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NEBRASKA MEDICINE GROUP LIFE, AD&D AND OPTIONAL LIFE INSURANCE PLAN 401k Plan overview

Plan NameNEBRASKA MEDICINE GROUP LIFE, AD&D AND OPTIONAL LIFE INSURANCE PLAN
Plan identification number 502

NEBRASKA MEDICINE GROUP LIFE, AD&D AND OPTIONAL LIFE INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

NEBRASKA MEDICINE has sponsored the creation of one or more 401k plans.

Company Name:NEBRASKA MEDICINE
Employer identification number (EIN):911858433
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NEBRASKA MEDICINE GROUP LIFE, AD&D AND OPTIONAL LIFE INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022018-01-01LAURIE L. WILLBURN2019-08-22
5022017-01-01
5022017-01-01
5022016-01-01
5022015-01-01KIMBERLY JENNINGS
5022014-01-01PAULETTE DAVIDSON
5022013-01-01TADD PULLIN
5022012-01-01TADD PULLIN
5022011-01-01NAT PONTICELLO
5022009-01-01NAT PONTICELLO

Plan Statistics for NEBRASKA MEDICINE GROUP LIFE, AD&D AND OPTIONAL LIFE INSURANCE PLAN

401k plan membership statisitcs for NEBRASKA MEDICINE GROUP LIFE, AD&D AND OPTIONAL LIFE INSURANCE PLAN

Measure Date Value
2018: NEBRASKA MEDICINE GROUP LIFE, AD&D AND OPTIONAL LIFE INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-017,006
Total number of active participants reported on line 7a of the Form 55002018-01-010
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-010
Number of employers contributing to the scheme2018-01-010
2017: NEBRASKA MEDICINE GROUP LIFE, AD&D AND OPTIONAL LIFE INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-016,684
Total number of active participants reported on line 7a of the Form 55002017-01-010
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-010
Number of employers contributing to the scheme2017-01-010
2016: NEBRASKA MEDICINE GROUP LIFE, AD&D AND OPTIONAL LIFE INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-016,136
Total number of active participants reported on line 7a of the Form 55002016-01-016,646
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-016,646
2015: NEBRASKA MEDICINE GROUP LIFE, AD&D AND OPTIONAL LIFE INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-015,594
Total number of active participants reported on line 7a of the Form 55002015-01-016,136
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-016,136
2014: NEBRASKA MEDICINE GROUP LIFE, AD&D AND OPTIONAL LIFE INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-014,689
Total number of active participants reported on line 7a of the Form 55002014-01-014,916
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-014,916
2013: NEBRASKA MEDICINE GROUP LIFE, AD&D AND OPTIONAL LIFE INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-014,971
Total number of active participants reported on line 7a of the Form 55002013-01-014,811
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-014,811
2012: NEBRASKA MEDICINE GROUP LIFE, AD&D AND OPTIONAL LIFE INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-015,093
Total number of active participants reported on line 7a of the Form 55002012-01-014,971
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-014,971
2011: NEBRASKA MEDICINE GROUP LIFE, AD&D AND OPTIONAL LIFE INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-015,183
Total number of active participants reported on line 7a of the Form 55002011-01-015,093
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 participants2011-01-015,093
2009: NEBRASKA MEDICINE GROUP LIFE, AD&D AND OPTIONAL LIFE INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-014,617
Total number of active participants reported on line 7a of the Form 55002009-01-014,902
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 participants2009-01-014,902

Form 5500 Responses for NEBRASKA MEDICINE GROUP LIFE, AD&D AND OPTIONAL LIFE INSURANCE PLAN

2018: NEBRASKA MEDICINE GROUP LIFE, AD&D AND OPTIONAL LIFE INSURANCE PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01This submission is the final filingYes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: NEBRASKA MEDICINE GROUP LIFE, AD&D AND OPTIONAL LIFE INSURANCE 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 filingYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: NEBRASKA MEDICINE GROUP LIFE, AD&D AND OPTIONAL LIFE INSURANCE PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
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: NEBRASKA MEDICINE GROUP LIFE, AD&D AND OPTIONAL LIFE INSURANCE PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
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: NEBRASKA MEDICINE GROUP LIFE, AD&D AND OPTIONAL LIFE INSURANCE PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
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: NEBRASKA MEDICINE GROUP LIFE, AD&D AND OPTIONAL LIFE INSURANCE PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
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: NEBRASKA MEDICINE GROUP LIFE, AD&D AND OPTIONAL LIFE INSURANCE PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
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: NEBRASKA MEDICINE GROUP LIFE, AD&D AND OPTIONAL LIFE INSURANCE PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
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: NEBRASKA MEDICINE GROUP LIFE, AD&D AND OPTIONAL LIFE INSURANCE PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
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

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL157323
Policy instance 1
Insurance contract or identification numberGL157323
Number of Individuals Covered6973
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $93,536
Total amount of fees paid to insurance companyUSD $210,456
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $1,870,721
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $86,912
Amount paid for insurance broker fees195552
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG049W4
Policy instance 1
Insurance contract or identification numberGLUG049W4
Number of Individuals Covered6755
Insurance policy start date2017-01-01
Insurance policy end date2017-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $304,614
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL157323
Policy instance 2
Insurance contract or identification numberGL157323
Number of Individuals Covered6786
Insurance policy start date2017-03-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $56,460
Total amount of fees paid to insurance companyUSD $101,628
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $1,129,203
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $56,460
Amount paid for insurance broker fees101628
Additional information about fees paid to insurance brokerADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
Insurance broker nameGALLAGHER BENEFIT SERVICES, INC.

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