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GROUP HEALTH INSURANCE PLAN 401k Plan overview

Plan NameGROUP HEALTH INSURANCE PLAN
Plan identification number 515

GROUP HEALTH INSURANCE PLAN Benefits

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

401k Sponsoring company profile

DOW JONES LOCAL MEDIA GROUP has sponsored the creation of one or more 401k plans.

Company Name:DOW JONES LOCAL MEDIA GROUP
Employer identification number (EIN):141513238
NAIC Classification:323100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP HEALTH INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5152012-01-01PATRICIA GATTO
5152011-01-01PATRICIA GATTO
5152010-01-01PATRICIA GATTO
5152009-01-01CATHERINE PAFFENROTH

Plan Statistics for GROUP HEALTH INSURANCE PLAN

401k plan membership statisitcs for GROUP HEALTH INSURANCE PLAN

Measure Date Value
2012: GROUP HEALTH INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01795
Total number of active participants reported on line 7a of the Form 55002012-01-01594
Number of retired or separated participants receiving benefits2012-01-01149
Total of all active and inactive participants2012-01-01743
2011: GROUP HEALTH INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-011,393
Total number of active participants reported on line 7a of the Form 55002011-01-01636
Number of retired or separated participants receiving benefits2011-01-01159
Total of all active and inactive participants2011-01-01795
2010: GROUP HEALTH INSURANCE PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-012,083
Total number of active participants reported on line 7a of the Form 55002010-01-011,154
Number of retired or separated participants receiving benefits2010-01-01239
Total of all active and inactive participants2010-01-011,393
2009: GROUP HEALTH INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-011,143
Total number of active participants reported on line 7a of the Form 55002009-01-011,627
Number of retired or separated participants receiving benefits2009-01-01456
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-012,083
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-012,083

Form 5500 Responses for GROUP HEALTH INSURANCE PLAN

2012: GROUP HEALTH INSURANCE PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: GROUP HEALTH INSURANCE PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: GROUP HEALTH INSURANCE PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: GROUP HEALTH INSURANCE PLAN 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

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number697486-479213
Policy instance 1
Insurance contract or identification number697486-479213
Number of Individuals Covered743
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $10,000
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $157,431
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,000
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS LLC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number697486-479213
Policy instance 1
Insurance contract or identification number697486-479213
Number of Individuals Covered795
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $9,167
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $160,900
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 number697486-479213
Policy instance 1
Insurance contract or identification number697486-479213
Number of Individuals Covered1393
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $10,000
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $151,855
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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