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SUPPLEMENT INSURANCE FOR EMPLOYEES OF SHARON REGIONAL HEALTH SYSTEM 401k Plan overview

Plan NameSUPPLEMENT INSURANCE FOR EMPLOYEES OF SHARON REGIONAL HEALTH SYSTEM
Plan identification number 507

SUPPLEMENT INSURANCE FOR EMPLOYEES OF SHARON REGIONAL HEALTH SYSTEM Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Other welfare benefit cover

401k Sponsoring company profile

CHRISTIAN H. BUHL LEGACY TRUST has sponsored the creation of one or more 401k plans.

Company Name:CHRISTIAN H. BUHL LEGACY TRUST
Employer identification number (EIN):250979377
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SUPPLEMENT INSURANCE FOR EMPLOYEES OF SHARON REGIONAL HEALTH SYSTEM

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5072014-01-01
5072013-01-01JOHN DAVIDSON JOHN DAVIDSON2014-07-24
5072012-01-01JOHN DAVIDSON
5072011-01-01JOHN DAVIDSON
5072009-01-01JOHN DAVIDSON

Plan Statistics for SUPPLEMENT INSURANCE FOR EMPLOYEES OF SHARON REGIONAL HEALTH SYSTEM

401k plan membership statisitcs for SUPPLEMENT INSURANCE FOR EMPLOYEES OF SHARON REGIONAL HEALTH SYSTEM

Measure Date Value
2014: SUPPLEMENT INSURANCE FOR EMPLOYEES OF SHARON REGIONAL HEALTH SYSTEM 2014 401k membership
Total participants, beginning-of-year2014-01-01276
Total number of active participants reported on line 7a of the Form 55002014-01-010
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 participants2014-01-010
2013: SUPPLEMENT INSURANCE FOR EMPLOYEES OF SHARON REGIONAL HEALTH SYSTEM 2013 401k membership
Total participants, beginning-of-year2013-01-01306
Total number of active participants reported on line 7a of the Form 55002013-01-01283
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 participants2013-01-01283
2012: SUPPLEMENT INSURANCE FOR EMPLOYEES OF SHARON REGIONAL HEALTH SYSTEM 2012 401k membership
Total participants, beginning-of-year2012-01-01366
Total number of active participants reported on line 7a of the Form 55002012-01-01313
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01313
2011: SUPPLEMENT INSURANCE FOR EMPLOYEES OF SHARON REGIONAL HEALTH SYSTEM 2011 401k membership
Total participants, beginning-of-year2011-01-01377
Total number of active participants reported on line 7a of the Form 55002011-01-01346
Total of all active and inactive participants2011-01-01346
2009: SUPPLEMENT INSURANCE FOR EMPLOYEES OF SHARON REGIONAL HEALTH SYSTEM 2009 401k membership
Total participants, beginning-of-year2009-01-01516
Total number of active participants reported on line 7a of the Form 55002009-01-01496
Total of all active and inactive participants2009-01-01496
Total participants2009-01-010

Form 5500 Responses for SUPPLEMENT INSURANCE FOR EMPLOYEES OF SHARON REGIONAL HEALTH SYSTEM

2014: SUPPLEMENT INSURANCE FOR EMPLOYEES OF SHARON REGIONAL HEALTH SYSTEM 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 filingYes
2014-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: SUPPLEMENT INSURANCE FOR EMPLOYEES OF SHARON REGIONAL HEALTH SYSTEM 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: SUPPLEMENT INSURANCE FOR EMPLOYEES OF SHARON REGIONAL HEALTH SYSTEM 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: SUPPLEMENT INSURANCE FOR EMPLOYEES OF SHARON REGIONAL HEALTH SYSTEM 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: SUPPLEMENT INSURANCE FOR EMPLOYEES OF SHARON REGIONAL HEALTH SYSTEM 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

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberHG030
Policy instance 2
Insurance contract or identification numberHG030
Number of Individuals Covered289
Insurance policy start date2014-01-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $8,355
Total amount of fees paid to insurance companyUSD $1,314
Other welfare benefits providedSUPPLEMENTAL VOLUNTARY INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $59,986
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $90
Insurance broker organization code?3
Amount paid for insurance broker fees807
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker nameHOUGH CHARLES C
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberHR893
Policy instance 1
Insurance contract or identification numberHR893
Number of Individuals Covered8
Insurance policy start date2014-01-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $407
Total amount of fees paid to insurance companyUSD $39
Other welfare benefits providedSUPPLEMENTAL VOLUNTARY INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $2,424
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $109
Insurance broker organization code?3
Amount paid for insurance broker fees24
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker nameDENNIS L HULSE
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberHR893
Policy instance 1
Insurance contract or identification numberHR893
Number of Individuals Covered11
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,453
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 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
Other welfare benefits providedSUPPLEMENTAL VOLUNTARY INSURANCE
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 $10,688
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $396
Insurance broker organization code?3
Insurance broker nameBILLY M CRAIN
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberHG030
Policy instance 2
Insurance contract or identification numberHG030
Number of Individuals Covered308
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $28,146
Total amount of fees paid to insurance companyUSD $32
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
Other welfare benefits providedSUPPLEMENTAL VOLUNTARY INSURANCE
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 $208,815
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,307
Amount paid for insurance broker fees20
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker organization code?3
Insurance broker nameSAM DALESANDRO
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberHR893
Policy instance 1
Insurance contract or identification numberHR893
Number of Individuals Covered9
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,481
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedSUPPLEMENTAL VOLUNTARY INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $10,514
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $377
Insurance broker organization code?3
Insurance broker nameCHARLES C HOUGH
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberHG030
Policy instance 2
Insurance contract or identification numberHG030
Number of Individuals Covered314
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $25,848
Total amount of fees paid to insurance companyUSD $112
Other welfare benefits providedSUPPLEMENTAL VOLUNTARY INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $214,231
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $446
Insurance broker organization code?3
Amount paid for insurance broker fees70
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker nameGERSON EVAN
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberHG030
Policy instance 1
Insurance contract or identification numberHG030
Number of Individuals Covered344
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $23,537
Total amount of fees paid to insurance companyUSD $857
Other welfare benefits providedSUPPLEMENTAL VOLUNTARY INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $222,741
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberHR893
Policy instance 2
Insurance contract or identification numberHR893
Number of Individuals Covered10
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $685
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedSUPPLEMENTAL VOLUNTARY INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $7,690
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberHR893
Policy instance 1
Insurance contract or identification numberHR893
Number of Individuals Covered9
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $727
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedSUPPLEMENTAL VOLUNTARY INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $9,899
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $208
Insurance broker organization code?3
Amount paid for insurance broker fees0
Insurance broker nameCHARLES C HOUGH
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract numberHG030
Policy instance 2
Insurance contract or identification numberHG030
Number of Individuals Covered369
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $24,478
Total amount of fees paid to insurance companyUSD $1,061
Other welfare benefits providedSUPPLEMENTAL VOLUNTARY INSURANCE
Welfare Benefit Premiums Paid to CarrierUSD $235,997
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $558
Insurance broker organization code?3
Amount paid for insurance broker fees663
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker nameSTELLO LISA
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number400001000 09959
Policy instance 3
Insurance contract or identification number400001000 09959
Number of Individuals Covered53
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $3,313
Total amount of fees paid to insurance companyUSD $131
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,083
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,313
Amount paid for insurance broker fees131
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameGILBERTS INSURANCE AGENCY INC

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