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LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC 401k Plan overview

Plan NameLIFE INSURANCE BENEFITS FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC
Plan identification number 504

LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC Benefits

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

401k Sponsoring company profile

FLAMBEAU HOSPITAL INC has sponsored the creation of one or more 401k plans.

Company Name:FLAMBEAU HOSPITAL INC
Employer identification number (EIN):390973724
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042016-01-01
5042015-01-01
5042014-01-01
5042013-01-01
5042012-01-01PAUL RYBAK
5042011-01-01BARBAR J MICHALSKI
5042009-01-01BARBARA J MICHALSKI

Plan Statistics for LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC

401k plan membership statisitcs for LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC

Measure Date Value
2016: LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC 2016 401k membership
Total participants, beginning-of-year2016-01-01138
Total number of active participants reported on line 7a of the Form 55002016-01-010
Total of all active and inactive participants2016-01-010
Total participants2016-01-010
2015: LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC 2015 401k membership
Total participants, beginning-of-year2015-01-01142
Total number of active participants reported on line 7a of the Form 55002015-01-01138
Total of all active and inactive participants2015-01-01138
Total participants2015-01-01138
2014: LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC 2014 401k membership
Total participants, beginning-of-year2014-01-01143
Total number of active participants reported on line 7a of the Form 55002014-01-01142
Total of all active and inactive participants2014-01-01142
Total participants2014-01-01142
2013: LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC 2013 401k membership
Total participants, beginning-of-year2013-01-01156
Total number of active participants reported on line 7a of the Form 55002013-01-01143
Total of all active and inactive participants2013-01-01143
Total participants2013-01-01143
2012: LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC 2012 401k membership
Total participants, beginning-of-year2012-01-01148
Total number of active participants reported on line 7a of the Form 55002012-01-01156
Total of all active and inactive participants2012-01-01156
Total participants2012-01-01156
2011: LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC 2011 401k membership
Total participants, beginning-of-year2011-01-01148
Total number of active participants reported on line 7a of the Form 55002011-01-01148
Total of all active and inactive participants2011-01-01148
Total participants2011-01-01148
2009: LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC 2009 401k membership
Total participants, beginning-of-year2009-01-01152
Total number of active participants reported on line 7a of the Form 55002009-01-01148
Total of all active and inactive participants2009-01-01148
Total participants2009-01-01148

Form 5500 Responses for LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC

2016: LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01This submission is the final filingYes
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC 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: LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC 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: LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC 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: LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC 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: LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: LIFE INSURANCE BENEFITS FOR EMPLOYEES OF FLAMBEAU HOSPITAL INC 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

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number214554
Policy instance 1
Insurance contract or identification number214554
Number of Individuals Covered138
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $4,109
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $27,394
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $4,109
Insurance broker organization code?3
Insurance broker nameISG ADVISORS LLC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number214554
Policy instance 1
Insurance contract or identification number214554
Number of Individuals Covered142
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $3,558
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,720
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,558
Insurance broker organization code?3
Insurance broker nameISG ADVISORS LLC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number214554
Policy instance 1
Insurance contract or identification number214554
Number of Individuals Covered143
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $3,413
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $22,526
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,413
Insurance broker organization code?3
Insurance broker nameISG ADVISORS LLC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number214554
Policy instance 1
Insurance contract or identification number214554
Number of Individuals Covered156
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $3,818
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,514
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $141
Insurance broker organization code?3
Insurance broker nameISG ADVISORS LLC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number214554
Policy instance 1
Insurance contract or identification number214554
Number of Individuals Covered148
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $3,683
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,555
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 )
Policy contract numberALLO7369
Policy instance 1
Insurance contract or identification numberALLO7369
Number of Individuals Covered147
Insurance policy start date2010-01-01
Insurance policy end date2010-07-31
Total amount of commissions paid to insurance brokerUSD $719
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,988
Commission paid to Insurance BrokerUSD $719
Insurance broker organization code?3
Insurance broker nameCOTTINGHAM & BUTLER INS SERVICES
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number214554
Policy instance 2
Insurance contract or identification number214554
Number of Individuals Covered148
Insurance policy start date2010-08-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $1,507
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,048
Commission paid to Insurance BrokerUSD $1,507
Insurance broker organization code?3
Insurance broker nameISG ADVISORS LLC

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