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EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 401k Plan overview

Plan NameEMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE
Plan identification number 506

EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental

401k Sponsoring company profile

MARLBORO COLLEGE has sponsored the creation of one or more 401k plans.

Company Name:MARLBORO COLLEGE
Employer identification number (EIN):030179593
NAIC Classification:611000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5062020-01-01
5062019-01-01
5062018-01-01ROBERT WEBBER
5062017-01-01ROBERT WEBBER
5062016-01-01ANNE M PRATT
5062015-01-01ANNE M PRATT
5062014-01-01ANNE M PRATT
5062013-01-01ANNE M PRATT
5062012-01-01ANNE M PRATT
5062011-01-01ANNE PRATT
5062009-01-01ANNE PRATT ANNE PRATT2010-10-15

Plan Statistics for EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE

401k plan membership statisitcs for EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE

Measure Date Value
2020: EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 2020 401k membership
Total participants, beginning-of-year2020-01-0191
Total number of active participants reported on line 7a of the Form 55002020-01-010
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-010
2019: EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 2019 401k membership
Total participants, beginning-of-year2019-01-0185
Total number of active participants reported on line 7a of the Form 55002019-01-0156
Number of retired or separated participants receiving benefits2019-01-0135
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-0191
2018: EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 2018 401k membership
Total participants, beginning-of-year2018-01-0192
Total number of active participants reported on line 7a of the Form 55002018-01-0153
Number of retired or separated participants receiving benefits2018-01-0132
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-0185
2017: EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 2017 401k membership
Total participants, beginning-of-year2017-01-0191
Total number of active participants reported on line 7a of the Form 55002017-01-0164
Number of retired or separated participants receiving benefits2017-01-0128
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-0192
2016: EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 2016 401k membership
Total participants, beginning-of-year2016-01-0189
Total number of active participants reported on line 7a of the Form 55002016-01-0168
Number of retired or separated participants receiving benefits2016-01-0123
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-0191
2015: EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 2015 401k membership
Total participants, beginning-of-year2015-01-0188
Total number of active participants reported on line 7a of the Form 55002015-01-0169
Number of retired or separated participants receiving benefits2015-01-0120
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-0189
2014: EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 2014 401k membership
Total participants, beginning-of-year2014-01-0191
Total number of active participants reported on line 7a of the Form 55002014-01-0175
Number of retired or separated participants receiving benefits2014-01-0113
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-0188
2013: EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 2013 401k membership
Total participants, beginning-of-year2013-01-0192
Total number of active participants reported on line 7a of the Form 55002013-01-0180
Number of retired or separated participants receiving benefits2013-01-0111
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-0191
2012: EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 2012 401k membership
Total participants, beginning-of-year2012-01-0182
Total number of active participants reported on line 7a of the Form 55002012-01-0184
Number of retired or separated participants receiving benefits2012-01-018
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-0192
2011: EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 2011 401k membership
Total participants, beginning-of-year2011-01-0184
Total number of active participants reported on line 7a of the Form 55002011-01-0179
Number of retired or separated participants receiving benefits2011-01-019
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-0188
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-0188
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: EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 2009 401k membership
Total participants, beginning-of-year2009-01-0177
Total number of active participants reported on line 7a of the Form 55002009-01-0176
Number of retired or separated participants receiving benefits2009-01-012
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-0178
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-0178
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

Financial Data on EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE

Measure Date Value
2020 : EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 2020 401k financial data
Total income from all sources2020-12-31$-159,770
Expenses. Total of all expenses incurred2020-12-31$21,122
Benefits paid (including direct rollovers)2020-12-31$15,028
Total plan assets at end of year2020-12-31$0
Total plan assets at beginning of year2020-12-31$180,892
Value of fidelity bond covering the plan2020-12-31$500,000
Expenses. Other expenses not covered elsewhere2020-12-31$6,094
Other income received2020-12-31$9,960
Net income (gross income less expenses)2020-12-31$-180,892
Net plan assets at end of year (total assets less liabilities)2020-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$180,892
Total contributions received or receivable from employer(s)2020-12-31$-169,730
2019 : EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 2019 401k financial data
Total income from all sources2019-12-31$39,329
Expenses. Total of all expenses incurred2019-12-31$11,903
Benefits paid (including direct rollovers)2019-12-31$5,096
Total plan assets at end of year2019-12-31$180,892
Total plan assets at beginning of year2019-12-31$153,466
Value of fidelity bond covering the plan2019-12-31$500,000
Expenses. Other expenses not covered elsewhere2019-12-31$6,807
Other income received2019-12-31$27,290
Net income (gross income less expenses)2019-12-31$27,426
Net plan assets at end of year (total assets less liabilities)2019-12-31$180,892
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$153,466
Total contributions received or receivable from employer(s)2019-12-31$12,039
2018 : EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 2018 401k financial data
Total income from all sources2018-12-31$185
Expenses. Total of all expenses incurred2018-12-31$16,735
Benefits paid (including direct rollovers)2018-12-31$10,205
Total plan assets at end of year2018-12-31$153,466
Total plan assets at beginning of year2018-12-31$170,016
Value of fidelity bond covering the plan2018-12-31$500,000
Expenses. Other expenses not covered elsewhere2018-12-31$6,530
Other income received2018-12-31$-8,956
Net income (gross income less expenses)2018-12-31$-16,550
Net plan assets at end of year (total assets less liabilities)2018-12-31$153,466
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$170,016
Total contributions received or receivable from employer(s)2018-12-31$9,141
2017 : EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 2017 401k financial data
Total income from all sources2017-12-31$37,382
Expenses. Total of all expenses incurred2017-12-31$8,299
Benefits paid (including direct rollovers)2017-12-31$1,845
Total plan assets at end of year2017-12-31$170,016
Total plan assets at beginning of year2017-12-31$140,933
Value of fidelity bond covering the plan2017-12-31$500,000
Expenses. Other expenses not covered elsewhere2017-12-31$6,454
Other income received2017-12-31$22,284
Net income (gross income less expenses)2017-12-31$29,083
Net plan assets at end of year (total assets less liabilities)2017-12-31$170,016
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$140,933
Total contributions received or receivable from employer(s)2017-12-31$15,098
2016 : EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 2016 401k financial data
Total income from all sources2016-12-31$24,770
Expenses. Total of all expenses incurred2016-12-31$7,066
Benefits paid (including direct rollovers)2016-12-31$214
Total plan assets at end of year2016-12-31$140,933
Total plan assets at beginning of year2016-12-31$123,229
Value of fidelity bond covering the plan2016-12-31$500,000
Expenses. Other expenses not covered elsewhere2016-12-31$6,852
Other income received2016-12-31$8,202
Net income (gross income less expenses)2016-12-31$17,704
Net plan assets at end of year (total assets less liabilities)2016-12-31$140,933
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$123,229
Total contributions received or receivable from employer(s)2016-12-31$16,568
2015 : EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 2015 401k financial data
Total income from all sources2015-12-31$18,661
Expenses. Total of all expenses incurred2015-12-31$13,023
Benefits paid (including direct rollovers)2015-12-31$5,218
Total plan assets at end of year2015-12-31$123,229
Total plan assets at beginning of year2015-12-31$117,591
Value of fidelity bond covering the plan2015-12-31$500,000
Expenses. Other expenses not covered elsewhere2015-12-31$7,805
Other income received2015-12-31$65
Net income (gross income less expenses)2015-12-31$5,638
Net plan assets at end of year (total assets less liabilities)2015-12-31$123,229
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$117,591
Total contributions received or receivable from employer(s)2015-12-31$18,596
2014 : EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 2014 401k financial data
Total income from all sources2014-12-31$22,258
Expenses. Total of all expenses incurred2014-12-31$11,309
Benefits paid (including direct rollovers)2014-12-31$3,746
Total plan assets at end of year2014-12-31$117,591
Total plan assets at beginning of year2014-12-31$106,642
Value of fidelity bond covering the plan2014-12-31$500,000
Expenses. Other expenses not covered elsewhere2014-12-31$7,563
Other income received2014-12-31$4,779
Net income (gross income less expenses)2014-12-31$10,949
Net plan assets at end of year (total assets less liabilities)2014-12-31$117,591
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$106,642
Total contributions received or receivable from employer(s)2014-12-31$17,479
2013 : EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 2013 401k financial data
Total income from all sources2013-12-31$31,516
Expenses. Total of all expenses incurred2013-12-31$9,035
Benefits paid (including direct rollovers)2013-12-31$1,524
Total plan assets at end of year2013-12-31$106,642
Total plan assets at beginning of year2013-12-31$84,161
Value of fidelity bond covering the plan2013-12-31$500,000
Expenses. Other expenses not covered elsewhere2013-12-31$7,511
Other income received2013-12-31$14,087
Net income (gross income less expenses)2013-12-31$22,481
Net plan assets at end of year (total assets less liabilities)2013-12-31$106,642
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$84,161
Total contributions received or receivable from employer(s)2013-12-31$17,429
2012 : EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 2012 401k financial data
Total income from all sources2012-12-31$28,387
Expenses. Total of all expenses incurred2012-12-31$8,377
Benefits paid (including direct rollovers)2012-12-31$387
Total plan assets at end of year2012-12-31$84,161
Total plan assets at beginning of year2012-12-31$64,151
Value of fidelity bond covering the plan2012-12-31$500,000
Other income received2012-12-31$9,293
Net income (gross income less expenses)2012-12-31$20,010
Net plan assets at end of year (total assets less liabilities)2012-12-31$84,161
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$64,151
Total contributions received or receivable from employer(s)2012-12-31$19,094
Expenses. Administrative service providers (salaries,fees and commissions)2012-12-31$7,990
2011 : EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 2011 401k financial data
Total income from all sources2011-12-31$17,555
Expenses. Total of all expenses incurred2011-12-31$7,782
Total plan assets at end of year2011-12-31$64,151
Total plan assets at beginning of year2011-12-31$54,378
Value of fidelity bond covering the plan2011-12-31$500,000
Other income received2011-12-31$-720
Net income (gross income less expenses)2011-12-31$9,773
Net plan assets at end of year (total assets less liabilities)2011-12-31$64,151
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$54,378
Total contributions received or receivable from employer(s)2011-12-31$18,275
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$7,782
2010 : EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 2010 401k financial data
Total income from all sources2010-12-31$24,700
Expenses. Total of all expenses incurred2010-12-31$5,696
Total plan assets at end of year2010-12-31$54,378
Total plan assets at beginning of year2010-12-31$35,374
Value of fidelity bond covering the plan2010-12-31$500,000
Other income received2010-12-31$5,495
Net income (gross income less expenses)2010-12-31$19,004
Net plan assets at end of year (total assets less liabilities)2010-12-31$54,378
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$35,374
Total contributions received or receivable from employer(s)2010-12-31$19,205
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$5,696

Form 5500 Responses for EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE

2020: EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingYes
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
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 funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 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 funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 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 funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 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 – TrustYes
2014-01-01Plan benefit arrangement - TrustYes
2013: EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 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 – TrustYes
2013-01-01Plan benefit arrangement - TrustYes
2012: EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 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 – TrustYes
2012-01-01Plan benefit arrangement - TrustYes
2011: EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 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 – TrustYes
2011-01-01Plan benefit arrangement - TrustYes
2009: EMERITI RETIREE HEALTH PLAN FOR MARLBORO COLLEGE 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 funding arrangement – TrustYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number82036382038648
Policy instance 2
Insurance contract or identification number82036382038648
Number of Individuals Covered0
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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 BenefitYes
Vision Insurance Welfare BenefitNo
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 $1,065
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number820363
Policy instance 1
Insurance contract or identification number820363
Number of Individuals Covered0
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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 BenefitNo
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 $2,514
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number82036382038648
Policy instance 2
Insurance contract or identification number82036382038648
Number of Individuals Covered4
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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 BenefitYes
Vision Insurance Welfare BenefitNo
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 $1,284
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number820363
Policy instance 1
Insurance contract or identification number820363
Number of Individuals Covered2
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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 BenefitNo
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 $2,762
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number82036382038648
Policy instance 2
Insurance contract or identification number82036382038648
Number of Individuals Covered2
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
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 BenefitYes
Vision Insurance Welfare BenefitNo
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 $1,278
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number820363
Policy instance 1
Insurance contract or identification number820363
Number of Individuals Covered2
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
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 BenefitNo
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 $4,269
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number82036382038648
Policy instance 2
Insurance contract or identification number82036382038648
Number of Individuals Covered2
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
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 BenefitYes
Vision Insurance Welfare BenefitNo
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 $1,278
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number820363
Policy instance 1
Insurance contract or identification number820363
Number of Individuals Covered2
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
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 BenefitNo
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 $3,228
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number82036382038648
Policy instance 3
Insurance contract or identification number82036382038648
Number of Individuals Covered2
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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 BenefitYes
Vision Insurance Welfare BenefitNo
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 $601
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number820363
Policy instance 2
Insurance contract or identification number820363
Number of Individuals Covered2
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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 BenefitNo
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 $914
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number820363
Policy instance 1
Insurance contract or identification number820363
Number of Individuals Covered2
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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 BenefitNo
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 $751
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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