401k Plan data: GROUP TRAVEL ACCIDENT POLICY plan

GROUP TRAVEL ACCIDENT POLICY 401k Plan overview

Plan Name	GROUP TRAVEL ACCIDENT POLICY
Plan identification number	510

GROUP TRAVEL ACCIDENT POLICY Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

BRANDEIS UNIVERSITY has sponsored the creation of one or more 401k plans.

Company Name: BRANDEIS UNIVERSITY

Employer identification number (EIN): 042103552

NAIC Classification: 611000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP TRAVEL ACCIDENT POLICY

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
510 2019-01-01 KEVIN M PIERSON 2020-07-29
510 2017-01-01
510 2016-01-01
510 2015-01-01
510 2014-01-01
510 2013-01-01
510 2012-01-01 HARRY KALAJIAN HARRY KALAJIAN 2013-07-15
510 2011-01-01 HARRY KALAJIAN HARRY KALAJIAN 2012-07-13
510 2009-01-01 HARRY KALAJIAN HARRY KALAJIAN 2010-10-13

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
510	2019-01-01	KEVIN M PIERSON	2020-07-29
510	2017-01-01
510	2016-01-01
510	2015-01-01
510	2014-01-01
510	2013-01-01
510	2012-01-01	HARRY KALAJIAN		HARRY KALAJIAN	2013-07-15
510	2011-01-01	HARRY KALAJIAN		HARRY KALAJIAN	2012-07-13
510	2009-01-01	HARRY KALAJIAN		HARRY KALAJIAN	2010-10-13

Plan Statistics for GROUP TRAVEL ACCIDENT POLICY

401k plan membership statisitcs for GROUP TRAVEL ACCIDENT POLICY

Measure Date Value
2019: GROUP TRAVEL ACCIDENT POLICY 2019 401k membership
Total participants, beginning-of-year 2019-01-01 1,985
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 0
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 0
2017: GROUP TRAVEL ACCIDENT POLICY 2017 401k membership
Total participants, beginning-of-year 2017-01-01 1,918
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 1,900
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 1,900
2016: GROUP TRAVEL ACCIDENT POLICY 2016 401k membership
Total participants, beginning-of-year 2016-01-01 1,891
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 1,918
Total of all active and inactive participants 2016-01-01 1,918
Total participants 2016-01-01 1,918
2015: GROUP TRAVEL ACCIDENT POLICY 2015 401k membership
Total participants, beginning-of-year 2015-01-01 1,675
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 1,891
Total of all active and inactive participants 2015-01-01 1,891
Total participants 2015-01-01 1,891
2014: GROUP TRAVEL ACCIDENT POLICY 2014 401k membership
Total participants, beginning-of-year 2014-01-01 1,713
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 1,675
Total of all active and inactive participants 2014-01-01 1,675
Total participants 2014-01-01 1,675
2013: GROUP TRAVEL ACCIDENT POLICY 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1,695
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 1,713
Total of all active and inactive participants 2013-01-01 1,713
Total participants 2013-01-01 1,713
2012: GROUP TRAVEL ACCIDENT POLICY 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1,721
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 1,695
Total of all active and inactive participants 2012-01-01 1,695
Total participants 2012-01-01 1,695
2011: GROUP TRAVEL ACCIDENT POLICY 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,655
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 1,721
Total of all active and inactive participants 2011-01-01 1,721
Total participants 2011-01-01 1,721
2009: GROUP TRAVEL ACCIDENT POLICY 2009 401k membership
Total participants, beginning-of-year 2009-01-01 1,698
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 1,666
Total of all active and inactive participants 2009-01-01 1,666
Total participants 2009-01-01 1,666

Measure	Date	Value
2019: GROUP TRAVEL ACCIDENT POLICY 2019 401k membership
Total participants, beginning-of-year	2019-01-01	1,985
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	0
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	0
2017: GROUP TRAVEL ACCIDENT POLICY 2017 401k membership
Total participants, beginning-of-year	2017-01-01	1,918
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	1,900
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	1,900
2016: GROUP TRAVEL ACCIDENT POLICY 2016 401k membership
Total participants, beginning-of-year	2016-01-01	1,891
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	1,918
Total of all active and inactive participants	2016-01-01	1,918
Total participants	2016-01-01	1,918
2015: GROUP TRAVEL ACCIDENT POLICY 2015 401k membership
Total participants, beginning-of-year	2015-01-01	1,675
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	1,891
Total of all active and inactive participants	2015-01-01	1,891
Total participants	2015-01-01	1,891
2014: GROUP TRAVEL ACCIDENT POLICY 2014 401k membership
Total participants, beginning-of-year	2014-01-01	1,713
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	1,675
Total of all active and inactive participants	2014-01-01	1,675
Total participants	2014-01-01	1,675
2013: GROUP TRAVEL ACCIDENT POLICY 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,695
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	1,713
Total of all active and inactive participants	2013-01-01	1,713
Total participants	2013-01-01	1,713
2012: GROUP TRAVEL ACCIDENT POLICY 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,721
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	1,695
Total of all active and inactive participants	2012-01-01	1,695
Total participants	2012-01-01	1,695
2011: GROUP TRAVEL ACCIDENT POLICY 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,655
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1,721
Total of all active and inactive participants	2011-01-01	1,721
Total participants	2011-01-01	1,721
2009: GROUP TRAVEL ACCIDENT POLICY 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,698
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	1,666
Total of all active and inactive participants	2009-01-01	1,666
Total participants	2009-01-01	1,666

Form 5500 Responses for GROUP TRAVEL ACCIDENT POLICY

2019: GROUP TRAVEL ACCIDENT POLICY 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	Yes
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2017: GROUP TRAVEL ACCIDENT POLICY 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: GROUP TRAVEL ACCIDENT POLICY 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: GROUP TRAVEL ACCIDENT POLICY 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: GROUP TRAVEL ACCIDENT POLICY 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: GROUP TRAVEL ACCIDENT POLICY 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: GROUP TRAVEL ACCIDENT POLICY 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: GROUP TRAVEL ACCIDENT POLICY 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: GROUP TRAVEL ACCIDENT POLICY 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )
Policy contract number	ADD N04947757
Policy instance	1
ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )
Policy contract number	ADD N04947757
Policy instance	1
ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )
Policy contract number	ADD N04947757
Policy instance	1
ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )
Policy contract number	ADD N04947757
Policy instance	1
ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )
Policy contract number	ADD N0 4947757
Policy instance	1
ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )
Policy contract number	ADD N0 4947757
Policy instance	1
ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )
Policy contract number	ADD N0 4947757
Policy instance	1
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number	GTP 000 9101933
Policy instance	1

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Company Name:	BRANDEIS UNIVERSITY
Employer identification number (EIN):	042103552
NAIC Classification:	611000