BLUE CROSS BLUE SHIELD OF MASSACHUSETTS 401k Plan overview

BLUE CROSS BLUE SHIELD OF MASSACHUSETTS Benefits

401k Sponsoring company profile

Company Name:	CLARK UNIVERSITY
Employer identification number (EIN):	042111203
NAIC Classification:	611000

Form 5500 Filing Information

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
504	2014-05-01	DAVID EVERITT
504	2014-05-01	DAVID EVERITT
504	2013-05-01	DAVID EVERITT
504	2011-05-01	JACQUELINE CAPOMACCHIO
504	2009-05-01	JACQUELINE CAPOMACCHIO

Plan Statistics for BLUE CROSS BLUE SHIELD OF MASSACHUSETTS

Measure	Date	Value
2014: BLUE CROSS BLUE SHIELD OF MASSACHUSETTS 2014 401k membership
Total participants, beginning-of-year	2014-05-01	481
Total number of active participants reported on line 7a of the Form 5500	2014-05-01	0
Number of retired or separated participants receiving benefits	2014-05-01	0
Number of other retired or separated participants entitled to future benefits	2014-05-01	0
Total of all active and inactive participants	2014-05-01	0
Total participants	2014-05-01	507
2013: BLUE CROSS BLUE SHIELD OF MASSACHUSETTS 2013 401k membership
Total participants, beginning-of-year	2013-05-01	446
Total number of active participants reported on line 7a of the Form 5500	2013-05-01	481
Number of retired or separated participants receiving benefits	2013-05-01	0
Number of other retired or separated participants entitled to future benefits	2013-05-01	0
Total of all active and inactive participants	2013-05-01	481
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-05-01	0
Total participants	2013-05-01	481
Number of participants with account balances	2013-05-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-05-01	0
2011: BLUE CROSS BLUE SHIELD OF MASSACHUSETTS 2011 401k membership
Total participants, beginning-of-year	2011-05-01	372
Total number of active participants reported on line 7a of the Form 5500	2011-05-01	446
Total of all active and inactive participants	2011-05-01	446
Total participants	2011-05-01	446
2009: BLUE CROSS BLUE SHIELD OF MASSACHUSETTS 2009 401k membership
Total participants, beginning-of-year	2009-05-01	353
Total number of active participants reported on line 7a of the Form 5500	2009-05-01	353
Total of all active and inactive participants	2009-05-01	353
Total participants	2009-05-01	353

Form 5500 Responses for BLUE CROSS BLUE SHIELD OF MASSACHUSETTS

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• BLUE CROSS/BLUE SHIELD OF MICHIGAN GAYLORD DIVISION PLAN [EIN = 340549970]
• BLUE CROSS BLUE SHIELD GROUP INSURANCE [EIN = 160743037]
• BLUE CROSS OF NORTHEASTERN PENNSYLVANIA [EIN = 231743282]
• BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA [EIN = 561038919]
• BLUE CROSS BLUE SHIELD ALABAMA [EIN = 630355713]
• BLUE CROSS BLUE SHIELD OF ALABAMA MEDICAL [EIN = 630843226]
• BLUE CROSS BLUE SHEILD OF ALABAMA [EIN = 273410813]
• BLUE CROSS AND BLUE SHIELD OF ALABAMA [EIN = 630103830]
• BLUE CROSS BLUE SHIELD OF ALABAMA MEDICAL [EIN = 630843226]
• BLUE CROSS BLUE SHEILD OF NORTH CAROLINA [EIN = 562384240]
• BLUE CROSS BLUE SHIELD ALABAMA DENTAL [EIN = 630355713]
• BLUE CROSS BLUE SHIELD PLAN [EIN = 451580204]
• BLUE CROSS BLUE SHIELD OF MICHIGAN EMPLOYEES' MASTER RETIREMENT TRUST [EIN = 301140600]
• BLUE CROSS BLUE SHIELD OF MINNESOTA [EIN = 416050237]
• BLUE CROSS ANIMAL HOSPITAL GROUP 401(K) PLAN [EIN = 870903171]
• BLUE CROSS & BLUE SHIELD OF RHODE ISLAND GROUP BUSINESS TRAVEL ACCIDENT PLAN [EIN = 050158952]
• BLUE CROSS BLUE SHIELD OF ALABAMA MEDICAL [EIN = 630843226]
• BLUE CROSS BLUE SHIELD OF ARIZONA, INC. EXECUTIVE SEVERANCE PLAN [EIN = 860004538]
• BLUE CROSS BLUE SHIELD OF TEXAS MEDICAL INSURANCE PLAN [EIN = 842662763]
• BLUE CROSS BLUE SHIELD OF ALABAMA [EIN = 630843226]
• BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA [EIN = 223851031]
• BLUE CROSS BLUE SHIELD OF ND SEVERANCE PLAN [EIN = 262326076]
• BLUE CROSS BLUE SHIELD OF NORTH DAKOTA HEALTHCARE REIMBURSEMENT PLAN [EIN = 262326076]
• BLUE CROSS BLUE SHIELD OF AZ [EIN = 882806512]
• BLUE CROSS PET CARE, INC 401K PLAN [EIN = 873520766]
• BLUE CROSS OF IDAHO RETIREE HEALTH REIMBURSEMENT ARRANGEMENT [EIN = 820344294]
• BLUE CROSS BLUE SHIELD OF ALABAMA [EIN = 831077369]
• BLUE CROSS BLUE SHIELD OF ALABAMA [EIN = 630843226]

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