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TRIVERGENT HEALTH ALLIANCE, MSO HEALTH AND WELFARE BENEFITS PLAN 401k Plan overview

Plan NameTRIVERGENT HEALTH ALLIANCE, MSO HEALTH AND WELFARE BENEFITS PLAN
Plan identification number 501

TRIVERGENT HEALTH ALLIANCE, MSO HEALTH AND WELFARE BENEFITS 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
  • Severance pay
  • Other welfare benefit cover

401k Sponsoring company profile

TRIVERGENT HEALTH ALLIANCE, MSO has sponsored the creation of one or more 401k plans.

Company Name:TRIVERGENT HEALTH ALLIANCE, MSO
Employer identification number (EIN):465568009
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TRIVERGENT HEALTH ALLIANCE, MSO HEALTH AND WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012020-01-01
5012019-01-01
5012018-01-01SHANA WOLFE RAYMOND A. GRAHE2019-04-25
5012017-01-01SHANA WOLFE RAYMOND A. GRAHE2018-05-02
5012016-01-01SHANA WOLFE RAYMOND A. GRAHE2017-07-24
5012015-01-01SHANA WOLFE RAYMOND A. GRAHE2016-08-26
5012014-07-06RAYMOND GRAHE RAYMOND GRAHE2015-10-15

Plan Statistics for TRIVERGENT HEALTH ALLIANCE, MSO HEALTH AND WELFARE BENEFITS PLAN

401k plan membership statisitcs for TRIVERGENT HEALTH ALLIANCE, MSO HEALTH AND WELFARE BENEFITS PLAN

Measure Date Value
2020: TRIVERGENT HEALTH ALLIANCE, MSO HEALTH AND WELFARE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01292
Total number of active participants reported on line 7a of the Form 55002020-01-010
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-010
2019: TRIVERGENT HEALTH ALLIANCE, MSO HEALTH AND WELFARE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01866
Total number of active participants reported on line 7a of the Form 55002019-01-01491
Number of retired or separated participants receiving benefits2019-01-013
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01494
2018: TRIVERGENT HEALTH ALLIANCE, MSO HEALTH AND WELFARE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-011,218
Total number of active participants reported on line 7a of the Form 55002018-01-01856
Number of retired or separated participants receiving benefits2018-01-016
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01862
2017: TRIVERGENT HEALTH ALLIANCE, MSO HEALTH AND WELFARE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-011,231
Total number of active participants reported on line 7a of the Form 55002017-01-011,094
Number of retired or separated participants receiving benefits2017-01-017
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-011,101
2016: TRIVERGENT HEALTH ALLIANCE, MSO HEALTH AND WELFARE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-011,125
Total number of active participants reported on line 7a of the Form 55002016-01-011,930
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-011,930
2015: TRIVERGENT HEALTH ALLIANCE, MSO HEALTH AND WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01548
Total number of active participants reported on line 7a of the Form 55002015-01-01648
Number of retired or separated participants receiving benefits2015-01-017
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01655
2014: TRIVERGENT HEALTH ALLIANCE, MSO HEALTH AND WELFARE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-060
Total number of active participants reported on line 7a of the Form 55002014-07-061,156
Number of retired or separated participants receiving benefits2014-07-060
Number of other retired or separated participants entitled to future benefits2014-07-060
Total of all active and inactive participants2014-07-061,156
Total participants2014-07-061,156

Form 5500 Responses for TRIVERGENT HEALTH ALLIANCE, MSO HEALTH AND WELFARE BENEFITS PLAN

2020: TRIVERGENT HEALTH ALLIANCE, MSO HEALTH AND WELFARE BENEFITS PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingYes
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: TRIVERGENT HEALTH ALLIANCE, MSO HEALTH AND WELFARE BENEFITS PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: TRIVERGENT HEALTH ALLIANCE, MSO HEALTH AND WELFARE BENEFITS PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: TRIVERGENT HEALTH ALLIANCE, MSO HEALTH AND WELFARE BENEFITS PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: TRIVERGENT HEALTH ALLIANCE, MSO HEALTH AND WELFARE BENEFITS PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: TRIVERGENT HEALTH ALLIANCE, MSO HEALTH AND WELFARE BENEFITS PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: TRIVERGENT HEALTH ALLIANCE, MSO HEALTH AND WELFARE BENEFITS PLAN 2014 form 5500 responses
2014-07-06Type of plan entitySingle employer plan
2014-07-06First time form 5500 has been submittedYes
2014-07-06Submission has been amendedNo
2014-07-06This submission is the final filingNo
2014-07-06This return/report is a short plan year return/report (less than 12 months)Yes
2014-07-06Plan is a collectively bargained planNo
2014-07-06Plan funding arrangement – InsuranceYes
2014-07-06Plan funding arrangement – General assets of the sponsorYes
2014-07-06Plan benefit arrangement – InsuranceYes
2014-07-06Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number938171
Policy instance 3
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number53101
Policy instance 2
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0473578
Policy instance 1
US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 )
Policy contract numberUS1181256
Policy instance 3
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number53101
Policy instance 2
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0473578
Policy instance 1
US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 )
Policy contract numberUS952473
Policy instance 3
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number53101
Policy instance 2
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0473578
Policy instance 1
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0473578
Policy instance 1
NATIONAL HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 82538 )
Policy contract number4529NH
Policy instance 2
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0473578
Policy instance 1
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0473578-SHORT
Policy instance 1

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