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EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY 401k Plan overview

Plan NameEMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY
Plan identification number 507

EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY Benefits

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

401k Sponsoring company profile

ROSE-HULMAN INSTITUTE OF TECHNOLOGY has sponsored the creation of one or more 401k plans.

Company Name:ROSE-HULMAN INSTITUTE OF TECHNOLOGY
Employer identification number (EIN):350868149
NAIC Classification:611000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5072022-01-01
5072021-01-01
5072020-01-01
5072019-01-01
5072018-01-01
5072017-01-01ROBERT COONS
5072016-01-01ROBERT COONS
5072015-01-01ROBERT COONS
5072014-07-01MATTHEW DAVIS

Plan Statistics for EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY

401k plan membership statisitcs for EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY

Measure Date Value
2022: EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY 2022 401k membership
Total participants, beginning-of-year2022-01-01406
Total number of active participants reported on line 7a of the Form 55002022-01-01323
Number of retired or separated participants receiving benefits2022-01-01120
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01443
2021: EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY 2021 401k membership
Total participants, beginning-of-year2021-01-01366
Total number of active participants reported on line 7a of the Form 55002021-01-01321
Number of retired or separated participants receiving benefits2021-01-0185
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01406
2020: EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY 2020 401k membership
Total participants, beginning-of-year2020-01-01367
Total number of active participants reported on line 7a of the Form 55002020-01-01308
Number of retired or separated participants receiving benefits2020-01-0158
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01366
2019: EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY 2019 401k membership
Total participants, beginning-of-year2019-01-01335
Total number of active participants reported on line 7a of the Form 55002019-01-01303
Number of retired or separated participants receiving benefits2019-01-0164
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01367
2018: EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY 2018 401k membership
Total participants, beginning-of-year2018-01-01299
Total number of active participants reported on line 7a of the Form 55002018-01-01282
Number of retired or separated participants receiving benefits2018-01-0153
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01335
2017: EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY 2017 401k membership
Total participants, beginning-of-year2017-01-01229
Total number of active participants reported on line 7a of the Form 55002017-01-01257
Number of retired or separated participants receiving benefits2017-01-0142
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01299
2016: EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY 2016 401k membership
Total participants, beginning-of-year2016-01-01185
Total number of active participants reported on line 7a of the Form 55002016-01-01202
Number of retired or separated participants receiving benefits2016-01-0127
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01229
2015: EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY 2015 401k membership
Total participants, beginning-of-year2015-01-01121
Total number of active participants reported on line 7a of the Form 55002015-01-01167
Number of retired or separated participants receiving benefits2015-01-0118
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01185
2014: EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY 2014 401k membership
Total participants, beginning-of-year2014-07-010
Total number of active participants reported on line 7a of the Form 55002014-07-01120
Number of retired or separated participants receiving benefits2014-07-011
Number of other retired or separated participants entitled to future benefits2014-07-010
Total of all active and inactive participants2014-07-01121

Financial Data on EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY

Measure Date Value
2022 : EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$250,076
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$309,416
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$305,813
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$589,405
Value of total assets at end of year2022-12-31$1,930,413
Value of total assets at beginning of year2022-12-31$1,989,753
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$3,603
Total interest from all sources2022-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$122,605
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$122,605
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$2,000,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$197,084
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-59,340
Value of net assets at end of year (total assets less liabilities)2022-12-31$1,930,413
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$1,989,753
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$1,866,621
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$1,941,468
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-12-31$63,792
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-12-31$48,285
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-12-31$48,285
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$299,044
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-461,934
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$392,321
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$6,769
Contract administrator fees2022-12-31$3,603
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31FORVIS, LLP
Accountancy firm EIN2022-12-31440160260
2021 : EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$736,804
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$258,519
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$255,898
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$509,033
Value of total assets at end of year2021-12-31$1,989,753
Value of total assets at beginning of year2021-12-31$1,511,468
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$2,621
Total interest from all sources2021-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$170,160
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$170,160
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$2,000,000
If this is an individual account plan, was there a blackout period2021-12-31No
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$145,342
Administrative expenses (other) incurred2021-12-31$2,621
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$478,285
Value of net assets at end of year (total assets less liabilities)2021-12-31$1,989,753
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$1,511,468
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$1,941,468
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$1,470,752
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-12-31$48,285
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-12-31$40,716
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-12-31$40,716
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$251,045
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$57,611
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31Yes
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$363,691
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$4,853
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31BKD, LLP
Accountancy firm EIN2021-12-31440160260
2020 : EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total income from all sources (including contributions)2020-12-31$737,575
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$298,666
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$296,659
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$525,747
Value of total assets at end of year2020-12-31$1,511,468
Value of total assets at beginning of year2020-12-31$1,072,559
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$2,007
Total interest from all sources2020-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$83,335
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$83,335
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$2,000,000
If this is an individual account plan, was there a blackout period2020-12-31No
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$160,057
Administrative expenses (other) incurred2020-12-31$2,007
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$438,909
Value of net assets at end of year (total assets less liabilities)2020-12-31$1,511,468
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$1,072,559
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$1,470,752
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$1,047,690
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$40,716
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$24,869
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$24,869
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$292,367
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$128,493
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31Yes
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$365,690
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$4,292
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Unqualified
Accountancy firm name2020-12-31BKD, LLP
Accountancy firm EIN2020-12-31440160260
2019 : EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$0
Total income from all sources (including contributions)2019-12-31$638,105
Total income from all sources (including contributions)2019-12-31$638,105
Total loss/gain on sale of assets2019-12-31$0
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$269,282
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$268,052
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$268,052
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$457,640
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$457,640
Value of total assets at end of year2019-12-31$1,072,559
Value of total assets at end of year2019-12-31$1,072,559
Value of total assets at beginning of year2019-12-31$703,736
Value of total assets at beginning of year2019-12-31$703,736
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$1,230
Total interest from all sources2019-12-31$0
Total interest from all sources2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$45,677
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$45,677
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$45,677
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$45,677
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$500,000
If this is an individual account plan, was there a blackout period2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$15,273
Contributions received from participants2019-12-31$15,273
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$117,696
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$117,696
Administrative expenses (other) incurred2019-12-31$1,230
Administrative expenses (other) incurred2019-12-31$1,230
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$368,823
Value of net income/loss2019-12-31$368,823
Value of net assets at end of year (total assets less liabilities)2019-12-31$1,072,559
Value of net assets at end of year (total assets less liabilities)2019-12-31$1,072,559
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$703,736
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$703,736
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$1,047,690
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$1,047,690
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$660,335
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$660,335
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$24,869
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$24,869
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$43,401
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$43,401
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$43,401
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$43,401
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$268,052
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$268,052
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$134,788
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$134,788
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$324,671
Contributions received in cash from employer2019-12-31$324,671
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$0
Did the plan have assets held for investment2019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31BKD, LLP
Accountancy firm name2019-12-31BKD, LLP
Accountancy firm EIN2019-12-31440160260
Accountancy firm EIN2019-12-31440160260
2018 : EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$366,049
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$260,286
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$259,539
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$431,497
Value of total assets at end of year2018-12-31$703,736
Value of total assets at beginning of year2018-12-31$597,973
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$747
Total interest from all sources2018-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$37,656
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$37,656
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
If this is an individual account plan, was there a blackout period2018-12-31No
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$7,834
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$122,878
Administrative expenses (other) incurred2018-12-31$747
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$105,763
Value of net assets at end of year (total assets less liabilities)2018-12-31$703,736
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$597,973
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$660,335
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$553,377
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$43,401
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$44,596
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$44,596
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$257,365
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-103,104
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$300,785
Employer contributions (assets) at end of year2018-12-31$0
Employer contributions (assets) at beginning of year2018-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$2,174
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31BKD, LLP
Accountancy firm EIN2018-12-31440160260
2017 : EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$509,699
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$241,505
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$240,942
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$421,230
Value of total assets at end of year2017-12-31$597,973
Value of total assets at beginning of year2017-12-31$329,779
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$563
Total interest from all sources2017-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$26,950
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$26,950
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$121,398
Administrative expenses (other) incurred2017-12-31$563
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$268,194
Value of net assets at end of year (total assets less liabilities)2017-12-31$597,973
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$329,779
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$553,377
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$276,353
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$44,596
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$12,840
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$12,840
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$238,153
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$61,519
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$299,832
Employer contributions (assets) at end of year2017-12-31$0
Employer contributions (assets) at beginning of year2017-12-31$40,586
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$2,789
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31BKD, LLP
Accountancy firm EIN2017-12-31440160260
2016 : EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total income from all sources (including contributions)2016-12-31$421,049
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$225,446
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$225,046
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$404,458
Value of total assets at end of year2016-12-31$329,779
Value of total assets at beginning of year2016-12-31$134,176
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$400
Total interest from all sources2016-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$11,065
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$11,065
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$111,642
Administrative expenses (other) incurred2016-12-31$400
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$195,603
Value of net assets at end of year (total assets less liabilities)2016-12-31$329,779
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$134,176
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$276,353
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$129,944
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$12,840
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$4,232
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$4,232
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$225,046
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$5,526
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$292,816
Employer contributions (assets) at end of year2016-12-31$40,586
Employer contributions (assets) at beginning of year2016-12-31$0
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31BKD, LLP
Accountancy firm EIN2016-12-31440160260
2015 : EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$294,124
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$206,078
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$205,910
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$297,010
Value of total assets at end of year2015-12-31$134,176
Value of total assets at beginning of year2015-12-31$46,130
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$168
Total interest from all sources2015-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$6,911
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$6,911
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$500,000
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$104,242
Administrative expenses (other) incurred2015-12-31$168
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$88,046
Value of net assets at end of year (total assets less liabilities)2015-12-31$134,176
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$46,130
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$129,944
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$6,065
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$4,232
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$46
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$46
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$205,910
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-9,797
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$192,768
Employer contributions (assets) at end of year2015-12-31$0
Employer contributions (assets) at beginning of year2015-12-31$40,019
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31INSERO & CO. CPAS, LLP
Accountancy firm EIN2015-12-31475324570
2014 : EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY 2014 401k financial data
Total income from all sources2014-12-31$8,034
Expenses. Total of all expenses incurred2014-12-31$1,923
Benefits paid (including direct rollovers)2014-12-31$1,923
Total plan assets at end of year2014-12-31$6,111
Total plan assets at beginning of year2014-12-31$0
Value of fidelity bond covering the plan2014-12-31$500,000
Total contributions received or receivable from participants2014-12-31$498
Other income received2014-12-31$11
Net income (gross income less expenses)2014-12-31$6,111
Net plan assets at end of year (total assets less liabilities)2014-12-31$6,111
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$0
Total contributions received or receivable from employer(s)2014-12-31$7,525

Form 5500 Responses for EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY

2022: EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: EMERITI RETIREE HEALTH PLAN FOR ROSE-HULMAN INSTITUTE OF TECHNOLOGY 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01First time form 5500 has been submittedYes
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan funding arrangement – TrustYes
2014-07-01Plan benefit arrangement – InsuranceYes
2014-07-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number82036382039020
Policy instance 2
Insurance contract or identification number82036382039020
Number of Individuals Covered31
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
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 BenefitNo
Dental Insurance Welfare BenefitYes
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 $18,129
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 number820363
Policy instance 1
Insurance contract or identification number820363
Number of Individuals Covered119
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
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 BenefitNo
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 $277,368
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 number82036382039020
Policy instance 2
Insurance contract or identification number82036382039020
Number of Individuals Covered6
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
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 BenefitNo
Dental Insurance Welfare BenefitYes
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 $3,340
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 number820363
Policy instance 1
Insurance contract or identification number820363
Number of Individuals Covered109
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
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 BenefitNo
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 $232,038
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 number82036382039020
Policy instance 2
Insurance contract or identification number82036382039020
Number of Individuals Covered6
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
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 BenefitNo
Dental Insurance Welfare BenefitYes
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 $3,340
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 number820363
Policy instance 1
Insurance contract or identification number820363
Number of Individuals Covered102
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
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 BenefitNo
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 $286,320
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 number82036382039020
Policy instance 2
Insurance contract or identification number82036382039020
Number of Individuals Covered7
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
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 BenefitNo
Dental Insurance Welfare BenefitYes
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 $3,336
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 number820363
Policy instance 1
Insurance contract or identification number820363
Number of Individuals Covered101
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
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 BenefitNo
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 $247,422
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 number82036382039020
Policy instance 2
Insurance contract or identification number82036382039020
Number of Individuals Covered12
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
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 BenefitNo
Dental Insurance Welfare BenefitYes
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 $3,340
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 number820363
Policy instance 1
Insurance contract or identification number820363
Number of Individuals Covered80
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
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 BenefitNo
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 $191,963
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 number82036382039020
Policy instance 3
Insurance contract or identification number82036382039020
Number of Individuals Covered6
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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 BenefitNo
Dental Insurance Welfare BenefitYes
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 $3,142
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 number820363
Policy instance 2
Insurance contract or identification number820363
Number of Individuals Covered42
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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 BenefitNo
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 $61,528
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 number820363
Policy instance 1
Insurance contract or identification number820363
Number of Individuals Covered68
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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 BenefitNo
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 $72,207
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 numberAE351468
Policy instance 1
Insurance contract or identification numberAE351468
Number of Individuals Covered4
Insurance policy start date2014-07-01
Insurance policy end date2014-12-31
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 BenefitNo
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 $4,626
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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