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SMH EMPLOYEE GROUP LIFE 401k Plan overview

Plan NameSMH EMPLOYEE GROUP LIFE
Plan identification number 503

SMH EMPLOYEE GROUP LIFE Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance

401k Sponsoring company profile

HSHS GOOD SHEPHERD HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name:HSHS GOOD SHEPHERD HOSPITAL
Employer identification number (EIN):370512290
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SMH EMPLOYEE GROUP LIFE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032019-01-01
5032018-01-01AARON PUCHBAUER AARON PUCHBAUER2019-07-23
5032017-01-01AARON PUCHBAUER AARON PUCHBAUER2018-08-28
5032016-01-01MARILYN SEARS
5032015-01-01MARILYN SEARS MARILYN SEARS2016-10-04
5032014-01-01MARILYN SEARS MARILYN SEARS2015-07-28
5032013-01-01PHILIP MILLER
5032012-01-01PHILIP MILLER
5032011-01-01PHILIP MILLER
5032010-01-01PHILIP MILLER
5032009-01-01PHILIP MILLER

Plan Statistics for SMH EMPLOYEE GROUP LIFE

401k plan membership statisitcs for SMH EMPLOYEE GROUP LIFE

Measure Date Value
2019: SMH EMPLOYEE GROUP LIFE 2019 401k membership
Total participants, beginning-of-year2019-01-0196
Total number of active participants reported on line 7a of the Form 55002019-01-0198
Total of all active and inactive participants2019-01-0198
Total participants2019-01-0198
2018: SMH EMPLOYEE GROUP LIFE 2018 401k membership
Total participants, beginning-of-year2018-01-0174
Total number of active participants reported on line 7a of the Form 55002018-01-0196
Total of all active and inactive participants2018-01-0196
Total participants2018-01-0196
2017: SMH EMPLOYEE GROUP LIFE 2017 401k membership
Total participants, beginning-of-year2017-01-0197
Total number of active participants reported on line 7a of the Form 55002017-01-0174
Total of all active and inactive participants2017-01-0174
Total participants2017-01-0174
2016: SMH EMPLOYEE GROUP LIFE 2016 401k membership
Total participants, beginning-of-year2016-01-0192
Total number of active participants reported on line 7a of the Form 55002016-01-0197
Total of all active and inactive participants2016-01-0197
Total participants2016-01-0197
2015: SMH EMPLOYEE GROUP LIFE 2015 401k membership
Total participants, beginning-of-year2015-01-0197
Total number of active participants reported on line 7a of the Form 55002015-01-0192
Total of all active and inactive participants2015-01-0192
Total participants2015-01-0192
2014: SMH EMPLOYEE GROUP LIFE 2014 401k membership
Total participants, beginning-of-year2014-01-01101
Total number of active participants reported on line 7a of the Form 55002014-01-0197
Total of all active and inactive participants2014-01-0197
Total participants2014-01-0197
2013: SMH EMPLOYEE GROUP LIFE 2013 401k membership
Total participants, beginning-of-year2013-01-01112
Total number of active participants reported on line 7a of the Form 55002013-01-01101
Total of all active and inactive participants2013-01-01101
Total participants2013-01-01101
2012: SMH EMPLOYEE GROUP LIFE 2012 401k membership
Total participants, beginning-of-year2012-01-01133
Total number of active participants reported on line 7a of the Form 55002012-01-01112
Total of all active and inactive participants2012-01-01112
Total participants2012-01-01112
2011: SMH EMPLOYEE GROUP LIFE 2011 401k membership
Total participants, beginning-of-year2011-01-01128
Total number of active participants reported on line 7a of the Form 55002011-01-01133
Total of all active and inactive participants2011-01-01133
Total participants2011-01-01133
2010: SMH EMPLOYEE GROUP LIFE 2010 401k membership
Total participants, beginning-of-year2010-01-01119
Total number of active participants reported on line 7a of the Form 55002010-01-01128
Total of all active and inactive participants2010-01-01128
Total participants2010-01-01128
2009: SMH EMPLOYEE GROUP LIFE 2009 401k membership
Total participants, beginning-of-year2009-01-01132
Total number of active participants reported on line 7a of the Form 55002009-01-01119
Total of all active and inactive participants2009-01-01119
Total participants2009-01-01119

Form 5500 Responses for SMH EMPLOYEE GROUP LIFE

2019: SMH EMPLOYEE GROUP LIFE 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: SMH EMPLOYEE GROUP LIFE 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: SMH EMPLOYEE GROUP LIFE 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: SMH EMPLOYEE GROUP LIFE 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 – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: SMH EMPLOYEE GROUP LIFE 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01First time form 5500 has been submittedYes
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 – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: SMH EMPLOYEE GROUP LIFE 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 – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: SMH EMPLOYEE GROUP LIFE 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: SMH EMPLOYEE GROUP LIFE 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: SMH EMPLOYEE GROUP LIFE 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
2010: SMH EMPLOYEE GROUP LIFE 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
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 – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: SMH EMPLOYEE GROUP LIFE 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

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0AKL2
Policy instance 1
Insurance contract or identification numberGVTL0AKL2
Number of Individuals Covered98
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
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 $3,518
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $528
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTLOAKL2
Policy instance 1
Insurance contract or identification numberGVTLOAKL2
Number of Individuals Covered96
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
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 BenefitNo
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 $4,210
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $517
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0AKL2
Policy instance 1
Insurance contract or identification numberGVTL0AKL2
Number of Individuals Covered74
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
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 BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
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 $31,075
Commission paid to Insurance BrokerUSD $4,661
Insurance broker organization code?3
Insurance broker nameUNITED OF OMAHA LIFE INSURANCE COMP

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