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WINONA HEALTH MEDICAL BENEFIT PLAN 401k Plan overview

Plan NameWINONA HEALTH MEDICAL BENEFIT PLAN
Plan identification number 503

WINONA HEALTH MEDICAL BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

WINONA HEALTH SERVICES has sponsored the creation of one or more 401k plans.

Company Name:WINONA HEALTH SERVICES
Employer identification number (EIN):410713914
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WINONA HEALTH MEDICAL BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032022-10-01REBECCA LAMBERTY2024-03-05
5032021-10-01REBECCA LAMBERTY2023-04-05
5032020-10-01REBECCA LAMBERTY2022-04-08
5032019-10-01
5032018-10-01
5032017-10-01
5032016-10-01REBECCA LAMBERTY
5032015-10-01KATHY WADE
5032014-10-01
5032013-10-01KATHY WADE
5032012-10-01ASHLEY ANDERSON
5032011-10-01MICHAEL SKROCH
5032009-10-01MICHAEL SKROCH WILLIAM GOULD2011-04-11

Plan Statistics for WINONA HEALTH MEDICAL BENEFIT PLAN

401k plan membership statisitcs for WINONA HEALTH MEDICAL BENEFIT PLAN

Measure Date Value
2022: WINONA HEALTH MEDICAL BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-10-01650
Total number of active participants reported on line 7a of the Form 55002022-10-01653
Number of retired or separated participants receiving benefits2022-10-010
Number of other retired or separated participants entitled to future benefits2022-10-010
Total of all active and inactive participants2022-10-01653
Number of employers contributing to the scheme2022-10-010
2021: WINONA HEALTH MEDICAL BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-10-01563
Total number of active participants reported on line 7a of the Form 55002021-10-01650
Number of retired or separated participants receiving benefits2021-10-010
Number of other retired or separated participants entitled to future benefits2021-10-010
Total of all active and inactive participants2021-10-01650
Number of employers contributing to the scheme2021-10-010
2020: WINONA HEALTH MEDICAL BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-10-01568
Total number of active participants reported on line 7a of the Form 55002020-10-01563
Number of retired or separated participants receiving benefits2020-10-010
Number of other retired or separated participants entitled to future benefits2020-10-010
Total of all active and inactive participants2020-10-01563
Number of employers contributing to the scheme2020-10-010
2019: WINONA HEALTH MEDICAL BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-10-01598
Total number of active participants reported on line 7a of the Form 55002019-10-01563
Number of retired or separated participants receiving benefits2019-10-015
Total of all active and inactive participants2019-10-01568
2018: WINONA HEALTH MEDICAL BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-10-01623
Total number of active participants reported on line 7a of the Form 55002018-10-01593
Number of retired or separated participants receiving benefits2018-10-015
Total of all active and inactive participants2018-10-01598
2017: WINONA HEALTH MEDICAL BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-10-01685
Total number of active participants reported on line 7a of the Form 55002017-10-01618
Number of retired or separated participants receiving benefits2017-10-015
Total of all active and inactive participants2017-10-01623
2016: WINONA HEALTH MEDICAL BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-10-01670
Total number of active participants reported on line 7a of the Form 55002016-10-01675
Number of retired or separated participants receiving benefits2016-10-0110
Total of all active and inactive participants2016-10-01685
2015: WINONA HEALTH MEDICAL BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-01660
Total number of active participants reported on line 7a of the Form 55002015-10-01660
Number of retired or separated participants receiving benefits2015-10-0110
Total of all active and inactive participants2015-10-01670
2014: WINONA HEALTH MEDICAL BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-10-01701
Total number of active participants reported on line 7a of the Form 55002014-10-01649
Number of retired or separated participants receiving benefits2014-10-0111
Total of all active and inactive participants2014-10-01660
2013: WINONA HEALTH MEDICAL BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-10-01699
Total number of active participants reported on line 7a of the Form 55002013-10-01685
Number of retired or separated participants receiving benefits2013-10-0116
Total of all active and inactive participants2013-10-01701
2012: WINONA HEALTH MEDICAL BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-10-01821
Total number of active participants reported on line 7a of the Form 55002012-10-01674
Number of retired or separated participants receiving benefits2012-10-0125
Total of all active and inactive participants2012-10-01699
2011: WINONA HEALTH MEDICAL BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-10-01629
Total number of active participants reported on line 7a of the Form 55002011-10-01805
Number of retired or separated participants receiving benefits2011-10-0116
Total of all active and inactive participants2011-10-01821
2009: WINONA HEALTH MEDICAL BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-10-01743
Total number of active participants reported on line 7a of the Form 55002009-10-01704
Number of retired or separated participants receiving benefits2009-10-0125
Total of all active and inactive participants2009-10-01729
Total participants2009-10-01729

Form 5500 Responses for WINONA HEALTH MEDICAL BENEFIT PLAN

2022: WINONA HEALTH MEDICAL BENEFIT PLAN 2022 form 5500 responses
2022-10-01Type of plan entitySingle employer plan
2022-10-01Plan funding arrangement – InsuranceYes
2022-10-01Plan funding arrangement – General assets of the sponsorYes
2022-10-01Plan benefit arrangement – InsuranceYes
2022-10-01Plan benefit arrangement – General assets of the sponsorYes
2021: WINONA HEALTH MEDICAL BENEFIT PLAN 2021 form 5500 responses
2021-10-01Type of plan entitySingle employer plan
2021-10-01Plan funding arrangement – InsuranceYes
2021-10-01Plan funding arrangement – General assets of the sponsorYes
2021-10-01Plan benefit arrangement – InsuranceYes
2021-10-01Plan benefit arrangement – General assets of the sponsorYes
2020: WINONA HEALTH MEDICAL BENEFIT PLAN 2020 form 5500 responses
2020-10-01Type of plan entitySingle employer plan
2020-10-01Plan funding arrangement – General assets of the sponsorYes
2020-10-01Plan benefit arrangement – General assets of the sponsorYes
2019: WINONA HEALTH MEDICAL BENEFIT PLAN 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01Plan funding arrangement – General assets of the sponsorYes
2019-10-01Plan benefit arrangement – General assets of the sponsorYes
2018: WINONA HEALTH MEDICAL BENEFIT PLAN 2018 form 5500 responses
2018-10-01Type of plan entitySingle employer plan
2018-10-01Plan funding arrangement – General assets of the sponsorYes
2018-10-01Plan benefit arrangement – General assets of the sponsorYes
2017: WINONA HEALTH MEDICAL BENEFIT PLAN 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01Plan funding arrangement – General assets of the sponsorYes
2017-10-01Plan benefit arrangement – General assets of the sponsorYes
2016: WINONA HEALTH MEDICAL BENEFIT PLAN 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01Plan funding arrangement – General assets of the sponsorYes
2016-10-01Plan benefit arrangement – General assets of the sponsorYes
2015: WINONA HEALTH MEDICAL BENEFIT PLAN 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01Plan funding arrangement – General assets of the sponsorYes
2015-10-01Plan benefit arrangement – General assets of the sponsorYes
2014: WINONA HEALTH MEDICAL BENEFIT PLAN 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01Plan funding arrangement – General assets of the sponsorYes
2014-10-01Plan benefit arrangement – General assets of the sponsorYes
2013: WINONA HEALTH MEDICAL BENEFIT PLAN 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01Plan funding arrangement – General assets of the sponsorYes
2013-10-01Plan benefit arrangement – General assets of the sponsorYes
2012: WINONA HEALTH MEDICAL BENEFIT PLAN 2012 form 5500 responses
2012-10-01Type of plan entitySingle employer plan
2012-10-01Plan funding arrangement – General assets of the sponsorYes
2012-10-01Plan benefit arrangement – General assets of the sponsorYes
2011: WINONA HEALTH MEDICAL BENEFIT PLAN 2011 form 5500 responses
2011-10-01Type of plan entitySingle employer plan
2011-10-01Plan funding arrangement – General assets of the sponsorYes
2011-10-01Plan benefit arrangement – General assets of the sponsorYes
2009: WINONA HEALTH MEDICAL BENEFIT PLAN 2009 form 5500 responses
2009-10-01Type of plan entitySingle employer plan
2009-10-01Submission has been amendedNo
2009-10-01This submission is the final filingNo
2009-10-01This return/report is a short plan year return/report (less than 12 months)No
2009-10-01Plan is a collectively bargained planNo
2009-10-01Plan funding arrangement – InsuranceYes
2009-10-01Plan funding arrangement – General assets of the sponsorYes
2009-10-01Plan benefit arrangement – InsuranceYes
2009-10-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number68548-8
Policy instance 1
Insurance contract or identification number68548-8
Number of Individuals Covered1386
Insurance policy start date2022-10-01
Insurance policy end date2023-09-30
Total amount of commissions paid to insurance brokerUSD $32,174
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $559,298
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,162
Amount paid for insurance broker fees0
Insurance broker organization code?3
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-042239
Policy instance 2
Insurance contract or identification number010-042239
Number of Individuals Covered550
Insurance policy start date2022-10-01
Insurance policy end date2023-09-30
Total amount of commissions paid to insurance brokerUSD $4,743
Total amount of fees paid to insurance companyUSD $287
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $36,476
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,507
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerFEES
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number477080
Policy instance 3
Insurance contract or identification number477080
Number of Individuals Covered653
Insurance policy start date2022-10-01
Insurance policy end date2023-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $6,504
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $287,229
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees6504
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number68548-8
Policy instance 1
Insurance contract or identification number68548-8
Number of Individuals Covered1352
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $75,257
Total amount of fees paid to insurance companyUSD $20,000
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $263,505
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $75,257
Amount paid for insurance broker fees20000
Additional information about fees paid to insurance brokerTECHNOLOGY FEE
Insurance broker organization code?3
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-042239
Policy instance 2
Insurance contract or identification number010-042239
Number of Individuals Covered558
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $308
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $38,907
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees308
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number477080
Policy instance 3
Insurance contract or identification number477080
Number of Individuals Covered658
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $14,341
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $286,812
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees14341
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )
Policy contract numberACC-0000000596
Policy instance 4
Insurance contract or identification numberACC-0000000596
Number of Individuals Covered309
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $2,071
Total amount of fees paid to insurance companyUSD $0
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
Other welfare benefits providedCRITICAL ILLNESS,ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $14,659
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,071
Amount paid for insurance broker fees0
Insurance broker organization code?3
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number299-9220
Policy instance 1
Insurance contract or identification number299-9220
Number of Individuals Covered629
Insurance policy start date2010-10-01
Insurance policy end date2011-09-30
Total amount of commissions paid to insurance brokerUSD $20,590
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 $257,373
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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