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FAITH REGIONAL HEALTH SERVICES EMPLOYEE BENEFITS PLAN 401k Plan overview

Plan NameFAITH REGIONAL HEALTH SERVICES EMPLOYEE BENEFITS PLAN
Plan identification number 503

FAITH REGIONAL HEALTH SERVICES EMPLOYEE BENEFITS PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Dental
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

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

Company Name:FAITH REGIONAL HEALTH SERVICES
Employer identification number (EIN):470796875
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FAITH REGIONAL HEALTH SERVICES EMPLOYEE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032015-01-01JANET PINKELMAN
5032014-01-01CATHY DORENBACH
5032013-01-01CATHY DORENBACH
5032012-01-01CATHY DORENBACH
5032011-01-01CATHY DORENBACH
5032010-01-01CATHY DORENBACH
5032009-01-01CATHY DORENBACH

Plan Statistics for FAITH REGIONAL HEALTH SERVICES EMPLOYEE BENEFITS PLAN

401k plan membership statisitcs for FAITH REGIONAL HEALTH SERVICES EMPLOYEE BENEFITS PLAN

Measure Date Value
2015: FAITH REGIONAL HEALTH SERVICES EMPLOYEE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-011,026
Total number of active participants reported on line 7a of the Form 55002015-01-010
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-010
2014: FAITH REGIONAL HEALTH SERVICES EMPLOYEE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-011,051
Total number of active participants reported on line 7a of the Form 55002014-01-011,018
Number of retired or separated participants receiving benefits2014-01-012
Total of all active and inactive participants2014-01-011,020
Total participants2014-01-011,020
2013: FAITH REGIONAL HEALTH SERVICES EMPLOYEE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01994
Total number of active participants reported on line 7a of the Form 55002013-01-011,045
Number of retired or separated participants receiving benefits2013-01-016
Total of all active and inactive participants2013-01-011,051
Total participants2013-01-011,051
2012: FAITH REGIONAL HEALTH SERVICES EMPLOYEE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-011,040
Total number of active participants reported on line 7a of the Form 55002012-01-01988
Number of retired or separated participants receiving benefits2012-01-016
Total of all active and inactive participants2012-01-01994
Total participants2012-01-01994
2011: FAITH REGIONAL HEALTH SERVICES EMPLOYEE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-011,070
Total number of active participants reported on line 7a of the Form 55002011-01-011,033
Number of retired or separated participants receiving benefits2011-01-017
Total of all active and inactive participants2011-01-011,040
Total participants2011-01-011,040
2010: FAITH REGIONAL HEALTH SERVICES EMPLOYEE BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-011,149
Total number of active participants reported on line 7a of the Form 55002010-01-011,051
Number of retired or separated participants receiving benefits2010-01-0119
Total of all active and inactive participants2010-01-011,070
Total participants2010-01-011,070
2009: FAITH REGIONAL HEALTH SERVICES EMPLOYEE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-011,140
Total number of active participants reported on line 7a of the Form 55002009-01-011,137
Number of retired or separated participants receiving benefits2009-01-0112
Total of all active and inactive participants2009-01-011,149
Total participants2009-01-011,149

Form 5500 Responses for FAITH REGIONAL HEALTH SERVICES EMPLOYEE BENEFITS PLAN

2015: FAITH REGIONAL HEALTH SERVICES EMPLOYEE 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 filingYes
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: FAITH REGIONAL HEALTH SERVICES EMPLOYEE BENEFITS PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: FAITH REGIONAL HEALTH SERVICES EMPLOYEE BENEFITS PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: FAITH REGIONAL HEALTH SERVICES EMPLOYEE BENEFITS PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: FAITH REGIONAL HEALTH SERVICES EMPLOYEE BENEFITS PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: FAITH REGIONAL HEALTH SERVICES EMPLOYEE BENEFITS PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: FAITH REGIONAL HEALTH SERVICES EMPLOYEE BENEFITS PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-301111
Policy instance 1
Insurance contract or identification number010-301111
Number of Individuals Covered1052
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $10,278
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 BenefitYes
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 $53,741
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,278
Insurance broker organization code?3
Insurance broker nameUNICO MIDLANDS LLC
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010301111
Policy instance 1
Insurance contract or identification number010301111
Number of Individuals Covered1020
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $10,018
Total amount of fees paid to insurance companyUSD $1,847
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 BenefitYes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,018
Amount paid for insurance broker fees1847
Additional information about fees paid to insurance brokerPRODUCER COMPENSATION BONUS
Insurance broker organization code?3
Insurance broker nameUNICO MIDLANDS LLC
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010301111
Policy instance 1
Insurance contract or identification number010301111
Number of Individuals Covered1051
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $10,147
Total amount of fees paid to insurance companyUSD $1,535
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 BenefitYes
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,485
Amount paid for insurance broker fees1000
Additional information about fees paid to insurance brokerPRODUCER COMPENSATION BONUS
Insurance broker organization code?3
Insurance broker nameMIDLANDS FINANCIAL BENEFITS
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010301111
Policy instance 1
Insurance contract or identification number010301111
Number of Individuals Covered994
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $9,818
Total amount of fees paid to insurance companyUSD $498
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,818
Amount paid for insurance broker fees498
Additional information about fees paid to insurance brokerPRODUCER COMPENSATION BONUS
Insurance broker organization code?3
Insurance broker nameMIDLANDS FINANCIAL BENEFITS
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010301111
Policy instance 1
Insurance contract or identification number010301111
Number of Individuals Covered1040
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $11,529
Total amount of fees paid to insurance companyUSD $1,202
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010301111
Policy instance 1
Insurance contract or identification number010301111
Number of Individuals Covered1070
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $13,057
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,057
Insurance broker organization code?3
Insurance broker nameMIDLANDS FINANCIAL BENEFITS

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