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| Plan Name | MENDOTA COMMUNITY HOSPITAL EMPLOYEES GROUP LIFE INSURANCE PLAN |
| Plan identification number | 508 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | MENDOTA COMMUNITY HOSPITAL |
| Employer identification number (EIN): | 362167785 |
| NAIC Classification: | 622000 |
| NAIC Description: | Hospitals |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 508 | 2013-01-01 | KIM KENNEDY | |||
| 508 | 2012-01-01 | LYNN KLEIN | |||
| 508 | 2011-01-01 | LYNN KLEIN | |||
| 508 | 2009-01-01 | LYNN KLEIN |
| Measure | Date | Value |
|---|---|---|
| 2013: MENDOTA COMMUNITY HOSPITAL EMPLOYEES GROUP LIFE INSURANCE PLAN 2013 401k membership | ||
| Total participants, beginning-of-year | 2013-01-01 | 277 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 0 |
| Total of all active and inactive participants | 2013-01-01 | 0 |
| 2012: MENDOTA COMMUNITY HOSPITAL EMPLOYEES GROUP LIFE INSURANCE PLAN 2012 401k membership | ||
| Total participants, beginning-of-year | 2012-01-01 | 260 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 277 |
| Total of all active and inactive participants | 2012-01-01 | 277 |
| 2011: MENDOTA COMMUNITY HOSPITAL EMPLOYEES GROUP LIFE INSURANCE PLAN 2011 401k membership | ||
| Total participants, beginning-of-year | 2011-01-01 | 257 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 260 |
| Total of all active and inactive participants | 2011-01-01 | 260 |
| 2009: MENDOTA COMMUNITY HOSPITAL EMPLOYEES GROUP LIFE INSURANCE PLAN 2009 401k membership | ||
| Total participants, beginning-of-year | 2009-01-01 | 251 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 263 |
| Total of all active and inactive participants | 2009-01-01 | 263 |
| 2013: MENDOTA COMMUNITY HOSPITAL EMPLOYEES GROUP LIFE INSURANCE PLAN 2013 form 5500 responses | ||
|---|---|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | This submission is the final filing | Yes |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: MENDOTA COMMUNITY HOSPITAL EMPLOYEES GROUP LIFE INSURANCE PLAN 2012 form 5500 responses | ||
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: MENDOTA COMMUNITY HOSPITAL EMPLOYEES GROUP LIFE 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 benefit arrangement – Insurance | Yes |
| 2009: MENDOTA COMMUNITY HOSPITAL EMPLOYEES GROUP LIFE 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 benefit arrangement – Insurance | Yes |
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