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EPHRAIM MCDOWELL HEALTH VOLUNTARY VISION PLAN 401k Plan overview

Plan NameEPHRAIM MCDOWELL HEALTH VOLUNTARY VISION PLAN
Plan identification number 520

EPHRAIM MCDOWELL HEALTH VOLUNTARY VISION PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Vision

401k Sponsoring company profile

EPHRAIM MCDOWELL HEALTH has sponsored the creation of one or more 401k plans.

Company Name:EPHRAIM MCDOWELL HEALTH
Employer identification number (EIN):610492356
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EPHRAIM MCDOWELL HEALTH VOLUNTARY VISION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5202018-01-01
5202018-01-01LIBBY MAYES2020-07-23
5202017-01-01LIBBY MAYES LIBBY MAYES2018-07-30
5202017-01-01 LIBBY MAYES2018-07-30
5202016-01-01LIBBY MAYES
5202015-01-01CARL METZ CARL METZ2016-07-27
5202014-01-01CARL METZ CARL METZ2015-09-30
5202013-01-01CARL METZ CARL METZ2014-10-11
5202012-01-01CARL METZ CARL METZ2014-04-10
5202011-01-01CARL METZ
5202009-01-01CARL METZ
5202009-01-01 CARL METZ2011-10-13
5202009-01-01CARL METZ
5202009-01-01CARL METZ
5202009-01-01CARL METZ
5202009-01-01 CARL METZ2010-10-14
5202009-01-01CARL METZ

Plan Statistics for EPHRAIM MCDOWELL HEALTH VOLUNTARY VISION PLAN

401k plan membership statisitcs for EPHRAIM MCDOWELL HEALTH VOLUNTARY VISION PLAN

Measure Date Value
2018: EPHRAIM MCDOWELL HEALTH VOLUNTARY VISION PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01944
Total number of active participants reported on line 7a of the Form 55002018-01-011,007
Total of all active and inactive participants2018-01-011,007
2017: EPHRAIM MCDOWELL HEALTH VOLUNTARY VISION PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01933
Total number of active participants reported on line 7a of the Form 55002017-01-01933
Number of retired or separated participants receiving benefits2017-01-0111
Total of all active and inactive participants2017-01-01944
Total participants2017-01-01944
2016: EPHRAIM MCDOWELL HEALTH VOLUNTARY VISION PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01949
Total number of active participants reported on line 7a of the Form 55002016-01-01949
Total of all active and inactive participants2016-01-01949
Total participants2016-01-01949
2015: EPHRAIM MCDOWELL HEALTH VOLUNTARY VISION PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01939
Total number of active participants reported on line 7a of the Form 55002015-01-01939
Total of all active and inactive participants2015-01-01939
Total participants2015-01-01939
2014: EPHRAIM MCDOWELL HEALTH VOLUNTARY VISION PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01901
Total number of active participants reported on line 7a of the Form 55002014-01-01901
Total of all active and inactive participants2014-01-01901
Total participants2014-01-01901
2013: EPHRAIM MCDOWELL HEALTH VOLUNTARY VISION PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01920
Total number of active participants reported on line 7a of the Form 55002013-01-01920
Total of all active and inactive participants2013-01-01920
Total participants2013-01-01920
2012: EPHRAIM MCDOWELL HEALTH VOLUNTARY VISION PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01869
Total number of active participants reported on line 7a of the Form 55002012-01-01891
Total of all active and inactive participants2012-01-01891
Total participants2012-01-01891
2011: EPHRAIM MCDOWELL HEALTH VOLUNTARY VISION PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01837
Total number of active participants reported on line 7a of the Form 55002011-01-01820
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-01820
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01820
Number of participants with account balances2011-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2009: EPHRAIM MCDOWELL HEALTH VOLUNTARY VISION PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01684
Total number of active participants reported on line 7a of the Form 55002009-01-01673
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01673
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01673
Number of participants with account balances2009-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Form 5500 Responses for EPHRAIM MCDOWELL HEALTH VOLUNTARY VISION PLAN

2018: EPHRAIM MCDOWELL HEALTH VOLUNTARY VISION PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedYes
2018-01-01This submission is the final filingYes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: EPHRAIM MCDOWELL HEALTH VOLUNTARY VISION PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedYes
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 benefit arrangement – InsuranceYes
2016: EPHRAIM MCDOWELL HEALTH VOLUNTARY VISION PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01First time form 5500 has been submittedYes
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 benefit arrangement – InsuranceYes
2015: EPHRAIM MCDOWELL HEALTH VOLUNTARY VISION PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01First time form 5500 has been submittedYes
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 benefit arrangement – InsuranceYes
2014: EPHRAIM MCDOWELL HEALTH VOLUNTARY VISION PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01First time form 5500 has been submittedYes
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 benefit arrangement – InsuranceYes
2013: EPHRAIM MCDOWELL HEALTH VOLUNTARY VISION PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01First time form 5500 has been submittedYes
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 benefit arrangement – InsuranceYes
2012: EPHRAIM MCDOWELL HEALTH VOLUNTARY VISION PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01First time form 5500 has been submittedYes
2012-01-01Submission has been amendedYes
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 benefit arrangement – InsuranceYes
2011: EPHRAIM MCDOWELL HEALTH VOLUNTARY VISION PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01First time form 5500 has been submittedYes
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 benefit arrangement – InsuranceYes
2009: EPHRAIM MCDOWELL HEALTH VOLUNTARY VISION PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedYes
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 benefit arrangement – InsuranceYes

Insurance Providers Used on plan

DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract numberX19001002C01C02
Policy instance 1
Insurance contract or identification numberX19001002C01C02
Number of Individuals Covered2075
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $15,531
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $155,309
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,113
Insurance broker organization code?3
DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract numberX19001002C01C02
Policy instance 1
Insurance contract or identification numberX19001002C01C02
Number of Individuals Covered944
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $13,532
Are there contracts with allocated funds for individual policies?0
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 BenefitNo
Vision Insurance Welfare BenefitYes
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 $146,464
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,532
Additional information about fees paid to insurance brokerADMINISTRATIVE
Insurance broker organization code?3
Insurance broker nameKHA SOLUTIONS
DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract numberX19001002C01C02
Policy instance 1
Insurance contract or identification numberX19001002C01C02
Number of Individuals Covered939
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $12,868
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 BenefitNo
Vision Insurance Welfare BenefitYes
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 $128,684
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,868
Additional information about fees paid to insurance brokerADMINISTRATIVE
Insurance broker organization code?3
Insurance broker nameKHA SOLUTIONS
DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract numberX19001002C01C02
Policy instance 1
Insurance contract or identification numberX19001002C01C02
Number of Individuals Covered901
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $11,665
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 BenefitNo
Vision Insurance Welfare BenefitYes
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 $127,068
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,665
Additional information about fees paid to insurance brokerADMINISTRATIVE
Insurance broker organization code?3
Insurance broker nameKHA SOLUTIONS
DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract numberX19001002C01C02
Policy instance 1
Insurance contract or identification numberX19001002C01C02
Number of Individuals Covered920
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $10,646
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 BenefitNo
Vision Insurance Welfare BenefitYes
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 $116,030
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,646
Additional information about fees paid to insurance brokerADMINISTRATIVE
Insurance broker organization code?3
Insurance broker nameKHA SOLUTIONS
DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract numberX19001002C01C02
Policy instance 1
Insurance contract or identification numberX19001002C01C02
Number of Individuals Covered891
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $11,149
Total amount of fees paid to insurance companyUSD $5,017
Vision Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Welfare Benefit Premiums Paid to CarrierUSD $111,495
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,149
Amount paid for insurance broker fees5017
Additional information about fees paid to insurance brokerADMINISTRATIVE
Insurance broker organization code?3
Insurance broker nameKHA SOLUTIONS
DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract numberX19001002C01C02
Policy instance 1
Insurance contract or identification numberX19001002C01C02
Number of Individuals Covered820
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $9,284
Total amount of fees paid to insurance companyUSD $4,178
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $92,837
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DAVIS VISION (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract numberX19001002C01C02
Policy instance 1
Insurance contract or identification numberX19001002C01C02
Number of Individuals Covered804
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $8,808
Total amount of fees paid to insurance companyUSD $3,964
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $96,159
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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