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FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. GROUP MEDICAL PLAN 401k Plan overview

Plan NameFAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. GROUP MEDICAL PLAN
Plan identification number 505

FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. GROUP MEDICAL PLAN Benefits

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

401k Sponsoring company profile

FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. has sponsored the creation of one or more 401k plans.

Company Name:FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC.
Employer identification number (EIN):350900741
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. GROUP MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5052017-01-01
5052016-01-01HAYLEE CAVINS
5052015-01-01RHONDA MCPHERSON
5052014-01-01RHONDA MCPHERSON
5052013-01-01RHONDA MCPHERSON
5052012-01-01RHONDA MCPHERSON RHONDA MCPHERSON2013-05-10
5052011-01-01RHONDA MCPHERSON RHONDA MCPHERSON2012-07-19
5052010-01-01RHONDA MCPHERSON RHONDA MCPHERSON2011-07-13
5052009-01-01RHONDA MCPHERSON

Plan Statistics for FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. GROUP MEDICAL PLAN

401k plan membership statisitcs for FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. GROUP MEDICAL PLAN

Measure Date Value
2017: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. GROUP MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01208
Total number of active participants reported on line 7a of the Form 55002017-01-01208
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 participants2017-01-01208
2016: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. GROUP MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01220
Total number of active participants reported on line 7a of the Form 55002016-01-01208
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 participants2016-01-01208
2015: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. GROUP MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01251
Total number of active participants reported on line 7a of the Form 55002015-01-01217
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-013
Total of all active and inactive participants2015-01-01220
2014: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. GROUP MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01282
Total number of active participants reported on line 7a of the Form 55002014-01-01277
Number of retired or separated participants receiving benefits2014-01-015
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01282
2013: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. GROUP MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01287
Total number of active participants reported on line 7a of the Form 55002013-01-01277
Number of retired or separated participants receiving benefits2013-01-015
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-01282
2012: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. GROUP MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01277
Total number of active participants reported on line 7a of the Form 55002012-01-01282
Number of retired or separated participants receiving benefits2012-01-015
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-01287
2011: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. GROUP MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01294
Total number of active participants reported on line 7a of the Form 55002011-01-01282
Number of retired or separated participants receiving benefits2011-01-012
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01284
2010: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. GROUP MEDICAL PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01292
Total number of active participants reported on line 7a of the Form 55002010-01-01317
Number of retired or separated participants receiving benefits2010-01-012
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-01319
2009: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. GROUP MEDICAL PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01306
Total number of active participants reported on line 7a of the Form 55002009-01-01292
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 participants2009-01-01292
Total participants2009-01-01292

Form 5500 Responses for FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. GROUP MEDICAL PLAN

2017: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. GROUP MEDICAL PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. GROUP MEDICAL 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 – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. GROUP MEDICAL 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 – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. GROUP MEDICAL 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 – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. GROUP MEDICAL 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 – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. GROUP MEDICAL 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 – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. GROUP MEDICAL 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 – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. GROUP MEDICAL PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedYes
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 – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. GROUP MEDICAL 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 – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number1000711
Policy instance 1
Insurance contract or identification number1000711
Number of Individuals Covered429
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $2,077
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedORGAN/TISSUE TRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $20,765
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,077
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameEPIC INSURANCE SOLUTIONS
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE4710000
Policy instance 2
Insurance contract or identification numberE4710000
Number of Individuals Covered51
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $11,660
Total amount of fees paid to insurance companyUSD $3,620
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $19,011
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,864
Amount paid for insurance broker fees628
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameEPIC INSURANCE SOLUTIONS, LLC

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