Summary Annual Report:
For Bethany Medical Center Employee Benefit Plan
This is a summary of the annual report of the Bethany Medical Center Employee Benefit Plan, EIN 56-1564485, Plan No. 501, for period 11/01/2024 through 10/31/2025. The annual report has been filed with the Employee Benefits Security Administration, U.S. Department of Labor, as required under the Employee Retirement Income Security Act of 1974 (ERISA).
Bethany Medical Center has committed itself to pay certain self-insured Medical, and Dental claims incurred under the terms of the plan.
Insurance Information
The plan has contracts with United of Omaha Life Insurance Company to pay Vision, Life Insurance, Short-term Disability, Long-term Disability, Accidental Death and Dismemberment, Critical Illness and Accident claims incurred under the terms of the plan. The total premiums paid for the plan year ending 10/31/2025 were $321,006.
Your Rights to Additional Information
You have the right to receive a copy of the full annual report, or any part thereof, on request. The items listed below are included in that report:
- insurance information, including sales commissions paid by insurance carriers;
To obtain a copy of the full annual report, or any part thereof, write or call the office of Bethany Medical Center at 507 Lindsay Street, High Point, NC, 27262 or by telephone at 336-883-0029.
You also have the legally protected right to examine the annual report at the main office of the plan (Bethany Medical Center, 507 Lindsay Street, High Point, NC, 27262) and at the U.S. Department of Labor in Washington, D.C., or to obtain a copy from the U.S. Department of Labor upon payment of copying costs. Requests to the Department should be addressed to: Public Disclosure Room, Room N1513, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue, N.W., Washington, D.C. 20210. Or you may access a copy on the DOL’s web site www.efast.dol.gov.
Paperwork Reduction Act
Statement According to the Paperwork Reduction Act of 1995 (Pub. L. 104-13) (PRA), no persons are required to respond to a collection of information unless such collection displays a valid Office of Management and Budget (OMB) control number. The Department notes that a Federal agency cannot conduct or sponsor a collection of information unless it is approved by OMB under the PRA, and displays a currently valid OMB control number, and the public is not required to respond to a collection of information unless it displays a currently valid OMB control number. See 44 U.S.C. 3507. Also, notwithstanding any other provisions of law, no person shall be subject to penalty for failing to comply with a collection of information if the collection of information does not display a currently valid OMB control number. See 44 U.S.C. 3512.
The public reporting burden for this collection of information is estimated to average less than one minute per notice (approximately 3 hours and 11 minutes per plan). Interested parties are encouraged to send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Department of Labor, Office of the Chief Information Officer, Attention: Departmental Clearance Officer, 200 Constitution Avenue, N.W., Room N-1301, Washington, DC 20210 or email DOL_PRA_PUBLIC@dol.gov and reference the OMB Control Number 1210-0040.
OMB Control Number 1210-0040 (expires 03/31/2026)