401k Plan data: THOMAS MEMORIAL HOSPITAL EMPLOYEES' RETIREMENT PLAN plan

THOMAS MEMORIAL HOSPITAL EMPLOYEES' RETIREMENT PLAN 401k Plan overview

Plan Name	THOMAS MEMORIAL HOSPITAL EMPLOYEES' RETIREMENT PLAN
Plan identification number	002

THOMAS MEMORIAL HOSPITAL EMPLOYEES' RETIREMENT PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 403(b)(1) arrangement - See Limited Pension Plan Reporting instructions for Code section 403(b)(1) arrangements for certain exempt organizations.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

HERBERT J. MEMORIAL HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name: HERBERT J. MEMORIAL HOSPITAL

Employer identification number (EIN): 550404900

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THOMAS MEMORIAL HOSPITAL EMPLOYEES' RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2014-01-01 CHARLIE COVERT 2014-08-26
002 2013-01-01 CHARLIE COVERT 2014-07-24
002 2012-07-01 CHARLIE COVERT
002 2012-01-01 CHARLIE COVERT
002 2011-01-01 CHARLIE COVERT
002 2010-01-01 CHARLIE COVERT
002 2009-01-01 CHARLIE COVERT

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
002	2014-01-01	CHARLIE COVERT	2014-08-26
002	2013-01-01	CHARLIE COVERT	2014-07-24
002	2012-07-01	CHARLIE COVERT
002	2012-01-01	CHARLIE COVERT
002	2011-01-01	CHARLIE COVERT
002	2010-01-01	CHARLIE COVERT
002	2009-01-01	CHARLIE COVERT

Plan Statistics for THOMAS MEMORIAL HOSPITAL EMPLOYEES' RETIREMENT PLAN

401k plan membership statisitcs for THOMAS MEMORIAL HOSPITAL EMPLOYEES' RETIREMENT PLAN

Measure Date Value
2012: THOMAS MEMORIAL HOSPITAL EMPLOYEES' RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-07-01 809
Total number of active participants reported on line 7a of the Form 5500 2012-07-01 980
Number of retired or separated participants receiving benefits 2012-07-01 2
Number of other retired or separated participants entitled to future benefits 2012-07-01 11
Total of all active and inactive participants 2012-07-01 993
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-07-01 0
Total participants 2012-07-01 993
Number of participants with account balances 2012-07-01 494
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-07-01 0
Total participants, beginning-of-year 2012-01-01 1,219
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 0
Number of retired or separated participants receiving benefits 2012-01-01 23
Total of all active and inactive participants 2012-01-01 23
Total participants 2012-01-01 23
Number of participants with account balances 2012-01-01 23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: THOMAS MEMORIAL HOSPITAL EMPLOYEES' RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 988
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 806
Number of retired or separated participants receiving benefits 2011-01-01 60
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 866
Total participants 2011-01-01 866
Number of participants with account balances 2011-01-01 866
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: THOMAS MEMORIAL HOSPITAL EMPLOYEES' RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 1,224
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 868
Number of retired or separated participants receiving benefits 2010-01-01 18
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 886
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 886
Number of participants with account balances 2010-01-01 886
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 86
2009: THOMAS MEMORIAL HOSPITAL EMPLOYEES' RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 2,309
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 890
Number of retired or separated participants receiving benefits 2009-01-01 37
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 927
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 927
Number of participants with account balances 2009-01-01 927
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2012: THOMAS MEMORIAL HOSPITAL EMPLOYEES' RETIREMENT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-07-01	809
Total number of active participants reported on line 7a of the Form 5500	2012-07-01	980
Number of retired or separated participants receiving benefits	2012-07-01	2
Number of other retired or separated participants entitled to future benefits	2012-07-01	11
Total of all active and inactive participants	2012-07-01	993
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-07-01	0
Total participants	2012-07-01	993
Number of participants with account balances	2012-07-01	494
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-07-01	0
Total participants, beginning-of-year	2012-01-01	1,219
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	0
Number of retired or separated participants receiving benefits	2012-01-01	23
Total of all active and inactive participants	2012-01-01	23
Total participants	2012-01-01	23
Number of participants with account balances	2012-01-01	23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: THOMAS MEMORIAL HOSPITAL EMPLOYEES' RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	988
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	806
Number of retired or separated participants receiving benefits	2011-01-01	60
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	866
Total participants	2011-01-01	866
Number of participants with account balances	2011-01-01	866
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: THOMAS MEMORIAL HOSPITAL EMPLOYEES' RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	1,224
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	868
Number of retired or separated participants receiving benefits	2010-01-01	18
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	886
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	886
Number of participants with account balances	2010-01-01	886
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	86
2009: THOMAS MEMORIAL HOSPITAL EMPLOYEES' RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	2,309
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	890
Number of retired or separated participants receiving benefits	2009-01-01	37
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	927
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	927
Number of participants with account balances	2009-01-01	927
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on THOMAS MEMORIAL HOSPITAL EMPLOYEES' RETIREMENT PLAN

Measure	Date	Value
2012 : THOMAS MEMORIAL HOSPITAL EMPLOYEES' RETIREMENT PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$21,210
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$2,732,467
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$10,776
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$146
Value of total corrective distributions	2012-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$2,639,292
Value of total assets at end of year	2012-12-31	$2,742,901
Value of total assets at beginning of year	2012-12-31	$0
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$10,630
Total interest from all sources	2012-12-31	$347
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$48,172
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2012-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$48,172
Was this plan covered by a fidelity bond	2012-12-31	No
If this is an individual account plan, was there a blackout period	2012-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$789,409
Participant contributions at end of year	2012-12-31	$41,407
Participant contributions at beginning of year	2012-12-31	$123,485
Participant contributions at end of year	2012-12-31	$60,311
Participant contributions at beginning of year	2012-12-31	$48,661
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$1,696,664
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-12-31	$21,210
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$2,721,691
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$2,721,691
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$2,629,169
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$13,933,525
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$1,460,684
Interest on participant loans	2012-12-31	$347
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$343,351
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$343,351
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-12-31	$29,270
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$5,349,056
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$44,656
Net investment gain/loss from pooled separate accounts	2012-12-31	$185,438
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$153,219
Employer contributions (assets) at end of year	2012-12-31	$12,014
Employer contributions (assets) at beginning of year	2012-12-31	$9,409
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$146
Contract administrator fees	2012-12-31	$10,630
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2012-12-31	No
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	SUTTLE & STALNAKER, PLLC
Accountancy firm EIN	2012-12-31	558723494
2011 : THOMAS MEMORIAL HOSPITAL EMPLOYEES' RETIREMENT PLAN 2011 401k financial data
Total income from all sources (including contributions)	2011-12-31	$1,374,681
Total of all expenses incurred	2011-12-31	$1,049,463
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$1,025,590
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$1,864,487
Value of total assets at end of year	2011-12-31	$21,268,171
Value of total assets at beginning of year	2011-12-31	$20,942,953
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$23,873
Total interest from all sources	2011-12-31	$111,984
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	No
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$1,415,351
Participant contributions at end of year	2011-12-31	$123,485
Participant contributions at beginning of year	2011-12-31	$136,153
Participant contributions at end of year	2011-12-31	$48,661
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$163,048
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$325,218
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$21,268,171
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$20,942,953
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$13,933,525
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$13,456,342
Value of interest in pooled separate accounts at end of year	2011-12-31	$1,460,684
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$1,703,850
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$343,351
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$276,672
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$276,672
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$111,984
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$5,349,056
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$5,369,936
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-31	$-606,623
Net investment gain/loss from pooled separate accounts	2011-12-31	$4,833
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$286,088
Employer contributions (assets) at end of year	2011-12-31	$9,409
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$1,025,590
Contract administrator fees	2011-12-31	$23,873
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2011-12-31	No
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	SUTTLE AND STALNAKER, PLLC
Accountancy firm EIN	2011-12-31	558723494
2010 : THOMAS MEMORIAL HOSPITAL EMPLOYEES' RETIREMENT PLAN 2010 401k financial data
Total income from all sources (including contributions)	2010-12-31	$4,060,238
Total of all expenses incurred	2010-12-31	$953,059
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$904,465
Expenses. Certain deemed distributions of participant loans	2010-12-31	$31,263
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$2,216,347
Value of total assets at end of year	2010-12-31	$20,942,953
Value of total assets at beginning of year	2010-12-31	$17,835,774
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$17,331
Total interest from all sources	2010-12-31	$63,512
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Was this plan covered by a fidelity bond	2010-12-31	No
If this is an individual account plan, was there a blackout period	2010-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$1,418,409
Participant contributions at end of year	2010-12-31	$136,153
Participant contributions at beginning of year	2010-12-31	$43,923
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$509,962
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$3,107,179
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$20,942,953
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$17,835,774
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$13,456,342
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$11,170,017
Value of interest in pooled separate accounts at end of year	2010-12-31	$1,703,850
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$1,454,588
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$276,672
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$262,837
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$262,837
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$63,512
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$5,369,936
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$4,904,409
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$1,515,043
Net investment gain/loss from pooled separate accounts	2010-12-31	$265,336
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$287,976
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$904,465
Contract administrator fees	2010-12-31	$17,331
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2010-12-31	No
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	SUTTLE AND STALNAKER PLLC
Accountancy firm EIN	2010-12-31	558723494

Form 5500 Responses for THOMAS MEMORIAL HOSPITAL EMPLOYEES' RETIREMENT PLAN

2012: THOMAS MEMORIAL HOSPITAL EMPLOYEES' RETIREMENT PLAN 2012 form 5500 responses
2012-07-01	Type of plan entity	Single employer plan
2012-07-01	Submission has been amended	No
2012-07-01	This submission is the final filing	No
2012-07-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2012-07-01	Plan is a collectively bargained plan	No
2012-07-01	Plan funding arrangement – Insurance	Yes
2012-07-01	Plan funding arrangement – Trust	Yes
2012-07-01	Plan benefit arrangement – Insurance	Yes
2012-07-01	Plan benefit arrangement - Trust	Yes
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: THOMAS MEMORIAL HOSPITAL EMPLOYEES' RETIREMENT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: THOMAS MEMORIAL HOSPITAL EMPLOYEES' RETIREMENT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: THOMAS MEMORIAL HOSPITAL EMPLOYEES' RETIREMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	This submission is the final filing	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

VARIABLE ANNUITY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70238 )

Policy contract number

70676

Policy instance

Insurance contract or identification number	70676
Number of Individuals Covered	0
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-082408

Policy instance

Insurance contract or identification number	GA-082408
Number of Individuals Covered	0
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $4,848
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,848
Insurance broker organization code?	3
Insurance broker name	G & W EQUITY SALES, INC.

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

82159

Policy instance

Insurance contract or identification number	82159
Number of Individuals Covered	0
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62944 )

Policy contract number

075065

Policy instance

Insurance contract or identification number	075065
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

82159

Policy instance

Insurance contract or identification number	82159
Number of Individuals Covered	4
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-082408

Policy instance

Insurance contract or identification number	GA-082408
Number of Individuals Covered	108
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $8,217
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62944 )

Policy contract number

075065

Policy instance

Insurance contract or identification number	075065
Number of Individuals Covered	667
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $36,943
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Welfare Benefit Premiums Paid to Carrier	USD $36,943
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

82159

Policy instance

Insurance contract or identification number	82159
Number of Individuals Covered	4
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-082408

Policy instance

Insurance contract or identification number	GA-082408
Number of Individuals Covered	115
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3
Insurance broker name	G & W EQUITY SALES, INC.

AXA EQUITABLE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62944 )

Policy contract number

075065

Policy instance

Insurance contract or identification number	075065
Number of Individuals Covered	672
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $32,506
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $16,705
Insurance broker organization code?	3
Insurance broker name	K. SAMPATH

Potentially related plans

THOMAS MEMORIAL HOSPITAL FLEXIBLE BENEFITS PLAN [EIN = 260440674]

Was this data useful?

If you found the data here useful, PLEASE HELP US. We are a start-up and believe in making information freely available. By linking to us, posting on twitter, facebook and linkedin about us and generally spreading the word, you'll help us to grow. Our vision is to provide high quality data about the activities of all the companies in the world and where possible make it free to use and view. Finding and integrating data from thousands of data sources is time consuming and needs lots of effort. By simply spreading the word about us, you will help us. Please use the share buttons. It will only take a few seconds of your time. Thanks for helping

Information Disclaimer

The information provided on this website is not advice, endorsement or recommendation
The information published is supplied by third parties so we make no warranty on the accuracy, completeness etc. This information is provided "as-is". The information is subject to change as we obtain updates and corrections from the primary information sources.
You are free to use the information for your own personal research on the understanding to do so is at your own risk.

See full terms and conditions

Company Name:	HERBERT J. MEMORIAL HOSPITAL
Employer identification number (EIN):	550404900
NAIC Classification:	622000
NAIC Description:	Hospitals