401k Plan data: MUNROE REGIONAL MEDICAL CENTER DENTAL INSURANCE plan

MUNROE REGIONAL MEDICAL CENTER DENTAL INSURANCE 401k Plan overview

Plan Name	MUNROE REGIONAL MEDICAL CENTER DENTAL INSURANCE
Plan identification number	507

MUNROE REGIONAL MEDICAL CENTER DENTAL INSURANCE Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Dental

401k Sponsoring company profile

MUNROE REGIONAL HEALTH SYSTEM, INC. has sponsored the creation of one or more 401k plans.

Company Name: MUNROE REGIONAL HEALTH SYSTEM, INC.

Employer identification number (EIN): 592390209

NAIC Classification: 813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Additional information about MUNROE REGIONAL HEALTH SYSTEM, INC.

Jurisdiction of Incorporation: Florida Department of State Division of Corporations

Incorporation Date: 1983-08-04

Company Identification Number: 769732

Legal Registered Office Address: 723 EAST FT. KING ST

OCALA

34471

More information about MUNROE REGIONAL HEALTH SYSTEM, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MUNROE REGIONAL MEDICAL CENTER DENTAL INSURANCE

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
507 2013-10-01 JON KURTZ
507 2012-10-01 BECKY TILLEY
507 2011-10-01 BECKY TILLEY DANIEL OCONNOR 2013-03-11
507 2009-10-01 DANIEL OCONNOR RICHARD MUTARELLI 2011-07-27

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
507	2013-10-01	JON KURTZ
507	2012-10-01	BECKY TILLEY
507	2011-10-01	BECKY TILLEY	DANIEL OCONNOR	2013-03-11
507	2009-10-01	DANIEL OCONNOR	RICHARD MUTARELLI	2011-07-27

Plan Statistics for MUNROE REGIONAL MEDICAL CENTER DENTAL INSURANCE

401k plan membership statisitcs for MUNROE REGIONAL MEDICAL CENTER DENTAL INSURANCE

Measure Date Value
2013: MUNROE REGIONAL MEDICAL CENTER DENTAL INSURANCE 2013 401k membership
Total participants, beginning-of-year 2013-10-01 1,649
Total number of active participants reported on line 7a of the Form 5500 2013-10-01 1,599
Total of all active and inactive participants 2013-10-01 1,599
Total participants 2013-10-01 1,599
2012: MUNROE REGIONAL MEDICAL CENTER DENTAL INSURANCE 2012 401k membership
Total participants, beginning-of-year 2012-10-01 1,653
Total number of active participants reported on line 7a of the Form 5500 2012-10-01 1,649
Total of all active and inactive participants 2012-10-01 1,649
Total participants 2012-10-01 1,649
2011: MUNROE REGIONAL MEDICAL CENTER DENTAL INSURANCE 2011 401k membership
Total participants, beginning-of-year 2011-10-01 1,680
Total number of active participants reported on line 7a of the Form 5500 2011-10-01 1,653
Total of all active and inactive participants 2011-10-01 1,653
Total participants 2011-10-01 1,653
2009: MUNROE REGIONAL MEDICAL CENTER DENTAL INSURANCE 2009 401k membership
Total participants, beginning-of-year 2009-10-01 1,571
Total number of active participants reported on line 7a of the Form 5500 2009-10-01 1,571
Total of all active and inactive participants 2009-10-01 1,571
Total participants 2009-10-01 1,571

Measure	Date	Value
2013: MUNROE REGIONAL MEDICAL CENTER DENTAL INSURANCE 2013 401k membership
Total participants, beginning-of-year	2013-10-01	1,649
Total number of active participants reported on line 7a of the Form 5500	2013-10-01	1,599
Total of all active and inactive participants	2013-10-01	1,599
Total participants	2013-10-01	1,599
2012: MUNROE REGIONAL MEDICAL CENTER DENTAL INSURANCE 2012 401k membership
Total participants, beginning-of-year	2012-10-01	1,653
Total number of active participants reported on line 7a of the Form 5500	2012-10-01	1,649
Total of all active and inactive participants	2012-10-01	1,649
Total participants	2012-10-01	1,649
2011: MUNROE REGIONAL MEDICAL CENTER DENTAL INSURANCE 2011 401k membership
Total participants, beginning-of-year	2011-10-01	1,680
Total number of active participants reported on line 7a of the Form 5500	2011-10-01	1,653
Total of all active and inactive participants	2011-10-01	1,653
Total participants	2011-10-01	1,653
2009: MUNROE REGIONAL MEDICAL CENTER DENTAL INSURANCE 2009 401k membership
Total participants, beginning-of-year	2009-10-01	1,571
Total number of active participants reported on line 7a of the Form 5500	2009-10-01	1,571
Total of all active and inactive participants	2009-10-01	1,571
Total participants	2009-10-01	1,571

Form 5500 Responses for MUNROE REGIONAL MEDICAL CENTER DENTAL INSURANCE

2013: MUNROE REGIONAL MEDICAL CENTER DENTAL INSURANCE 2013 form 5500 responses
2013-10-01	Type of plan entity	Single employer plan
2013-10-01	Submission has been amended	No
2013-10-01	This submission is the final filing	No
2013-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-10-01	Plan is a collectively bargained plan	No
2013-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: MUNROE REGIONAL MEDICAL CENTER DENTAL INSURANCE 2012 form 5500 responses
2012-10-01	Type of plan entity	Single employer plan
2012-10-01	Submission has been amended	No
2012-10-01	This submission is the final filing	No
2012-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-10-01	Plan is a collectively bargained plan	No
2012-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: MUNROE REGIONAL MEDICAL CENTER DENTAL INSURANCE 2011 form 5500 responses
2011-10-01	Type of plan entity	Single employer plan
2011-10-01	Submission has been amended	No
2011-10-01	This submission is the final filing	No
2011-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-10-01	Plan is a collectively bargained plan	No
2011-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-10-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: MUNROE REGIONAL MEDICAL CENTER DENTAL INSURANCE 2009 form 5500 responses
2009-10-01	Type of plan entity	Single employer plan
2009-10-01	Submission has been amended	Yes
2009-10-01	This submission is the final filing	No
2009-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-10-01	Plan is a collectively bargained plan	No
2009-10-01	Plan funding arrangement – Insurance	Yes
2009-10-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

0440336

Policy instance

Insurance contract or identification number	0440336
Number of Individuals Covered	1599
Insurance policy start date	2013-10-01
Insurance policy end date	2014-03-31
Total amount of commissions paid to insurance broker	USD $36,712
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	Yes
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
Welfare Benefit Premiums Paid to Carrier	USD $66,628
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $36,712
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	MARKETING
Insurance broker organization code?	3
Insurance broker name	THE GARDNERGROUP

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00440336

Policy instance

Insurance contract or identification number	00440336
Number of Individuals Covered	1649
Insurance policy start date	2012-10-01
Insurance policy end date	2013-09-30
Total amount of commissions paid to insurance broker	USD $80,388
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	Yes
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
Welfare Benefit Premiums Paid to Carrier	USD $136,482
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $80,388
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	MARKETING
Insurance broker organization code?	3
Insurance broker name	THE GARDNER GROUP

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00440336

Policy instance

Insurance contract or identification number	00440336
Number of Individuals Covered	1653
Insurance policy start date	2011-10-01
Insurance policy end date	2012-09-30
Total amount of commissions paid to insurance broker	USD $74,854
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $127,087
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00440336

Policy instance

Insurance contract or identification number	00440336
Number of Individuals Covered	1680
Insurance policy start date	2010-10-01
Insurance policy end date	2011-09-30
Total amount of commissions paid to insurance broker	USD $75,396
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $128,006
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	MUNROE REGIONAL HEALTH SYSTEM, INC.
Employer identification number (EIN):	592390209
NAIC Classification:	813000
NAIC Description:	Religious, Grantmaking, Civic, Professional, and Similar Organizations

Jurisdiction of Incorporation:	Florida Department of State Division of Corporations
Incorporation Date:	1983-08-04
Company Identification Number:	769732
Legal Registered Office Address:	723 EAST FT. KING ST OCALA 34471