plan membership statisitcs for CARRIER CLINIC EMPLOYEES LIFE INSURANCE PLAN

Measure Date Value
2019: CARRIER CLINIC EMPLOYEES LIFE INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01650
Total number of active participants reported on line 7a of the Form 55002019-01-010
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-010
Number of employers contributing to the scheme2019-01-010
2018: CARRIER CLINIC EMPLOYEES LIFE INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01650
Total number of active participants reported on line 7a of the Form 55002018-01-01650
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 participants2018-01-01650
Number of employers contributing to the scheme2018-01-010
2017: CARRIER CLINIC EMPLOYEES LIFE INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01702
Total number of active participants reported on line 7a of the Form 55002017-01-01685
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 participants2017-01-01685
2016: CARRIER CLINIC EMPLOYEES LIFE INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01567
Total number of active participants reported on line 7a of the Form 55002016-01-01702
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 participants2016-01-01702
2015: CARRIER CLINIC EMPLOYEES LIFE INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01561
Total number of active participants reported on line 7a of the Form 55002015-01-01567
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 participants2015-01-01567
2014: CARRIER CLINIC EMPLOYEES LIFE INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01499
Total number of active participants reported on line 7a of the Form 55002014-01-01561
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 participants2014-01-01561
2013: CARRIER CLINIC EMPLOYEES LIFE INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01430
Total number of active participants reported on line 7a of the Form 55002013-01-01499
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 participants2013-01-01499
2012: CARRIER CLINIC EMPLOYEES LIFE INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01545
Total number of active participants reported on line 7a of the Form 55002012-01-01418
Number of retired or separated participants receiving benefits2012-01-0112
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01430
2011: CARRIER CLINIC EMPLOYEES LIFE INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01545
Total number of active participants reported on line 7a of the Form 55002011-01-01531
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01531
2009: CARRIER CLINIC EMPLOYEES LIFE INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01464
Total number of active participants reported on line 7a of the Form 55002009-01-01519
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01519

Form 5500 Responses for CARRIER CLINIC EMPLOYEES LIFE INSURANCE PLAN

2019: CARRIER CLINIC EMPLOYEES LIFE INSURANCE PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01This submission is the final filingYes
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: CARRIER CLINIC EMPLOYEES LIFE INSURANCE PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: CARRIER CLINIC EMPLOYEES LIFE INSURANCE PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: CARRIER CLINIC EMPLOYEES LIFE INSURANCE PLAN 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 – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: CARRIER CLINIC EMPLOYEES LIFE INSURANCE 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 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 – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: CARRIER CLINIC EMPLOYEES LIFE INSURANCE 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: CARRIER CLINIC EMPLOYEES LIFE INSURANCE 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: CARRIER CLINIC EMPLOYEES LIFE INSURANCE PLAN 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 – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: CARRIER CLINIC EMPLOYEES LIFE INSURANCE PLAN 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 – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: CARRIER CLINIC EMPLOYEES LIFE INSURANCE PLAN 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 – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX968287
Policy instance 1
Insurance contract or identification numberFLX968287
Number of Individuals Covered736
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $8,920
Total amount of fees paid to insurance companyUSD $719
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $105,825
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $8,920
Amount paid for insurance broker fees719
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX968287
Policy instance 1
Insurance contract or identification numberFLX968287
Number of Individuals Covered650
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $2,540
Total amount of fees paid to insurance companyUSD $1,917
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $29,764
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $2,540
Amount paid for insurance broker fees1917
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10209438
Policy instance 1
Insurance contract or identification number10209438
Number of Individuals Covered685
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,663
Total amount of fees paid to insurance companyUSD $247
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $53,434
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,663
Amount paid for insurance broker fees247
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.

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