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CASCADE HEALTHCARE COMMUNITY LIFE INSURANCE PLAN 401k Plan overview

Plan NameCASCADE HEALTHCARE COMMUNITY LIFE INSURANCE PLAN
Plan identification number 504

CASCADE HEALTHCARE COMMUNITY LIFE INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Other welfare benefit cover

401k Sponsoring company profile

ST. CHARLES HEALTH SYSTEM has sponsored the creation of one or more 401k plans.

Company Name:ST. CHARLES HEALTH SYSTEM
Employer identification number (EIN):930602940
NAIC Classification:622000
NAIC Description: Hospitals

Additional information about ST. CHARLES HEALTH SYSTEM

Jurisdiction of Incorporation: Oregon Secretary of State Corporations Division
Incorporation Date: 1971-12-08
Company Identification Number: 9522616
Legal Registered Office Address: 780 COMMERCIAL ST SE STE 100

SALEM
United States of America (USA)
97301

More information about ST. CHARLES HEALTH SYSTEM

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CASCADE HEALTHCARE COMMUNITY LIFE INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042012-01-01MISTY BENDER
5042011-01-01MISTY BENDER
5042010-01-01ADAM FULLER
5042009-01-01AMBER RHEMREV

Plan Statistics for CASCADE HEALTHCARE COMMUNITY LIFE INSURANCE PLAN

401k plan membership statisitcs for CASCADE HEALTHCARE COMMUNITY LIFE INSURANCE PLAN

Measure Date Value
2012: CASCADE HEALTHCARE COMMUNITY LIFE INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-012,484
Total number of active participants reported on line 7a of the Form 55002012-01-012,470
Number of retired or separated participants receiving benefits2012-01-0126
Number of other retired or separated participants entitled to future benefits2012-01-0127
Total of all active and inactive participants2012-01-012,523
Total participants2012-01-012,523
2011: CASCADE HEALTHCARE COMMUNITY LIFE INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-012,368
Total number of active participants reported on line 7a of the Form 55002011-01-012,493
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 participants2011-01-012,493
Total participants2011-01-012,493
2010: CASCADE HEALTHCARE COMMUNITY LIFE INSURANCE PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-012,452
Total number of active participants reported on line 7a of the Form 55002010-01-012,353
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-012,353
Total participants2010-01-012,353
2009: CASCADE HEALTHCARE COMMUNITY LIFE INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-012,668
Total number of active participants reported on line 7a of the Form 55002009-01-012,552
Number of retired or separated participants receiving benefits2009-01-014
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-012,556
Total participants2009-01-012,556

Form 5500 Responses for CASCADE HEALTHCARE COMMUNITY LIFE INSURANCE PLAN

2012: CASCADE HEALTHCARE COMMUNITY 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 filingYes
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: CASCADE HEALTHCARE COMMUNITY 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
2010: CASCADE HEALTHCARE COMMUNITY LIFE INSURANCE PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: CASCADE HEALTHCARE COMMUNITY 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

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number094010 0001
Policy instance 1
Insurance contract or identification number094010 0001
Number of Individuals Covered428
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $27,927
Total amount of fees paid to insurance companyUSD $1,396
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $186,183
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,927
Amount paid for insurance broker fees1396
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameTHE PARTNERS GROUP
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number221022
Policy instance 2
Insurance contract or identification number221022
Number of Individuals Covered2501
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $1,730
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $230,710
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees1730
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameTHE PARTNERS GROUP
PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 )
Policy contract number0007435594
Policy instance 3
Insurance contract or identification number0007435594
Number of Individuals Covered701
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $146,402
Total amount of fees paid to insurance companyUSD $23,435
Life Insurance Welfare BenefitNo
Other welfare benefits providedWORKSITE BENEFITS
Welfare Benefit Premiums Paid to CarrierUSD $183,856
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,616
Amount paid for insurance broker fees504
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameCUSTOM BENEFIT PROGRAMS INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0388173
Policy instance 4
Insurance contract or identification numberR0388173
Number of Individuals Covered181
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $48,396
Total amount of fees paid to insurance companyUSD $6,535
Life Insurance Welfare BenefitNo
Other welfare benefits providedWORKSITE BENEFITS
Welfare Benefit Premiums Paid to CarrierUSD $69,209
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,100
Amount paid for insurance broker fees176
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameCUSTOM BENEFIT PROGRAMS INC
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number221022 0001
Policy instance 1
Insurance contract or identification number221022 0001
Number of Individuals Covered2507
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of fees paid to insurance companyUSD $2,415
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $241,543
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number094010 0001
Policy instance 2
Insurance contract or identification number094010 0001
Number of Individuals Covered389
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $25,716
Total amount of fees paid to insurance companyUSD $1,714
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $171,437
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number221022 0001
Policy instance 1
Insurance contract or identification number221022 0001
Number of Individuals Covered2353
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of fees paid to insurance companyUSD $1,672
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $222,894
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees1672
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameTHE PARTNERS GROUP
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number221022 0005
Policy instance 2
Insurance contract or identification number221022 0005
Number of Individuals Covered16
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of fees paid to insurance companyUSD $5
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $691
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees5
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameTHE PARTNERS GROUP
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number094010
Policy instance 3
Insurance contract or identification number094010
Number of Individuals Covered345
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $23,122
Total amount of fees paid to insurance companyUSD $1,156
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $154,148
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,122
Amount paid for insurance broker fees1156
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION PAID
Insurance broker organization code?3
Insurance broker nameTHE PARTNERS GROUP

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