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ROGERS MEMORIAL HOSPITAL INC LIFE PLAN 401k Plan overview

Plan NameROGERS MEMORIAL HOSPITAL INC LIFE PLAN
Plan identification number 530

ROGERS MEMORIAL HOSPITAL INC LIFE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

ROGERS MEMORIAL HOSPITAL, INC has sponsored the creation of one or more 401k plans.

Company Name:ROGERS MEMORIAL HOSPITAL, INC
Employer identification number (EIN):391139101
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ROGERS MEMORIAL HOSPITAL INC LIFE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5302006-08-01CHRIS JAGODITZ2023-07-25

Plan Statistics for ROGERS MEMORIAL HOSPITAL INC LIFE PLAN

401k plan membership statisitcs for ROGERS MEMORIAL HOSPITAL INC LIFE PLAN

Measure Date Value
2006: ROGERS MEMORIAL HOSPITAL INC LIFE PLAN 2006 401k membership
Total participants, beginning-of-year2006-08-01449
Total number of active participants reported on line 7a of the Form 55002006-08-010
Number of retired or separated participants receiving benefits2006-08-010
Number of other retired or separated participants entitled to future benefits2006-08-010
Total of all active and inactive participants2006-08-010
Number of employers contributing to the scheme2006-08-010

Form 5500 Responses for ROGERS MEMORIAL HOSPITAL INC LIFE PLAN

2006: ROGERS MEMORIAL HOSPITAL INC LIFE PLAN 2006 form 5500 responses
2006-08-01Type of plan entitySingle employer plan
2006-08-01Submission has been amendedYes
2006-08-01This submission is the final filingYes
2006-08-01This return/report is a short plan year return/report (less than 12 months)Yes
2006-08-01Plan funding arrangement – InsuranceYes
2006-08-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE PAUL REVERE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67598 )
Policy contract number1043047
Policy instance 1
Insurance contract or identification number1043047
Number of Individuals Covered0
Insurance policy start date2006-08-01
Insurance policy end date2006-12-31
Total amount of commissions paid to insurance brokerUSD $6,485
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $124,821
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,485
Amount paid for insurance broker fees0
Insurance broker organization code?3

Potentially related plans

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