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MID-OHIO VALLEY MEDICAL GROUP, INC. GROUP LIFE & DISABILITY INSURANCE PLAN 401k Plan overview

Plan NameMID-OHIO VALLEY MEDICAL GROUP, INC. GROUP LIFE & DISABILITY INSURANCE PLAN
Plan identification number 502

MID-OHIO VALLEY MEDICAL GROUP, INC. GROUP LIFE & DISABILITY INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

MID-OHIO VALLEY MEDICAL GROUP, INC. has sponsored the creation of one or more 401k plans.

Company Name:MID-OHIO VALLEY MEDICAL GROUP, INC.
Employer identification number (EIN):550771901
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MID-OHIO VALLEY MEDICAL GROUP, INC. GROUP LIFE & DISABILITY INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022017-09-01ERNEST MILLER ERNEST MILLER2019-03-22
5022016-09-01
5022015-09-01ROBIN LYONS ROBIN LYONS2017-03-17
5022014-09-01CHARLIE MORGAN CHARLIE MORGAN2016-03-09
5022013-09-01CHARLES MORGAN CHARLES MORGAN2015-03-24
5022012-09-01ROBERT R. HEAVNER MD ROBERT R. HEAVNER MD2014-02-12
5022011-09-01ROBERT R. HEAVNER MD ROBERT R. HEAVNER MD2013-12-17
5022010-09-01ROBERT R. HEAVNER MD ROBERT R. HEAVNER MD2013-12-17
5022010-07-01ROBERT R. HEAVNER MD ROBERT R. HEAVNER MD2013-12-17
5022009-07-01ROBERT R. HEAVNER MD ROBERT R. HEAVNER MD2013-12-17
5022008-07-01ROBERT R. HEAVNER MD ROBERT R. HEAVNER MD2013-12-17

Plan Statistics for MID-OHIO VALLEY MEDICAL GROUP, INC. GROUP LIFE & DISABILITY INSURANCE PLAN

401k plan membership statisitcs for MID-OHIO VALLEY MEDICAL GROUP, INC. GROUP LIFE & DISABILITY INSURANCE PLAN

Measure Date Value
2017: MID-OHIO VALLEY MEDICAL GROUP, INC. GROUP LIFE & DISABILITY INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-09-01108
Total number of active participants reported on line 7a of the Form 55002017-09-01110
Number of retired or separated participants receiving benefits2017-09-010
Number of other retired or separated participants entitled to future benefits2017-09-010
Total of all active and inactive participants2017-09-01110
2016: MID-OHIO VALLEY MEDICAL GROUP, INC. GROUP LIFE & DISABILITY INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-09-01111
Total number of active participants reported on line 7a of the Form 55002016-09-01108
Number of retired or separated participants receiving benefits2016-09-010
Number of other retired or separated participants entitled to future benefits2016-09-010
Total of all active and inactive participants2016-09-01108
2015: MID-OHIO VALLEY MEDICAL GROUP, INC. GROUP LIFE & DISABILITY INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-09-01112
Total number of active participants reported on line 7a of the Form 55002015-09-01111
Number of retired or separated participants receiving benefits2015-09-010
Number of other retired or separated participants entitled to future benefits2015-09-010
Total of all active and inactive participants2015-09-01111
2014: MID-OHIO VALLEY MEDICAL GROUP, INC. GROUP LIFE & DISABILITY INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-09-01116
Total number of active participants reported on line 7a of the Form 55002014-09-01112
Number of retired or separated participants receiving benefits2014-09-010
Number of other retired or separated participants entitled to future benefits2014-09-010
Total of all active and inactive participants2014-09-01112
2013: MID-OHIO VALLEY MEDICAL GROUP, INC. GROUP LIFE & DISABILITY INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-09-01127
Total number of active participants reported on line 7a of the Form 55002013-09-01116
Number of retired or separated participants receiving benefits2013-09-010
Number of other retired or separated participants entitled to future benefits2013-09-010
Total of all active and inactive participants2013-09-01116
2012: MID-OHIO VALLEY MEDICAL GROUP, INC. GROUP LIFE & DISABILITY INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-09-01122
Total number of active participants reported on line 7a of the Form 55002012-09-01127
Number of retired or separated participants receiving benefits2012-09-010
Number of other retired or separated participants entitled to future benefits2012-09-010
Total of all active and inactive participants2012-09-01127
2011: MID-OHIO VALLEY MEDICAL GROUP, INC. GROUP LIFE & DISABILITY INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-09-01131
Total number of active participants reported on line 7a of the Form 55002011-09-01122
Number of retired or separated participants receiving benefits2011-09-010
Number of other retired or separated participants entitled to future benefits2011-09-010
Total of all active and inactive participants2011-09-01122
2010: MID-OHIO VALLEY MEDICAL GROUP, INC. GROUP LIFE & DISABILITY INSURANCE PLAN 2010 401k membership
Total participants, beginning-of-year2010-09-01118
Total number of active participants reported on line 7a of the Form 55002010-09-01131
Number of retired or separated participants receiving benefits2010-09-010
Number of other retired or separated participants entitled to future benefits2010-09-010
Total of all active and inactive participants2010-09-01131
Total participants, beginning-of-year2010-07-01115
Total number of active participants reported on line 7a of the Form 55002010-07-01118
Number of retired or separated participants receiving benefits2010-07-010
Number of other retired or separated participants entitled to future benefits2010-07-010
Total of all active and inactive participants2010-07-01118
2009: MID-OHIO VALLEY MEDICAL GROUP, INC. GROUP LIFE & DISABILITY INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-07-01116
Total number of active participants reported on line 7a of the Form 55002009-07-01115
Number of retired or separated participants receiving benefits2009-07-010
Number of other retired or separated participants entitled to future benefits2009-07-010
Total of all active and inactive participants2009-07-01115
Total participants2009-07-010
2008: MID-OHIO VALLEY MEDICAL GROUP, INC. GROUP LIFE & DISABILITY INSURANCE PLAN 2008 401k membership
Total participants, beginning-of-year2008-07-01105
Total number of active participants reported on line 7a of the Form 55002008-07-01116
Number of retired or separated participants receiving benefits2008-07-010
Number of other retired or separated participants entitled to future benefits2008-07-010
Total of all active and inactive participants2008-07-01116

Form 5500 Responses for MID-OHIO VALLEY MEDICAL GROUP, INC. GROUP LIFE & DISABILITY INSURANCE PLAN

2017: MID-OHIO VALLEY MEDICAL GROUP, INC. GROUP LIFE & DISABILITY INSURANCE PLAN 2017 form 5500 responses
2017-09-01Type of plan entitySingle employer plan
2017-09-01Submission has been amendedNo
2017-09-01This submission is the final filingNo
2017-09-01This return/report is a short plan year return/report (less than 12 months)No
2017-09-01Plan is a collectively bargained planNo
2017-09-01Plan funding arrangement – InsuranceYes
2017-09-01Plan benefit arrangement – InsuranceYes
2016: MID-OHIO VALLEY MEDICAL GROUP, INC. GROUP LIFE & DISABILITY INSURANCE PLAN 2016 form 5500 responses
2016-09-01Type of plan entitySingle employer plan
2016-09-01Submission has been amendedNo
2016-09-01This submission is the final filingNo
2016-09-01This return/report is a short plan year return/report (less than 12 months)No
2016-09-01Plan is a collectively bargained planNo
2016-09-01Plan funding arrangement – InsuranceYes
2016-09-01Plan benefit arrangement – InsuranceYes
2015: MID-OHIO VALLEY MEDICAL GROUP, INC. GROUP LIFE & DISABILITY INSURANCE PLAN 2015 form 5500 responses
2015-09-01Type of plan entitySingle employer plan
2015-09-01Submission has been amendedNo
2015-09-01This submission is the final filingNo
2015-09-01This return/report is a short plan year return/report (less than 12 months)No
2015-09-01Plan is a collectively bargained planNo
2015-09-01Plan funding arrangement – InsuranceYes
2015-09-01Plan benefit arrangement – InsuranceYes
2014: MID-OHIO VALLEY MEDICAL GROUP, INC. GROUP LIFE & DISABILITY INSURANCE PLAN 2014 form 5500 responses
2014-09-01Type of plan entitySingle employer plan
2014-09-01Submission has been amendedNo
2014-09-01This submission is the final filingNo
2014-09-01This return/report is a short plan year return/report (less than 12 months)No
2014-09-01Plan is a collectively bargained planNo
2014-09-01Plan funding arrangement – InsuranceYes
2014-09-01Plan benefit arrangement – InsuranceYes
2013: MID-OHIO VALLEY MEDICAL GROUP, INC. GROUP LIFE & DISABILITY INSURANCE PLAN 2013 form 5500 responses
2013-09-01Type of plan entitySingle employer plan
2013-09-01Submission has been amendedNo
2013-09-01This submission is the final filingNo
2013-09-01This return/report is a short plan year return/report (less than 12 months)No
2013-09-01Plan is a collectively bargained planNo
2013-09-01Plan funding arrangement – InsuranceYes
2013-09-01Plan benefit arrangement – InsuranceYes
2012: MID-OHIO VALLEY MEDICAL GROUP, INC. GROUP LIFE & DISABILITY INSURANCE PLAN 2012 form 5500 responses
2012-09-01Type of plan entitySingle employer plan
2012-09-01Submission has been amendedNo
2012-09-01This submission is the final filingNo
2012-09-01This return/report is a short plan year return/report (less than 12 months)No
2012-09-01Plan is a collectively bargained planNo
2012-09-01Plan funding arrangement – InsuranceYes
2012-09-01Plan benefit arrangement – InsuranceYes
2011: MID-OHIO VALLEY MEDICAL GROUP, INC. GROUP LIFE & DISABILITY INSURANCE PLAN 2011 form 5500 responses
2011-09-01Type of plan entitySingle employer plan
2011-09-01Submission has been amendedNo
2011-09-01This submission is the final filingNo
2011-09-01This return/report is a short plan year return/report (less than 12 months)No
2011-09-01Plan is a collectively bargained planNo
2011-09-01Plan funding arrangement – InsuranceYes
2011-09-01Plan benefit arrangement – InsuranceYes
2010: MID-OHIO VALLEY MEDICAL GROUP, INC. GROUP LIFE & DISABILITY INSURANCE PLAN 2010 form 5500 responses
2010-09-01Type of plan entitySingle employer plan
2010-09-01Submission has been amendedNo
2010-09-01This submission is the final filingNo
2010-09-01This return/report is a short plan year return/report (less than 12 months)No
2010-09-01Plan is a collectively bargained planNo
2010-09-01Plan funding arrangement – InsuranceYes
2010-09-01Plan benefit arrangement – InsuranceYes
2010-07-01Type of plan entitySingle employer plan
2010-07-01Submission has been amendedNo
2010-07-01This submission is the final filingNo
2010-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2010-07-01Plan is a collectively bargained planNo
2010-07-01Plan funding arrangement – InsuranceYes
2010-07-01Plan benefit arrangement – InsuranceYes
2009: MID-OHIO VALLEY MEDICAL GROUP, INC. GROUP LIFE & DISABILITY INSURANCE PLAN 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
2008: MID-OHIO VALLEY MEDICAL GROUP, INC. GROUP LIFE & DISABILITY INSURANCE PLAN 2008 form 5500 responses
2008-07-01Type of plan entitySingle employer plan
2008-07-01First time form 5500 has been submittedYes
2008-07-01Submission has been amendedNo
2008-07-01This submission is the final filingNo
2008-07-01This return/report is a short plan year return/report (less than 12 months)No
2008-07-01Plan is a collectively bargained planNo
2008-07-01Plan funding arrangement – InsuranceYes
2008-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number767252G
Policy instance 1
Insurance contract or identification number767252G
Number of Individuals Covered110
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $9,552
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $95,519
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number767252G
Policy instance 1
Insurance contract or identification number767252G
Number of Individuals Covered111
Insurance policy start date2015-09-01
Insurance policy end date2016-08-31
Total amount of commissions paid to insurance brokerUSD $10,152
Total amount of fees paid to insurance companyUSD $5
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $93,452
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,152
Insurance broker organization code?3
Amount paid for insurance broker fees5
Additional information about fees paid to insurance brokerBONUS PAID
Insurance broker nameHUNTINGTON INSURANCE, INC.
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number767252G
Policy instance 1
Insurance contract or identification number767252G
Number of Individuals Covered112
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $8,628
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $94,112
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,511
Insurance broker organization code?3
Insurance broker nameHUNTINGTON INSURANCE, INC.
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number767252G
Policy instance 1
Insurance contract or identification number767252G
Number of Individuals Covered116
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $10,365
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $95,811
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,365
Insurance broker organization code?3
Insurance broker nameSCHWENDEMAN AGENCY INC.
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number767252G
Policy instance 1
Insurance contract or identification number767252G
Number of Individuals Covered127
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $8,622
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $93,892
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,464
Insurance broker organization code?3
Insurance broker nameSCHWENDEMAN AGENCY INC.
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number767252G
Policy instance 1
Insurance contract or identification number767252G
Number of Individuals Covered122
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $9,171
Total amount of fees paid to insurance companyUSD $933
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $91,868
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number767252G
Policy instance 1
Insurance contract or identification number767252G
Number of Individuals Covered131
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $9,582
Total amount of fees paid to insurance companyUSD $2,242
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $87,987
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number767252G
Policy instance 1
Insurance contract or identification number767252G
Number of Individuals Covered118
Insurance policy start date2010-07-01
Insurance policy end date2010-08-31
Total amount of commissions paid to insurance brokerUSD $1,892
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $18,916
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number630048
Policy instance 3
Insurance contract or identification number630048
Number of Individuals Covered116
Insurance policy start date2008-07-01
Insurance policy end date2009-06-30
Total amount of commissions paid to insurance brokerUSD $1,612
Total amount of fees paid to insurance companyUSD $0
Life 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 $1,612
Insurance broker organization code?3
Insurance broker name3
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number630048
Policy instance 2
Insurance contract or identification number630048
Number of Individuals Covered116
Insurance policy start date2008-07-01
Insurance policy end date2009-06-30
Total amount of commissions paid to insurance brokerUSD $3,030
Total amount of fees paid to insurance companyUSD $0
Temporary Disability 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 $3,030
Insurance broker organization code?3
Insurance broker nameJERRY L. VILLERS
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number630048
Policy instance 1
Insurance contract or identification number630048
Number of Individuals Covered22
Insurance policy start date2008-07-01
Insurance policy end date2009-06-30
Total amount of commissions paid to insurance brokerUSD $3,835
Total amount of fees paid to insurance companyUSD $0
Long Term Disability 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 $3,835
Insurance broker organization code?3
Insurance broker nameJERRY L. VILLERS

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