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BLUE CROSS BLUE SHIELD HEALTH PLAN ROGER WILLIAMS UNIVERSITY 401k Plan overview

Plan NameBLUE CROSS BLUE SHIELD HEALTH PLAN ROGER WILLIAMS UNIVERSITY
Plan identification number 503

BLUE CROSS BLUE SHIELD HEALTH PLAN ROGER WILLIAMS UNIVERSITY Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

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

Company Name:ROGER WILLIAMS UNIVERSITY
Employer identification number (EIN):050277222
NAIC Classification:611000

Additional information about ROGER WILLIAMS UNIVERSITY

Jurisdiction of Incorporation: Secretary of State Rhode Island
Incorporation Date:
Company Identification Number: 000030256

More information about ROGER WILLIAMS UNIVERSITY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BLUE CROSS BLUE SHIELD HEALTH PLAN ROGER WILLIAMS UNIVERSITY

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032013-01-01CHRISTOPHER M. NERONHA
5032012-01-01CHRISTOPHER M. NERONHA
5032011-01-01CHRISTOPHER M. NERONHA
5032009-01-01CHRISTOPHER M. NERONHA

Plan Statistics for BLUE CROSS BLUE SHIELD HEALTH PLAN ROGER WILLIAMS UNIVERSITY

401k plan membership statisitcs for BLUE CROSS BLUE SHIELD HEALTH PLAN ROGER WILLIAMS UNIVERSITY

Measure Date Value
2013: BLUE CROSS BLUE SHIELD HEALTH PLAN ROGER WILLIAMS UNIVERSITY 2013 401k membership
Total participants, beginning-of-year2013-01-012,065
Total number of active participants reported on line 7a of the Form 55002013-01-010
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-010
2012: BLUE CROSS BLUE SHIELD HEALTH PLAN ROGER WILLIAMS UNIVERSITY 2012 401k membership
Total participants, beginning-of-year2012-01-012,090
Total number of active participants reported on line 7a of the Form 55002012-01-012,018
Number of retired or separated participants receiving benefits2012-01-0147
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-012,065
2011: BLUE CROSS BLUE SHIELD HEALTH PLAN ROGER WILLIAMS UNIVERSITY 2011 401k membership
Total participants, beginning-of-year2011-01-012,025
Total number of active participants reported on line 7a of the Form 55002011-01-012,034
Number of retired or separated participants receiving benefits2011-01-0136
Number of other retired or separated participants entitled to future benefits2011-01-0120
Total of all active and inactive participants2011-01-012,090
2009: BLUE CROSS BLUE SHIELD HEALTH PLAN ROGER WILLIAMS UNIVERSITY 2009 401k membership
Total participants, beginning-of-year2009-01-011,919
Total number of active participants reported on line 7a of the Form 55002009-01-011,957
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-011,957

Form 5500 Responses for BLUE CROSS BLUE SHIELD HEALTH PLAN ROGER WILLIAMS UNIVERSITY

2013: BLUE CROSS BLUE SHIELD HEALTH PLAN ROGER WILLIAMS UNIVERSITY 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 filingYes
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 – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: BLUE CROSS BLUE SHIELD HEALTH PLAN ROGER WILLIAMS UNIVERSITY 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 – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: BLUE CROSS BLUE SHIELD HEALTH PLAN ROGER WILLIAMS UNIVERSITY 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
2009: BLUE CROSS BLUE SHIELD HEALTH PLAN ROGER WILLIAMS UNIVERSITY 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

BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND (National Association of Insurance Commissioners NAIC id number: 53473 )
Policy contract number1485
Policy instance 1
Insurance contract or identification number1485
Number of Individuals Covered1983
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $208,553
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
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 $9,900,929
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $208,553
Insurance broker organization code?3
Insurance broker nameSTARKWEATHER & SHEPLEY INC
BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND (National Association of Insurance Commissioners NAIC id number: 53473 )
Policy contract number1485
Policy instance 1
Insurance contract or identification number1485
Number of Individuals Covered2018
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $141,814
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
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 $3,882,168
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $141,814
Insurance broker organization code?3
Insurance broker nameSTARKWEATHER & SHEPLEY INC
BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND (National Association of Insurance Commissioners NAIC id number: 53473 )
Policy contract number1485
Policy instance 1
Insurance contract or identification number1485
Number of Individuals Covered2034
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $146,022
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
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 $9,248,961
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS AND BLUE SHIELD OF RHODE ISLAND (National Association of Insurance Commissioners NAIC id number: 53473 )
Policy contract number1485
Policy instance 1
Insurance contract or identification number1485
Number of Individuals Covered1968
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $131,826
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
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 $8,760,433
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $118,913
Insurance broker organization code?3
Insurance broker nameSTARKWEATHER & SHEPLEY INC

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