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| Plan Name | THE ROTHBERG INSTITUTE, INC. HEALTH & WELFARE PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | THE ROTHBERG INSTITUTE, INC. |
| Employer identification number (EIN): | 061634985 |
| NAIC Classification: | 541700 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2017-12-01 | ||||
| 501 | 2016-12-01 | ELIZABETH WHAYLAND | |||
| 501 | 2015-12-01 | ELIZABETH WHAYLAND |
| Measure | Date | Value |
|---|---|---|
| 2017: THE ROTHBERG INSTITUTE, INC. HEALTH & WELFARE PLAN 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-12-01 | 174 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-12-01 | 235 |
| Total of all active and inactive participants | 2017-12-01 | 235 |
| Total participants | 2017-12-01 | 235 |
| 2016: THE ROTHBERG INSTITUTE, INC. HEALTH & WELFARE PLAN 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-12-01 | 247 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-12-01 | 174 |
| Total of all active and inactive participants | 2016-12-01 | 174 |
| Total participants | 2016-12-01 | 174 |
| 2015: THE ROTHBERG INSTITUTE, INC. HEALTH & WELFARE PLAN 2015 401k membership | ||
| Total participants, beginning-of-year | 2015-12-01 | 103 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-12-01 | 247 |
| Total of all active and inactive participants | 2015-12-01 | 247 |
| Total participants | 2015-12-01 | 0 |
| 2017: THE ROTHBERG INSTITUTE, INC. HEALTH & WELFARE PLAN 2017 form 5500 responses | ||
|---|---|---|
| 2017-12-01 | Type of plan entity | Mulitple employer plan |
| 2017-12-01 | Plan funding arrangement – Insurance | Yes |
| 2017-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: THE ROTHBERG INSTITUTE, INC. HEALTH & WELFARE PLAN 2016 form 5500 responses | ||
| 2016-12-01 | Type of plan entity | Mulitple employer plan |
| 2016-12-01 | Plan funding arrangement – Insurance | Yes |
| 2016-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: THE ROTHBERG INSTITUTE, INC. HEALTH & WELFARE PLAN 2015 form 5500 responses | ||
| 2015-12-01 | Type of plan entity | Mulitple employer plan |
| 2015-12-01 | First time form 5500 has been submitted | Yes |
| 2015-12-01 | Plan funding arrangement – Insurance | Yes |
| 2015-12-01 | Plan benefit arrangement – Insurance | Yes |
| ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 ) | |||||||||||||||||||
| Policy contract number | 057929 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
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| ANTHEM HEALTH PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 60217 ) | |||||||||||||||||||
| Policy contract number | 752881 | ||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||
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| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) | |||||||||||||||||||
| Policy contract number | AL000061699 | ||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||
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