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DEACONESS WOMENS HOSPITAL LTD PLAN 401k Plan overview

Plan NameDEACONESS WOMENS HOSPITAL LTD PLAN
Plan identification number 505

DEACONESS WOMENS HOSPITAL LTD PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Long-term disability cover

401k Sponsoring company profile

DEACONESS WOMENS HOSPITAL OF SOUTHERN INDIANA, LLC has sponsored the creation of one or more 401k plans.

Company Name:DEACONESS WOMENS HOSPITAL OF SOUTHERN INDIANA, LLC
Employer identification number (EIN):352062016
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DEACONESS WOMENS HOSPITAL LTD PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5052022-01-01CHRISTINA M. CADY2023-06-20
5052021-01-01CHRISTINEA M. CADY2022-05-25 CHRISTINEA M. CADY2022-05-25
5052020-01-01CHRISTINA M. CADY2021-06-14 CHRISTINA M. CADY2021-06-14
5052019-01-01CHRISTINA M. CADY2020-06-10 CHRISTINA M. CADY2020-06-10
5052018-01-01CHRISTINA M. CADY
5052017-01-01CHRISTINA M. CADY
5052016-01-01CHRISTINA M. CADY

Plan Statistics for DEACONESS WOMENS HOSPITAL LTD PLAN

401k plan membership statisitcs for DEACONESS WOMENS HOSPITAL LTD PLAN

Measure Date Value
2022: DEACONESS WOMENS HOSPITAL LTD PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01649
Total number of active participants reported on line 7a of the Form 55002022-01-01638
Number of retired or separated participants receiving benefits2022-01-012
Total of all active and inactive participants2022-01-01640
Total participants2022-01-01640
2021: DEACONESS WOMENS HOSPITAL LTD PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01606
Total number of active participants reported on line 7a of the Form 55002021-01-01636
Total of all active and inactive participants2021-01-01636
Total participants2021-01-01636
2020: DEACONESS WOMENS HOSPITAL LTD PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01600
Total number of active participants reported on line 7a of the Form 55002020-01-01599
Total of all active and inactive participants2020-01-01599
Total participants2020-01-01599
2019: DEACONESS WOMENS HOSPITAL LTD PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01575
Total number of active participants reported on line 7a of the Form 55002019-01-01596
Number of retired or separated participants receiving benefits2019-01-012
Total of all active and inactive participants2019-01-01598
Total participants2019-01-01598
2018: DEACONESS WOMENS HOSPITAL LTD PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01564
Total number of active participants reported on line 7a of the Form 55002018-01-01574
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 participants2018-01-01574
2017: DEACONESS WOMENS HOSPITAL LTD PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01549
Total number of active participants reported on line 7a of the Form 55002017-01-01561
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 participants2017-01-01561
2016: DEACONESS WOMENS HOSPITAL LTD PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01510
Total number of active participants reported on line 7a of the Form 55002016-01-01551
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 participants2016-01-01551

Form 5500 Responses for DEACONESS WOMENS HOSPITAL LTD PLAN

2022: DEACONESS WOMENS HOSPITAL LTD PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: DEACONESS WOMENS HOSPITAL LTD PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: DEACONESS WOMENS HOSPITAL LTD PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: DEACONESS WOMENS HOSPITAL LTD PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: DEACONESS WOMENS HOSPITAL LTD PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: DEACONESS WOMENS HOSPITAL LTD PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: DEACONESS WOMENS HOSPITAL LTD PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01First time form 5500 has been submittedYes
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

Insurance Providers Used on plan

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK 964894
Policy instance 1
Insurance contract or identification numberLK 964894
Number of Individuals Covered640
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $35,664
Total amount of fees paid to insurance companyUSD $874
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $261,425
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,664
Insurance broker organization code?3
Amount paid for insurance broker fees874
Additional information about fees paid to insurance brokerSERVICE FEES
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK 964894
Policy instance 1
Insurance contract or identification numberLK 964894
Number of Individuals Covered636
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $32,367
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $215,781
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,367
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK 964894
Policy instance 1
Insurance contract or identification numberLK 964894
Number of Individuals Covered599
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $15,175
Total amount of fees paid to insurance companyUSD $4,055
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $101,164
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $15,175
Amount paid for insurance broker fees4055
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 numberLK 964894
Policy instance 1
Insurance contract or identification numberLK 964894
Number of Individuals Covered598
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $32,907
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $219,382
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,907
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberLK 964894
Policy instance 1
Insurance contract or identification numberLK 964894
Number of Individuals Covered574
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $26,280
Total amount of fees paid to insurance companyUSD $3,645
Are there contracts with allocated funds for individual policies?0
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 BenefitYes
Unemployment Insurance Welfare BenefitNo
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 $175,199
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,280
Amount paid for insurance broker fees3645
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 numberLK 964894
Policy instance 1
Insurance contract or identification numberLK 964894
Number of Individuals Covered561
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $31,637
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
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 BenefitYes
Unemployment Insurance Welfare BenefitNo
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 $210,912
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,637
Insurance broker organization code?3
Insurance broker nameCLIPPINGER FINANCIAL GROUP

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