401k Plan data: HIGHMARK BLUE CROSS BLUE SHIELD plan

HIGHMARK BLUE CROSS BLUE SHIELD 401k Plan overview

Plan Name	HIGHMARK BLUE CROSS BLUE SHIELD
Plan identification number	501

HIGHMARK BLUE CROSS BLUE SHIELD Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Dental Vision Other welfare benefit cover

401k Sponsoring company profile

WESTERN PENNSYLVANIA SCHOOL FOR BLIND CHILDREN has sponsored the creation of one or more 401k plans.

Company Name: WESTERN PENNSYLVANIA SCHOOL FOR BLIND CHILDREN

Employer identification number (EIN): 251095385

NAIC Classification: 611000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HIGHMARK BLUE CROSS BLUE SHIELD

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2014-09-01 SUSAN MCALEER SUSAN MCALEER 2016-02-11
501 2013-09-01 SUSAN MCALEER SUSAN MCALEER 2015-03-24
501 2012-09-01 SUSAN MCALEER SUSAN MCALEER 2014-01-31
501 2011-09-01 SUSAN MCALEER SUSAN MCALEER 2013-02-15
501 2010-09-01 SUSAN MCALEER SUSAN MCALEER 2012-05-22
501 2009-09-01 SUSAN MCALEER SUSAN MCALEER 2011-02-28

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2014-09-01	SUSAN MCALEER	SUSAN MCALEER	2016-02-11
501	2013-09-01	SUSAN MCALEER	SUSAN MCALEER	2015-03-24
501	2012-09-01	SUSAN MCALEER	SUSAN MCALEER	2014-01-31
501	2011-09-01	SUSAN MCALEER	SUSAN MCALEER	2013-02-15
501	2010-09-01	SUSAN MCALEER	SUSAN MCALEER	2012-05-22
501	2009-09-01	SUSAN MCALEER	SUSAN MCALEER	2011-02-28

Plan Statistics for HIGHMARK BLUE CROSS BLUE SHIELD

401k plan membership statisitcs for HIGHMARK BLUE CROSS BLUE SHIELD

Measure Date Value
2014: HIGHMARK BLUE CROSS BLUE SHIELD 2014 401k membership
Total participants, beginning-of-year 2014-09-01 234
Total number of active participants reported on line 7a of the Form 5500 2014-09-01 0
Number of retired or separated participants receiving benefits 2014-09-01 0
Total of all active and inactive participants 2014-09-01 0
2013: HIGHMARK BLUE CROSS BLUE SHIELD 2013 401k membership
Total participants, beginning-of-year 2013-09-01 212
Total number of active participants reported on line 7a of the Form 5500 2013-09-01 220
Number of retired or separated participants receiving benefits 2013-09-01 14
Total of all active and inactive participants 2013-09-01 234
2012: HIGHMARK BLUE CROSS BLUE SHIELD 2012 401k membership
Total participants, beginning-of-year 2012-09-01 231
Total number of active participants reported on line 7a of the Form 5500 2012-09-01 219
Number of retired or separated participants receiving benefits 2012-09-01 18
Total of all active and inactive participants 2012-09-01 237
2011: HIGHMARK BLUE CROSS BLUE SHIELD 2011 401k membership
Total participants, beginning-of-year 2011-09-01 243
Total number of active participants reported on line 7a of the Form 5500 2011-09-01 222
Number of retired or separated participants receiving benefits 2011-09-01 15
Number of other retired or separated participants entitled to future benefits 2011-09-01 0
Total of all active and inactive participants 2011-09-01 237
2010: HIGHMARK BLUE CROSS BLUE SHIELD 2010 401k membership
Total participants, beginning-of-year 2010-09-01 232
Total number of active participants reported on line 7a of the Form 5500 2010-09-01 227
Number of retired or separated participants receiving benefits 2010-09-01 11
Number of other retired or separated participants entitled to future benefits 2010-09-01 2
Total of all active and inactive participants 2010-09-01 240
2009: HIGHMARK BLUE CROSS BLUE SHIELD 2009 401k membership
Total participants, beginning-of-year 2009-09-01 225
Total number of active participants reported on line 7a of the Form 5500 2009-09-01 226
Number of retired or separated participants receiving benefits 2009-09-01 14
Total of all active and inactive participants 2009-09-01 240

Measure	Date	Value
2014: HIGHMARK BLUE CROSS BLUE SHIELD 2014 401k membership
Total participants, beginning-of-year	2014-09-01	234
Total number of active participants reported on line 7a of the Form 5500	2014-09-01	0
Number of retired or separated participants receiving benefits	2014-09-01	0
Total of all active and inactive participants	2014-09-01	0
2013: HIGHMARK BLUE CROSS BLUE SHIELD 2013 401k membership
Total participants, beginning-of-year	2013-09-01	212
Total number of active participants reported on line 7a of the Form 5500	2013-09-01	220
Number of retired or separated participants receiving benefits	2013-09-01	14
Total of all active and inactive participants	2013-09-01	234
2012: HIGHMARK BLUE CROSS BLUE SHIELD 2012 401k membership
Total participants, beginning-of-year	2012-09-01	231
Total number of active participants reported on line 7a of the Form 5500	2012-09-01	219
Number of retired or separated participants receiving benefits	2012-09-01	18
Total of all active and inactive participants	2012-09-01	237
2011: HIGHMARK BLUE CROSS BLUE SHIELD 2011 401k membership
Total participants, beginning-of-year	2011-09-01	243
Total number of active participants reported on line 7a of the Form 5500	2011-09-01	222
Number of retired or separated participants receiving benefits	2011-09-01	15
Number of other retired or separated participants entitled to future benefits	2011-09-01	0
Total of all active and inactive participants	2011-09-01	237
2010: HIGHMARK BLUE CROSS BLUE SHIELD 2010 401k membership
Total participants, beginning-of-year	2010-09-01	232
Total number of active participants reported on line 7a of the Form 5500	2010-09-01	227
Number of retired or separated participants receiving benefits	2010-09-01	11
Number of other retired or separated participants entitled to future benefits	2010-09-01	2
Total of all active and inactive participants	2010-09-01	240
2009: HIGHMARK BLUE CROSS BLUE SHIELD 2009 401k membership
Total participants, beginning-of-year	2009-09-01	225
Total number of active participants reported on line 7a of the Form 5500	2009-09-01	226
Number of retired or separated participants receiving benefits	2009-09-01	14
Total of all active and inactive participants	2009-09-01	240

Form 5500 Responses for HIGHMARK BLUE CROSS BLUE SHIELD

2014: HIGHMARK BLUE CROSS BLUE SHIELD 2014 form 5500 responses
2014-09-01	Type of plan entity	Single employer plan
2014-09-01	This submission is the final filing	Yes
2014-09-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2014-09-01	Plan funding arrangement – Insurance	Yes
2014-09-01	Plan benefit arrangement – Insurance	Yes
2013: HIGHMARK BLUE CROSS BLUE SHIELD 2013 form 5500 responses
2013-09-01	Type of plan entity	Single employer plan
2013-09-01	Plan funding arrangement – Insurance	Yes
2013-09-01	Plan benefit arrangement – Insurance	Yes
2012: HIGHMARK BLUE CROSS BLUE SHIELD 2012 form 5500 responses
2012-09-01	Type of plan entity	Single employer plan
2012-09-01	Plan funding arrangement – Insurance	Yes
2012-09-01	Plan benefit arrangement – Insurance	Yes
2011: HIGHMARK BLUE CROSS BLUE SHIELD 2011 form 5500 responses
2011-09-01	Type of plan entity	Single employer plan
2011-09-01	Plan funding arrangement – Insurance	Yes
2011-09-01	Plan benefit arrangement – Insurance	Yes
2010: HIGHMARK BLUE CROSS BLUE SHIELD 2010 form 5500 responses
2010-09-01	Type of plan entity	Single employer plan
2010-09-01	Plan funding arrangement – Insurance	Yes
2010-09-01	Plan benefit arrangement – Insurance	Yes
2009: HIGHMARK BLUE CROSS BLUE SHIELD 2009 form 5500 responses
2009-09-01	Type of plan entity	Single employer plan
2009-09-01	This submission is the final filing	No
2009-09-01	Plan funding arrangement – Insurance	Yes
2009-09-01	Plan benefit arrangement – Insurance	Yes

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Company Name:	WESTERN PENNSYLVANIA SCHOOL FOR BLIND CHILDREN
Employer identification number (EIN):	251095385
NAIC Classification:	611000