401k Plan data: MENDOTA COMMUNITY HOSPITAL INSURANCE PLAN plan

MENDOTA COMMUNITY HOSPITAL INSURANCE PLAN 401k Plan overview

Plan Name	MENDOTA COMMUNITY HOSPITAL INSURANCE PLAN
Plan identification number	501

MENDOTA COMMUNITY HOSPITAL INSURANCE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision)

401k Sponsoring company profile

MENDOTA COMMUNITY HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name: MENDOTA COMMUNITY HOSPITAL

Employer identification number (EIN): 362167785

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MENDOTA COMMUNITY HOSPITAL INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2015-01-01 KIM KENNEDY
501 2014-01-01 KIM KENNEDY
501 2013-01-01 KIM KENNEDY
501 2012-01-01 LYNN KLEIN
501 2011-01-01 LYNN KLEIN
501 2010-01-01 LYNN KLEIN
501 2009-01-01 LYNN KLEIN

Plan id#	Filing Submission Date	Name of Administrator
501	2015-01-01	KIM KENNEDY
501	2014-01-01	KIM KENNEDY
501	2013-01-01	KIM KENNEDY
501	2012-01-01	LYNN KLEIN
501	2011-01-01	LYNN KLEIN
501	2010-01-01	LYNN KLEIN
501	2009-01-01	LYNN KLEIN

Plan Statistics for MENDOTA COMMUNITY HOSPITAL INSURANCE PLAN

401k plan membership statisitcs for MENDOTA COMMUNITY HOSPITAL INSURANCE PLAN

Measure Date Value
2015: MENDOTA COMMUNITY HOSPITAL INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 189
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 195
Total of all active and inactive participants 2015-01-01 195
2014: MENDOTA COMMUNITY HOSPITAL INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 208
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 187
Number of retired or separated participants receiving benefits 2014-01-01 2
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 189
2013: MENDOTA COMMUNITY HOSPITAL INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 210
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 200
Total of all active and inactive participants 2013-01-01 200
2012: MENDOTA COMMUNITY HOSPITAL INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 192
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 213
Number of retired or separated participants receiving benefits 2012-01-01 2
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 215
2011: MENDOTA COMMUNITY HOSPITAL INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 188
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 173
Total of all active and inactive participants 2011-01-01 173
2010: MENDOTA COMMUNITY HOSPITAL INSURANCE PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 192
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 195
Total of all active and inactive participants 2010-01-01 195
2009: MENDOTA COMMUNITY HOSPITAL INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 182
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 193
Total of all active and inactive participants 2009-01-01 193

Measure	Date	Value
2015: MENDOTA COMMUNITY HOSPITAL INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	189
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	195
Total of all active and inactive participants	2015-01-01	195
2014: MENDOTA COMMUNITY HOSPITAL INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	208
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	187
Number of retired or separated participants receiving benefits	2014-01-01	2
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	189
2013: MENDOTA COMMUNITY HOSPITAL INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	210
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	200
Total of all active and inactive participants	2013-01-01	200
2012: MENDOTA COMMUNITY HOSPITAL INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	192
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	213
Number of retired or separated participants receiving benefits	2012-01-01	2
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	215
2011: MENDOTA COMMUNITY HOSPITAL INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	188
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	173
Total of all active and inactive participants	2011-01-01	173
2010: MENDOTA COMMUNITY HOSPITAL INSURANCE PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	192
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	195
Total of all active and inactive participants	2010-01-01	195
2009: MENDOTA COMMUNITY HOSPITAL INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	182
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	193
Total of all active and inactive participants	2009-01-01	193

Form 5500 Responses for MENDOTA COMMUNITY HOSPITAL INSURANCE PLAN

2015: MENDOTA COMMUNITY HOSPITAL INSURANCE PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: MENDOTA COMMUNITY HOSPITAL INSURANCE PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: MENDOTA COMMUNITY HOSPITAL INSURANCE PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: MENDOTA COMMUNITY HOSPITAL INSURANCE PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: MENDOTA COMMUNITY HOSPITAL INSURANCE PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: MENDOTA COMMUNITY HOSPITAL INSURANCE PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: MENDOTA COMMUNITY HOSPITAL INSURANCE PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	This submission is the final filing	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

AMERICAN NATIONAL INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60739 )

Policy contract number

746719-10

Policy instance

Insurance contract or identification number	746719-10
Number of Individuals Covered	195
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Welfare Benefit Premiums Paid to Carrier	USD $339,920
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

Was this data useful?

If you found the data here useful, PLEASE HELP US. We are a start-up and believe in making information freely available. By linking to us, posting on twitter, facebook and linkedin about us and generally spreading the word, you'll help us to grow. Our vision is to provide high quality data about the activities of all the companies in the world and where possible make it free to use and view. Finding and integrating data from thousands of data sources is time consuming and needs lots of effort. By simply spreading the word about us, you will help us. Please use the share buttons. It will only take a few seconds of your time. Thanks for helping

Information Disclaimer

The information provided on this website is not advice, endorsement or recommendation
The information published is supplied by third parties so we make no warranty on the accuracy, completeness etc. This information is provided "as-is". The information is subject to change as we obtain updates and corrections from the primary information sources.
You are free to use the information for your own personal research on the understanding to do so is at your own risk.

See full terms and conditions

Company Name:	MENDOTA COMMUNITY HOSPITAL
Employer identification number (EIN):	362167785
NAIC Classification:	622000
NAIC Description:	Hospitals