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LAKEVIEW MEMORIAL HOSPITAL GROUP LIFE INSURANCE PL 401k Plan overview

Plan NameLAKEVIEW MEMORIAL HOSPITAL GROUP LIFE INSURANCE PL
Plan identification number 504

LAKEVIEW MEMORIAL HOSPITAL GROUP LIFE INSURANCE PL Benefits

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

401k Sponsoring company profile

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

Company Name:LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, INC.
Employer identification number (EIN):410811697
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LAKEVIEW MEMORIAL HOSPITAL GROUP LIFE INSURANCE PL

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042018-01-01DOUG JOHNSON DOUG JOHNSON2019-06-29
5042017-01-01DOUG JOHNSON2018-10-11 DOUG JOHNSON2018-10-11
5042016-01-01DOUG JOHNSON2017-07-17 DOUG JOHNSON2017-07-17
5042015-01-01DOUG JOHNSON2016-10-14 DOUG JOHNSON2016-10-14
5042014-01-01DOUG JOHNSON2015-10-13 DOUG JOHNSON2015-10-13
5042013-10-01DOUG JOHNSON2014-07-24 DOUG JOHNSON2014-07-24
5042012-10-01DOUG JOHNSON2013-12-15 DOUG JOHNSON2013-12-15
5042011-10-01DOUG JOHNSON2013-10-07 DOUG JOHNSON2013-10-07
5042009-07-01DOUGLAS JOHNSON

Plan Statistics for LAKEVIEW MEMORIAL HOSPITAL GROUP LIFE INSURANCE PL

401k plan membership statisitcs for LAKEVIEW MEMORIAL HOSPITAL GROUP LIFE INSURANCE PL

Measure Date Value
2018: LAKEVIEW MEMORIAL HOSPITAL GROUP LIFE INSURANCE PL 2018 401k membership
Total participants, beginning-of-year2018-01-01965
Total number of active participants reported on line 7a of the Form 55002018-01-01652
Number of retired or separated participants receiving benefits2018-01-019
Total of all active and inactive participants2018-01-01661
2017: LAKEVIEW MEMORIAL HOSPITAL GROUP LIFE INSURANCE PL 2017 401k membership
Total participants, beginning-of-year2017-01-01916
Total number of active participants reported on line 7a of the Form 55002017-01-01947
Number of retired or separated participants receiving benefits2017-01-0121
Total of all active and inactive participants2017-01-01968
2016: LAKEVIEW MEMORIAL HOSPITAL GROUP LIFE INSURANCE PL 2016 401k membership
Total participants, beginning-of-year2016-01-01843
Total number of active participants reported on line 7a of the Form 55002016-01-01907
Number of retired or separated participants receiving benefits2016-01-0119
Total of all active and inactive participants2016-01-01926
2015: LAKEVIEW MEMORIAL HOSPITAL GROUP LIFE INSURANCE PL 2015 401k membership
Total participants, beginning-of-year2015-01-01947
Total number of active participants reported on line 7a of the Form 55002015-01-01841
Number of retired or separated participants receiving benefits2015-01-012
Total of all active and inactive participants2015-01-01843
2014: LAKEVIEW MEMORIAL HOSPITAL GROUP LIFE INSURANCE PL 2014 401k membership
Total participants, beginning-of-year2014-01-01955
Total number of active participants reported on line 7a of the Form 55002014-01-01945
Number of retired or separated participants receiving benefits2014-01-012
Total of all active and inactive participants2014-01-01947
2013: LAKEVIEW MEMORIAL HOSPITAL GROUP LIFE INSURANCE PL 2013 401k membership
Total participants, beginning-of-year2013-10-01918
Total number of active participants reported on line 7a of the Form 55002013-10-01920
Number of retired or separated participants receiving benefits2013-10-018
Total of all active and inactive participants2013-10-01928
2012: LAKEVIEW MEMORIAL HOSPITAL GROUP LIFE INSURANCE PL 2012 401k membership
Total participants, beginning-of-year2012-10-01706
Total number of active participants reported on line 7a of the Form 55002012-10-01912
Number of retired or separated participants receiving benefits2012-10-016
Total of all active and inactive participants2012-10-01918
2011: LAKEVIEW MEMORIAL HOSPITAL GROUP LIFE INSURANCE PL 2011 401k membership
Total participants, beginning-of-year2011-10-01678
Total number of active participants reported on line 7a of the Form 55002011-10-01706
Total of all active and inactive participants2011-10-01706
2009: LAKEVIEW MEMORIAL HOSPITAL GROUP LIFE INSURANCE PL 2009 401k membership
Total participants, beginning-of-year2009-07-01638
Total number of active participants reported on line 7a of the Form 55002009-07-01588
Total of all active and inactive participants2009-07-01588
Total participants2009-07-010

Form 5500 Responses for LAKEVIEW MEMORIAL HOSPITAL GROUP LIFE INSURANCE PL

2018: LAKEVIEW MEMORIAL HOSPITAL GROUP LIFE INSURANCE PL 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01This submission is the final filingYes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: LAKEVIEW MEMORIAL HOSPITAL GROUP LIFE INSURANCE PL 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: LAKEVIEW MEMORIAL HOSPITAL GROUP LIFE INSURANCE PL 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: LAKEVIEW MEMORIAL HOSPITAL GROUP LIFE INSURANCE PL 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: LAKEVIEW MEMORIAL HOSPITAL GROUP LIFE INSURANCE PL 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: LAKEVIEW MEMORIAL HOSPITAL GROUP LIFE INSURANCE PL 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01This return/report is a short plan year return/report (less than 12 months)Yes
2013-10-01Plan funding arrangement – InsuranceYes
2013-10-01Plan benefit arrangement – InsuranceYes
2012: LAKEVIEW MEMORIAL HOSPITAL GROUP LIFE INSURANCE PL 2012 form 5500 responses
2012-10-01Type of plan entitySingle employer plan
2012-10-01Plan funding arrangement – InsuranceYes
2012-10-01Plan benefit arrangement – InsuranceYes
2011: LAKEVIEW MEMORIAL HOSPITAL GROUP LIFE INSURANCE PL 2011 form 5500 responses
2011-10-01Type of plan entitySingle employer plan
2011-10-01Plan funding arrangement – InsuranceYes
2011-10-01Plan benefit arrangement – InsuranceYes
2009: LAKEVIEW MEMORIAL HOSPITAL GROUP LIFE INSURANCE PL 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number34587
Policy instance 2
Insurance contract or identification number34587
Number of Individuals Covered939
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $591
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $26,816
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees591
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMMISSIONS
Insurance broker organization code?3
MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )
Policy contract number34587
Policy instance 1
Insurance contract or identification number34587
Number of Individuals Covered706
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $2,931
Life Insurance Welfare BenefitYes
Other welfare benefits providedSUPP. LIFE & DEPENDENT LIFE
Welfare Benefit Premiums Paid to CarrierUSD $133,047
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees2931
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMMISSIONS
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 965862
Policy instance 2
Insurance contract or identification numberOK 965862
Number of Individuals Covered965
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $459
Total amount of fees paid to insurance companyUSD $100
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $6,126
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $459
Amount paid for insurance broker fees100
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX964253
Policy instance 1
Insurance contract or identification numberFLX964253
Number of Individuals Covered662
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $12,008
Total amount of fees paid to insurance companyUSD $2,373
Life Insurance Welfare BenefitYes
Other welfare benefits providedSUPP. LIFE & DEPENDENT LIFE
Welfare Benefit Premiums Paid to CarrierUSD $160,111
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,008
Amount paid for insurance broker fees2373
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX964253
Policy instance 1
Insurance contract or identification numberFLX964253
Number of Individuals Covered843
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $13,775
Total amount of fees paid to insurance companyUSD $1,659
Life Insurance Welfare BenefitYes
Other welfare benefits providedSUPP. LIFE & DEPENDENT LIFE
Welfare Benefit Premiums Paid to CarrierUSD $183,660
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,775
Amount paid for insurance broker fees1659
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 965862
Policy instance 2
Insurance contract or identification numberOK 965862
Number of Individuals Covered843
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $518
Total amount of fees paid to insurance companyUSD $65
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $6,908
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $518
Amount paid for insurance broker fees65
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX964253
Policy instance 1
Insurance contract or identification numberFLX964253
Number of Individuals Covered955
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $11,667
Total amount of fees paid to insurance companyUSD $1,172
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedSUPP. LIFE & DEPENDENT LIFE
Welfare Benefit Premiums Paid to CarrierUSD $155,558
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,667
Amount paid for insurance broker fees1172
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 965862
Policy instance 2
Insurance contract or identification numberOK 965862
Number of Individuals Covered955
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $460
Total amount of fees paid to insurance companyUSD $47
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $6,135
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $460
Amount paid for insurance broker fees47
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 965862
Policy instance 2
Insurance contract or identification numberOK 965862
Number of Individuals Covered928
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $610
Total amount of fees paid to insurance companyUSD $79
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $6,250
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $610
Amount paid for insurance broker fees79
Insurance broker nameGALLAGHER BENEFIT SERVICE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX964253
Policy instance 1
Insurance contract or identification numberFLX964253
Number of Individuals Covered1602
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $14,268
Total amount of fees paid to insurance companyUSD $1,929
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedSUPP. LIFE & DEPENDENT LIFE
Welfare Benefit Premiums Paid to CarrierUSD $149,135
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,268
Amount paid for insurance broker fees1929
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX964253
Policy instance 1
Insurance contract or identification numberFLX964253
Number of Individuals Covered563
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $11,141
Total amount of fees paid to insurance companyUSD $2,164
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedSUPP. LIFE & DEPENDENT LIFE
Welfare Benefit Premiums Paid to CarrierUSD $151,994
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,141
Amount paid for insurance broker fees2164
Insurance broker nameGALLAGHER BENEFIT SERVICE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 965862
Policy instance 2
Insurance contract or identification numberOK 965862
Number of Individuals Covered563
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,690
Total amount of fees paid to insurance companyUSD $89
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $7,159
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,690
Amount paid for insurance broker fees89
Insurance broker nameGALLAGHER BENEFIT SERVICE
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX964253
Policy instance 1
Insurance contract or identification numberFLX964253
Number of Individuals Covered364
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $613
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedSUPP. LIFE & DEPENDENT LIFE
Welfare Benefit Premiums Paid to CarrierUSD $8,167
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberOK 965862
Policy instance 2
Insurance contract or identification numberOK 965862
Number of Individuals Covered364
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $38
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Other welfare benefits providedACCIDENTAL DEATH
Welfare Benefit Premiums Paid to CarrierUSD $511
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number0137636
Policy instance 1
Insurance contract or identification number0137636
Number of Individuals Covered1522
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $19,950
Total amount of fees paid to insurance companyUSD $17
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $148,692
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number137636
Policy instance 1
Insurance contract or identification number137636
Number of Individuals Covered1399
Insurance policy start date2010-07-01
Insurance policy end date2010-09-30
Total amount of commissions paid to insurance brokerUSD $5,720
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $5,720
Commission paid to Insurance BrokerUSD $1,399
Insurance broker organization code?3
Insurance broker nameUNISON, INC.

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