401k Plan data: MERIWETHER HEALTHCARE LLC WELFARE BENEFIT PLAN plan

MERIWETHER HEALTHCARE LLC WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	MERIWETHER HEALTHCARE LLC WELFARE BENEFIT PLAN
Plan identification number	501

MERIWETHER HEALTHCARE LLC WELFARE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover

401k Sponsoring company profile

MERIWETHER HEALTHCARE, LLC D/B/A WARM SPRINGS MEDICAL CENTER has sponsored the creation of one or more 401k plans.

Company Name: MERIWETHER HEALTHCARE, LLC D/B/A WARM SPRINGS MEDICAL CENTER

Employer identification number (EIN): 870764535

NAIC Classification: 621399
NAIC Description: Offices of All Other Miscellaneous Health Practitioners

Additional information about MERIWETHER HEALTHCARE, LLC D/B/A WARM SPRINGS MEDICAL CENTER

Jurisdiction of Incorporation: Georgia Department of States Corporations Division

Incorporation Date:

Company Identification Number: 427199

More information about MERIWETHER HEALTHCARE, LLC D/B/A WARM SPRINGS MEDICAL CENTER

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MERIWETHER HEALTHCARE LLC WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2018-01-01

Plan Statistics for MERIWETHER HEALTHCARE LLC WELFARE BENEFIT PLAN

401k plan membership statisitcs for MERIWETHER HEALTHCARE LLC WELFARE BENEFIT PLAN

Measure Date Value
2018: MERIWETHER HEALTHCARE LLC WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 127
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 131
Total of all active and inactive participants 2018-01-01 131
Total participants 2018-01-01 131

Measure	Date	Value
2018: MERIWETHER HEALTHCARE LLC WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	127
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	131
Total of all active and inactive participants	2018-01-01	131
Total participants	2018-01-01	131

Form 5500 Responses for MERIWETHER HEALTHCARE LLC WELFARE BENEFIT PLAN

2018: MERIWETHER HEALTHCARE LLC WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	First time form 5500 has been submitted	Yes
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )

Policy contract number

Policy instance

Total amount of commissions paid to insurance broker	USD $33,307
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	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 $33,307

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

Policy instance

Total amount of commissions paid to insurance broker	USD $668
Life Insurance Welfare Benefit	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 $622

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

Policy instance

Total amount of commissions paid to insurance broker	USD $3,144
Temporary Disability Insurance Welfare Benefit	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 $2,893

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

Policy instance

Total amount of commissions paid to insurance broker	USD $3,885
Long Term Disability Insurance Welfare Benefit	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 $3,574

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

Policy instance

Total amount of commissions paid to insurance broker	USD $3,174
Life Insurance Welfare Benefit	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 $2,914

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

97752221001

Policy instance

Insurance contract or identification number	97752221001
Number of Individuals Covered	150
Total amount of commissions paid to insurance broker	USD $1,030
Vision Insurance Welfare Benefit	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 $945

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Company Name:	MERIWETHER HEALTHCARE, LLC D/B/A WARM SPRINGS MEDICAL CENTER
Employer identification number (EIN):	870764535
NAIC Classification:	621399
NAIC Description:	Offices of All Other Miscellaneous Health Practitioners

Jurisdiction of Incorporation:	Georgia Department of States Corporations Division
Incorporation Date:
Company Identification Number:	427199