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THE GOOD SAMARITAN HOSPITAL WELFARE AND FLEXIBLE BENEFIT PLAN 401k Plan overview

Plan NameTHE GOOD SAMARITAN HOSPITAL WELFARE AND FLEXIBLE BENEFIT PLAN
Plan identification number 511

THE GOOD SAMARITAN HOSPITAL WELFARE AND FLEXIBLE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

WELLSPAN GOOD SAMARITAN has sponsored the creation of one or more 401k plans.

Company Name:WELLSPAN GOOD SAMARITAN
Employer identification number (EIN):230794160
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE GOOD SAMARITAN HOSPITAL WELFARE AND FLEXIBLE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5112015-01-01
5112014-01-01KIMBERLY FEEMAN
5112013-01-01KIMBERLY FEEMAN
5112012-01-01KIMBERLY FEEMAN
5112011-01-01KIMBERLY FEEMAN
5112010-01-01KIMBERLY FEEMAN
5112009-01-01KIMBERLY FEEMAN
5112007-01-01KIMBERLY FEEMAN
5112005-01-01KIMBERLY FEEMAN
5112004-01-01KIMBERLY FEEMAN

Plan Statistics for THE GOOD SAMARITAN HOSPITAL WELFARE AND FLEXIBLE BENEFIT PLAN

401k plan membership statisitcs for THE GOOD SAMARITAN HOSPITAL WELFARE AND FLEXIBLE BENEFIT PLAN

Measure Date Value
2015: THE GOOD SAMARITAN HOSPITAL WELFARE AND FLEXIBLE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-011,434
Total number of active participants reported on line 7a of the Form 55002015-01-010
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 participants2015-01-010
2014: THE GOOD SAMARITAN HOSPITAL WELFARE AND FLEXIBLE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-011,394
Total number of active participants reported on line 7a of the Form 55002014-01-011,358
Number of retired or separated participants receiving benefits2014-01-0176
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-011,434
2013: THE GOOD SAMARITAN HOSPITAL WELFARE AND FLEXIBLE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-011,448
Total number of active participants reported on line 7a of the Form 55002013-01-011,310
Number of retired or separated participants receiving benefits2013-01-0180
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-011,390
2012: THE GOOD SAMARITAN HOSPITAL WELFARE AND FLEXIBLE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-011,441
Total number of active participants reported on line 7a of the Form 55002012-01-011,362
Number of retired or separated participants receiving benefits2012-01-0186
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-011,448
2011: THE GOOD SAMARITAN HOSPITAL WELFARE AND FLEXIBLE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-011,427
Total number of active participants reported on line 7a of the Form 55002011-01-011,350
Number of retired or separated participants receiving benefits2011-01-0191
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-011,441
2010: THE GOOD SAMARITAN HOSPITAL WELFARE AND FLEXIBLE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-011,422
Total number of active participants reported on line 7a of the Form 55002010-01-011,318
Number of retired or separated participants receiving benefits2010-01-0198
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-011,416
2009: THE GOOD SAMARITAN HOSPITAL WELFARE AND FLEXIBLE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-011,459
Total number of active participants reported on line 7a of the Form 55002009-01-011,338
Number of retired or separated participants receiving benefits2009-01-01106
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-011,444
2007: THE GOOD SAMARITAN HOSPITAL WELFARE AND FLEXIBLE BENEFIT PLAN 2007 401k membership
Total participants, beginning-of-year2007-01-011,386
Total number of active participants reported on line 7a of the Form 55002007-01-011,300
Number of retired or separated participants receiving benefits2007-01-01126
Number of other retired or separated participants entitled to future benefits2007-01-010
Total of all active and inactive participants2007-01-011,426
2005: THE GOOD SAMARITAN HOSPITAL WELFARE AND FLEXIBLE BENEFIT PLAN 2005 401k membership
Total participants, beginning-of-year2005-01-011,362
Total number of active participants reported on line 7a of the Form 55002005-01-011,256
Number of retired or separated participants receiving benefits2005-01-01131
Number of other retired or separated participants entitled to future benefits2005-01-010
Total of all active and inactive participants2005-01-011,387
2004: THE GOOD SAMARITAN HOSPITAL WELFARE AND FLEXIBLE BENEFIT PLAN 2004 401k membership
Total participants, beginning-of-year2004-01-011,342
Total number of active participants reported on line 7a of the Form 55002004-01-011,226
Number of retired or separated participants receiving benefits2004-01-01136
Number of other retired or separated participants entitled to future benefits2004-01-010
Total of all active and inactive participants2004-01-011,362

Form 5500 Responses for THE GOOD SAMARITAN HOSPITAL WELFARE AND FLEXIBLE BENEFIT PLAN

2015: THE GOOD SAMARITAN HOSPITAL WELFARE AND FLEXIBLE BENEFIT 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 filingYes
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 funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: THE GOOD SAMARITAN HOSPITAL WELFARE AND FLEXIBLE BENEFIT 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 funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: THE GOOD SAMARITAN HOSPITAL WELFARE AND FLEXIBLE BENEFIT 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 funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: THE GOOD SAMARITAN HOSPITAL WELFARE AND FLEXIBLE BENEFIT 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 funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: THE GOOD SAMARITAN HOSPITAL WELFARE AND FLEXIBLE BENEFIT 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 funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: THE GOOD SAMARITAN HOSPITAL WELFARE AND FLEXIBLE BENEFIT PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: THE GOOD SAMARITAN HOSPITAL WELFARE AND FLEXIBLE BENEFIT 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 funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes
2007: THE GOOD SAMARITAN HOSPITAL WELFARE AND FLEXIBLE BENEFIT PLAN 2007 form 5500 responses
2007-01-01Type of plan entitySingle employer plan
2007-01-01Submission has been amendedNo
2007-01-01This submission is the final filingNo
2007-01-01This return/report is a short plan year return/report (less than 12 months)No
2007-01-01Plan is a collectively bargained planNo
2007-01-01Plan funding arrangement – InsuranceYes
2007-01-01Plan funding arrangement – General assets of the sponsorYes
2007-01-01Plan benefit arrangement – InsuranceYes
2007-01-01Plan benefit arrangement – General assets of the sponsorYes
2005: THE GOOD SAMARITAN HOSPITAL WELFARE AND FLEXIBLE BENEFIT PLAN 2005 form 5500 responses
2005-01-01Type of plan entitySingle employer plan
2005-01-01Submission has been amendedNo
2005-01-01This submission is the final filingNo
2005-01-01This return/report is a short plan year return/report (less than 12 months)No
2005-01-01Plan is a collectively bargained planNo
2005-01-01Plan funding arrangement – InsuranceYes
2005-01-01Plan funding arrangement – General assets of the sponsorYes
2005-01-01Plan benefit arrangement – InsuranceYes
2005-01-01Plan benefit arrangement – General assets of the sponsorYes
2004: THE GOOD SAMARITAN HOSPITAL WELFARE AND FLEXIBLE BENEFIT PLAN 2004 form 5500 responses
2004-01-01Type of plan entitySingle employer plan
2004-01-01Submission has been amendedNo
2004-01-01This submission is the final filingNo
2004-01-01This return/report is a short plan year return/report (less than 12 months)No
2004-01-01Plan is a collectively bargained planNo
2004-01-01Plan funding arrangement – InsuranceYes
2004-01-01Plan funding arrangement – General assets of the sponsorYes
2004-01-01Plan benefit arrangement – InsuranceYes
2004-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

AVALON INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 12358 )
Policy contract number00504141
Policy instance 3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 683686
Policy instance 2
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number68186-5
Policy instance 1
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberLTD 683686
Policy instance 2
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number68186-5
Policy instance 1
AVALON INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 12358 )
Policy contract number00504141
Policy instance 3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number217804
Policy instance 3
AVALON INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 12358 )
Policy contract number00504141
Policy instance 4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010137672
Policy instance 1
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number400001000 12762
Policy instance 2
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010137672
Policy instance 1
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number400001000 12762
Policy instance 2
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number217804
Policy instance 4
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number220794
Policy instance 3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number217804
Policy instance 5
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number16-01105-000
Policy instance 4
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number400001000 12762
Policy instance 3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010137672
Policy instance 2
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG 00606965
Policy instance 6
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG 00606965
Policy instance 1
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG 00606965
Policy instance 1
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX960108
Policy instance 3
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number16-01105-000
Policy instance 4
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 961177
Policy instance 2
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number16-01105-000
Policy instance 4
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 961177
Policy instance 2
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG 00606965
Policy instance 1
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX960108
Policy instance 3
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number16-011105-00
Policy instance 4
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX960108
Policy instance 3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 961177
Policy instance 2
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG 00606965
Policy instance 1
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX960108
Policy instance 3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 961177
Policy instance 2
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number015169
Policy instance 4
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG 00606965
Policy instance 1
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 961177
Policy instance 1
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX960108
Policy instance 2
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number16-009228-00
Policy instance 3
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number16-009228-00
Policy instance 3
PMAIC (National Association of Insurance Commissioners NAIC id number: 12262 )
Policy contract number100331 LTD
Policy instance 2
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX960108
Policy instance 1
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX960108
Policy instance 1
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number16-009228-00
Policy instance 3
PMAIC (National Association of Insurance Commissioners NAIC id number: 12262 )
Policy contract number100331 LTD
Policy instance 2

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