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GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 401k Plan overview

Plan NameGROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER
Plan identification number 505

GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Temporary disability (accident and sickness)

401k Sponsoring company profile

BURNETT MEDICAL CENTER has sponsored the creation of one or more 401k plans.

Company Name:BURNETT MEDICAL CENTER
Employer identification number (EIN):390938661
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5052022-01-01JULIE MCKENZIE2023-07-18 JULIE MCKENZIE2023-07-18
5052021-01-01JULIE MCKENZIE2022-07-15 JULIE MCKENZIE2022-07-15
5052020-01-01JULIE MCKENZIE2021-07-22 JULIE MCKENZIE2021-07-22
5052019-01-01SANDRA HINRICHS2020-07-02 SANDRA HINRICHS2020-07-02
5052018-01-01GORDON A LEWIS2019-07-31 GORDON A LEWIS2019-07-31
5052017-01-01
5052016-01-01
5052015-01-01
5052014-01-01
5052013-01-01
5052012-01-01SANDRA HINNICHS
5052011-01-01SANDRA HINRICHS
5052010-01-01SANDY HINRICHS
5052009-01-01SANDRA HINNCHS

Plan Statistics for GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER

401k plan membership statisitcs for GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER

Measure Date Value
2022: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2022 401k membership
Total participants, beginning-of-year2022-01-01172
Total number of active participants reported on line 7a of the Form 55002022-01-01153
Total of all active and inactive participants2022-01-01153
Total participants2022-01-01153
2021: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2021 401k membership
Total participants, beginning-of-year2021-01-01187
Total number of active participants reported on line 7a of the Form 55002021-01-01172
Total of all active and inactive participants2021-01-01172
Total participants2021-01-01172
2020: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2020 401k membership
Total participants, beginning-of-year2020-01-01174
Total number of active participants reported on line 7a of the Form 55002020-01-01187
Total of all active and inactive participants2020-01-01187
Total participants2020-01-01187
2019: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2019 401k membership
Total participants, beginning-of-year2019-01-01174
Total number of active participants reported on line 7a of the Form 55002019-01-01174
Total of all active and inactive participants2019-01-01174
Total participants2019-01-01174
2018: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2018 401k membership
Total participants, beginning-of-year2018-01-01180
Total number of active participants reported on line 7a of the Form 55002018-01-01174
Total of all active and inactive participants2018-01-01174
Total participants2018-01-01174
2017: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2017 401k membership
Total participants, beginning-of-year2017-01-01192
Total number of active participants reported on line 7a of the Form 55002017-01-01180
Total of all active and inactive participants2017-01-01180
Total participants2017-01-01180
2016: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2016 401k membership
Total participants, beginning-of-year2016-01-01191
Total number of active participants reported on line 7a of the Form 55002016-01-01192
Total of all active and inactive participants2016-01-01192
Total participants2016-01-01192
2015: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2015 401k membership
Total participants, beginning-of-year2015-01-01183
Total number of active participants reported on line 7a of the Form 55002015-01-01191
Total of all active and inactive participants2015-01-01191
Total participants2015-01-01191
2014: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2014 401k membership
Total participants, beginning-of-year2014-01-01183
Total number of active participants reported on line 7a of the Form 55002014-01-01183
Total of all active and inactive participants2014-01-01183
Total participants2014-01-01183
2013: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2013 401k membership
Total participants, beginning-of-year2013-01-01182
Total number of active participants reported on line 7a of the Form 55002013-01-01183
Total of all active and inactive participants2013-01-01183
Total participants2013-01-01183
2012: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2012 401k membership
Total participants, beginning-of-year2012-01-01184
Total number of active participants reported on line 7a of the Form 55002012-01-01182
Total of all active and inactive participants2012-01-01182
Total participants2012-01-01182
2011: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2011 401k membership
Total participants, beginning-of-year2011-01-01188
Total number of active participants reported on line 7a of the Form 55002011-01-01184
Total of all active and inactive participants2011-01-01184
Total participants2011-01-01184
2010: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2010 401k membership
Total participants, beginning-of-year2010-01-01185
Total number of active participants reported on line 7a of the Form 55002010-01-01188
Total of all active and inactive participants2010-01-01188
Total participants2010-01-01188
2009: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2009 401k membership
Total participants, beginning-of-year2009-01-01175
Total number of active participants reported on line 7a of the Form 55002009-01-01185
Total of all active and inactive participants2009-01-01185
Total participants2009-01-01185

Form 5500 Responses for GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER

2022: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 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: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 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: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 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: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 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: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: GROUP SHORT TERM DISABILITY INSURANCE FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 656342
Policy instance 1
Insurance contract or identification numberG 656342
Number of Individuals Covered153
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $24,826
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $114,127
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,967
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 656342
Policy instance 1
Insurance contract or identification numberG 656342
Number of Individuals Covered172
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $19,696
Total amount of fees paid to insurance companyUSD $2,095
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $93,789
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,696
Amount paid for insurance broker fees2095
Additional information about fees paid to insurance brokerADMINISTRATION
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 656342
Policy instance 1
Insurance contract or identification numberG 656342
Number of Individuals Covered187
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $19,549
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $93,093
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,549
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 656342
Policy instance 1
Insurance contract or identification numberG 656342
Number of Individuals Covered174
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $16,545
Total amount of fees paid to insurance companyUSD $1,666
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $78,786
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,545
Amount paid for insurance broker fees1666
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 656342
Policy instance 1
Insurance contract or identification numberG 656342
Number of Individuals Covered174
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $17,107
Total amount of fees paid to insurance companyUSD $2,840
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $81,462
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,107
Amount paid for insurance broker fees2840
Additional information about fees paid to insurance brokerADMINISTRATION
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 656342
Policy instance 1
Insurance contract or identification numberG 656342
Number of Individuals Covered180
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $16,427
Total amount of fees paid to insurance companyUSD $1,890
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $78,225
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,427
Amount paid for insurance broker fees1890
Additional information about fees paid to insurance brokerADMINISTRATIVE
Insurance broker organization code?3
Insurance broker nameLAMAIR MULOCK CONDON CO
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 656342
Policy instance 1
Insurance contract or identification numberG 656342
Number of Individuals Covered191
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $16,499
Total amount of fees paid to insurance companyUSD $1,135
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $78,568
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,499
Insurance broker organization code?3
Amount paid for insurance broker fees1135
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker nameNFP INSURANCE SERVICES INC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 656342
Policy instance 1
Insurance contract or identification numberG 656342
Number of Individuals Covered183
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $19,076
Total amount of fees paid to insurance companyUSD $1,102
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $90,839
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,076
Insurance broker organization code?3
Amount paid for insurance broker fees1102
Additional information about fees paid to insurance brokerADMINISTRATIVE FEE
Insurance broker nameNFP INSURANCE SERVICES INC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 656342
Policy instance 1
Insurance contract or identification numberG 656342
Number of Individuals Covered183
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $18,519
Total amount of fees paid to insurance companyUSD $3,710
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $88,117
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,519
Amount paid for insurance broker fees3710
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
Insurance broker nameISG ADVISORS LLC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 656342
Policy instance 1
Insurance contract or identification numberG 656342
Number of Individuals Covered182
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $22,850
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $87,120
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,617
Insurance broker organization code?3
Insurance broker nameNFP INSURANCE SERVICES INC
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 656342
Policy instance 1
Insurance contract or identification numberG 656342
Number of Individuals Covered184
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $20,391
Total amount of fees paid to insurance companyUSD $2,523
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $97,079
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberG 656342
Policy instance 2
Insurance contract or identification numberG 656342
Number of Individuals Covered188
Insurance policy start date2010-06-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $10,088
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $48,040
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,088
Insurance broker organization code?3
Insurance broker nameISG ADVISORS LLC
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number048-7796-00
Policy instance 1
Insurance contract or identification number048-7796-00
Number of Individuals Covered180
Insurance policy start date2010-01-01
Insurance policy end date2010-05-31
Total amount of commissions paid to insurance brokerUSD $10,893
Total amount of fees paid to insurance companyUSD $4,988
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,783
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,222
Insurance broker organization code?3
Amount paid for insurance broker fees4988
Additional information about fees paid to insurance brokerBONUS
Insurance broker nameNFP INS SERVICES INC

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