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THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 401k Plan overview

Plan NameTHE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN
Plan identification number 515

THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN Benefits

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

401k Sponsoring company profile

THE UNIVERSITY OF CHICAGO MEDICAL CENTER has sponsored the creation of one or more 401k plans.

Company Name:THE UNIVERSITY OF CHICAGO MEDICAL CENTER
Employer identification number (EIN):363488183
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5152021-07-01
5152020-07-01
5152019-07-01
5152018-07-01
5152017-07-01
5152016-07-01BOB HANLEY
5152015-07-01BOB HANLEY
5152014-07-01BOB HANLEY
5152013-07-01BOB HANLEY
5152012-07-01BOB HANLEY
5152011-07-01TERRY SOLEM
5152010-07-01TERRY SOLEM
5152009-07-01JOSEPH PULICHENE
5152008-07-01LARRY A. CALLAHAN
5152008-07-01LARRY A. CALLAHAN
5152007-07-01LARRY A. CALLAHAN

Plan Statistics for THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN

401k plan membership statisitcs for THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN

Measure Date Value
2021: THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-07-0110,939
Total number of active participants reported on line 7a of the Form 55002021-07-019,687
Number of retired or separated participants receiving benefits2021-07-011,845
Total of all active and inactive participants2021-07-0111,532
2020: THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-07-0110,873
Total number of active participants reported on line 7a of the Form 55002020-07-018,969
Number of retired or separated participants receiving benefits2020-07-011,970
Total of all active and inactive participants2020-07-0110,939
2019: THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-018,630
Total number of active participants reported on line 7a of the Form 55002019-07-0110,749
Number of retired or separated participants receiving benefits2019-07-01124
Total of all active and inactive participants2019-07-0110,873
2018: THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-07-016,620
Total number of active participants reported on line 7a of the Form 55002018-07-018,560
Number of retired or separated participants receiving benefits2018-07-0170
Number of other retired or separated participants entitled to future benefits2018-07-010
Total of all active and inactive participants2018-07-018,630
2017: THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-07-016,365
Total number of active participants reported on line 7a of the Form 55002017-07-016,520
Number of retired or separated participants receiving benefits2017-07-01100
Number of other retired or separated participants entitled to future benefits2017-07-010
Total of all active and inactive participants2017-07-016,620
2016: THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-016,098
Total number of active participants reported on line 7a of the Form 55002016-07-016,263
Number of retired or separated participants receiving benefits2016-07-01102
Number of other retired or separated participants entitled to future benefits2016-07-010
Total of all active and inactive participants2016-07-016,365
2015: THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-015,816
Total number of active participants reported on line 7a of the Form 55002015-07-016,033
Number of retired or separated participants receiving benefits2015-07-010
Number of other retired or separated participants entitled to future benefits2015-07-0165
Total of all active and inactive participants2015-07-016,098
2014: THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-015,829
Total number of active participants reported on line 7a of the Form 55002014-07-015,773
Number of retired or separated participants receiving benefits2014-07-0143
Number of other retired or separated participants entitled to future benefits2014-07-010
Total of all active and inactive participants2014-07-015,816
2013: THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-015,447
Total number of active participants reported on line 7a of the Form 55002013-07-015,752
Number of retired or separated participants receiving benefits2013-07-0177
Number of other retired or separated participants entitled to future benefits2013-07-010
Total of all active and inactive participants2013-07-015,829
2012: THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-07-015,436
Total number of active participants reported on line 7a of the Form 55002012-07-015,370
Number of retired or separated participants receiving benefits2012-07-0177
Number of other retired or separated participants entitled to future benefits2012-07-010
Total of all active and inactive participants2012-07-015,447
2011: THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-07-014,974
Total number of active participants reported on line 7a of the Form 55002011-07-015,007
Number of retired or separated participants receiving benefits2011-07-0171
Number of other retired or separated participants entitled to future benefits2011-07-010
Total of all active and inactive participants2011-07-015,078
2010: THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year2010-07-015,167
Total number of active participants reported on line 7a of the Form 55002010-07-014,885
Number of retired or separated participants receiving benefits2010-07-0189
Number of other retired or separated participants entitled to future benefits2010-07-010
Total of all active and inactive participants2010-07-014,974
2009: THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-07-015,116
Total number of active participants reported on line 7a of the Form 55002009-07-015,038
Number of retired or separated participants receiving benefits2009-07-01129
Number of other retired or separated participants entitled to future benefits2009-07-010
Total of all active and inactive participants2009-07-015,167
2008: THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2008 401k membership
Total participants, beginning-of-year2008-07-015,469
Total number of active participants reported on line 7a of the Form 55002008-07-014,998
Number of retired or separated participants receiving benefits2008-07-01118
Number of other retired or separated participants entitled to future benefits2008-07-010
Total of all active and inactive participants2008-07-015,116
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2008-07-010
Total participants2008-07-015,116
Number of participants with account balances2008-07-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2008-07-010
Number of employers contributing to the scheme2008-07-010
2007: THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2007 401k membership
Total participants, beginning-of-year2007-07-015,639
Total number of active participants reported on line 7a of the Form 55002007-07-015,352
Number of retired or separated participants receiving benefits2007-07-01117
Number of other retired or separated participants entitled to future benefits2007-07-010
Total of all active and inactive participants2007-07-015,469
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2007-07-010
Total participants2007-07-015,469
Number of participants with account balances2007-07-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2007-07-010
Number of employers contributing to the scheme2007-07-010

Financial Data on THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN

Measure Date Value
2019 : THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2019 401k financial data
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-06-30No
Was this plan covered by a fidelity bond2019-06-30No
If this is an individual account plan, was there a blackout period2019-06-30No
Were there any nonexempt tranactions with any party-in-interest2019-06-30No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-06-30No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2019-06-30No
Were any leases to which the plan was party in default or uncollectible2019-06-30No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-06-30No
Was there a failure to transmit to the plan any participant contributions2019-06-30No
Has the plan failed to provide any benefit when due under the plan2019-06-30No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-06-30No
Did the plan have assets held for investment2019-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-06-30No
2015 : THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-06-30$7,115,214
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-06-30$2,996,475
Total income from all sources (including contributions)2015-06-30$73,606,627
Total loss/gain on sale of assets2015-06-30$0
Total of all expenses incurred2015-06-30$77,581,059
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-06-30$75,287,196
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-06-30$73,606,627
Value of total assets at end of year2015-06-30$455,695
Value of total assets at beginning of year2015-06-30$311,388
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-06-30$2,293,863
Total interest from all sources2015-06-30$0
Total dividends received (eg from common stock, registered investment company shares)2015-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-06-30No
Administrative expenses professional fees incurred2015-06-30$15,150
Was this plan covered by a fidelity bond2015-06-30Yes
Value of fidelity bond cover2015-06-30$500,000
Were there any nonexempt tranactions with any party-in-interest2015-06-30No
Contributions received from participants2015-06-30$16,903,758
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-06-30$455,695
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-06-30$311,388
Administrative expenses (other) incurred2015-06-30$191,465
Liabilities. Value of operating payables at end of year2015-06-30$111,453
Liabilities. Value of operating payables at beginning of year2015-06-30$76,622
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-06-30No
Value of net income/loss2015-06-30$-3,974,432
Value of net assets at end of year (total assets less liabilities)2015-06-30$-6,659,519
Value of net assets at beginning of year (total assets less liabilities)2015-06-30$-2,685,087
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2015-06-30No
Were any leases to which the plan was party in default or uncollectible2015-06-30No
Expenses. Payments to insurance carriers foe the provision of benefits2015-06-30$38,614,226
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-06-30No
Was there a failure to transmit to the plan any participant contributions2015-06-30No
Has the plan failed to provide any benefit when due under the plan2015-06-30No
Contributions received in cash from employer2015-06-30$56,702,869
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-06-30$36,672,970
Contract administrator fees2015-06-30$2,087,248
Liabilities. Value of benefit claims payable at end of year2015-06-30$7,003,761
Liabilities. Value of benefit claims payable at beginning of year2015-06-30$2,919,853
Did the plan have assets held for investment2015-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-06-30No
Opinion of an independent qualified public accountant for this plan2015-06-30Unqualified
Accountancy firm name2015-06-30WASHINGTON, PITTMAN & MCKEEVER, LLC
Accountancy firm EIN2015-06-30364189747
2014 : THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-06-30$2,996,475
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-06-30$3,457,744
Total income from all sources (including contributions)2014-06-30$66,622,334
Total loss/gain on sale of assets2014-06-30$0
Total of all expenses incurred2014-06-30$66,128,562
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-06-30$64,674,801
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-06-30$66,622,334
Value of total assets at end of year2014-06-30$311,388
Value of total assets at beginning of year2014-06-30$278,885
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-06-30$1,453,761
Total interest from all sources2014-06-30$0
Total dividends received (eg from common stock, registered investment company shares)2014-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-06-30No
Administrative expenses professional fees incurred2014-06-30$15,150
Was this plan covered by a fidelity bond2014-06-30Yes
Value of fidelity bond cover2014-06-30$500,000
Were there any nonexempt tranactions with any party-in-interest2014-06-30No
Contributions received from participants2014-06-30$14,795,471
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-06-30$311,388
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-06-30$278,885
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-06-30$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-06-30$1,807,520
Administrative expenses (other) incurred2014-06-30$163,059
Liabilities. Value of operating payables at end of year2014-06-30$76,622
Liabilities. Value of operating payables at beginning of year2014-06-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-06-30No
Value of net income/loss2014-06-30$493,772
Value of net assets at end of year (total assets less liabilities)2014-06-30$-2,685,087
Value of net assets at beginning of year (total assets less liabilities)2014-06-30$-3,178,859
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2014-06-30No
Were any leases to which the plan was party in default or uncollectible2014-06-30No
Expenses. Payments to insurance carriers foe the provision of benefits2014-06-30$43,310,420
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-06-30No
Was there a failure to transmit to the plan any participant contributions2014-06-30No
Has the plan failed to provide any benefit when due under the plan2014-06-30No
Contributions received in cash from employer2014-06-30$51,826,863
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-06-30$21,364,381
Contract administrator fees2014-06-30$1,275,552
Liabilities. Value of benefit claims payable at end of year2014-06-30$2,919,853
Liabilities. Value of benefit claims payable at beginning of year2014-06-30$1,650,224
Did the plan have assets held for investment2014-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-06-30No
Opinion of an independent qualified public accountant for this plan2014-06-30Unqualified
Accountancy firm name2014-06-30WASHINGTON, PITTMAN & MCKEEVER, LLC
Accountancy firm EIN2014-06-30364189747
2013 : THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-06-30$3,457,744
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-06-30$3,247,280
Total income from all sources (including contributions)2013-06-30$70,103,330
Total loss/gain on sale of assets2013-06-30$0
Total of all expenses incurred2013-06-30$70,472,242
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-06-30$69,183,738
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-06-30$70,103,330
Value of total assets at end of year2013-06-30$278,885
Value of total assets at beginning of year2013-06-30$437,333
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-06-30$1,288,504
Total interest from all sources2013-06-30$0
Total dividends received (eg from common stock, registered investment company shares)2013-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-06-30No
Administrative expenses professional fees incurred2013-06-30$15,150
Was this plan covered by a fidelity bond2013-06-30Yes
Value of fidelity bond cover2013-06-30$500,000
Were there any nonexempt tranactions with any party-in-interest2013-06-30No
Contributions received from participants2013-06-30$14,119,005
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-06-30$278,885
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-06-30$437,333
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-06-30$1,807,520
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-06-30$1,836,454
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-06-30No
Value of net income/loss2013-06-30$-368,912
Value of net assets at end of year (total assets less liabilities)2013-06-30$-3,178,859
Value of net assets at beginning of year (total assets less liabilities)2013-06-30$-2,809,947
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2013-06-30No
Were any leases to which the plan was party in default or uncollectible2013-06-30No
Expenses. Payments to insurance carriers foe the provision of benefits2013-06-30$40,220,174
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-06-30No
Was there a failure to transmit to the plan any participant contributions2013-06-30No
Has the plan failed to provide any benefit when due under the plan2013-06-30No
Contributions received in cash from employer2013-06-30$55,984,325
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-06-30$28,963,564
Contract administrator fees2013-06-30$1,273,354
Liabilities. Value of benefit claims payable at end of year2013-06-30$1,650,224
Liabilities. Value of benefit claims payable at beginning of year2013-06-30$1,410,826
Did the plan have assets held for investment2013-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-06-30No
Opinion of an independent qualified public accountant for this plan2013-06-30Unqualified
Accountancy firm name2013-06-30WASHINGTON, PITTMAN & MCKEEVER, LLC
Accountancy firm EIN2013-06-30364189747
2012 : THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-06-30$3,247,280
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-06-30$1,222,037
Total income from all sources (including contributions)2012-06-30$58,180,128
Total loss/gain on sale of assets2012-06-30$0
Total of all expenses incurred2012-06-30$62,403,399
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-06-30$61,230,209
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-06-30$58,180,128
Value of total assets at end of year2012-06-30$437,333
Value of total assets at beginning of year2012-06-30$2,635,361
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-06-30$1,173,190
Total interest from all sources2012-06-30$0
Total dividends received (eg from common stock, registered investment company shares)2012-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-06-30No
Administrative expenses professional fees incurred2012-06-30$16,100
Was this plan covered by a fidelity bond2012-06-30Yes
Value of fidelity bond cover2012-06-30$500,000
Were there any nonexempt tranactions with any party-in-interest2012-06-30No
Contributions received from participants2012-06-30$12,615,563
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-06-30$437,333
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-06-30$2,635,361
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-06-30$1,836,454
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-06-30$59,900
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-06-30No
Value of net income/loss2012-06-30$-4,223,271
Value of net assets at end of year (total assets less liabilities)2012-06-30$-2,809,947
Value of net assets at beginning of year (total assets less liabilities)2012-06-30$1,413,324
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2012-06-30No
Were any leases to which the plan was party in default or uncollectible2012-06-30No
Expenses. Payments to insurance carriers foe the provision of benefits2012-06-30$38,581,808
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-06-30No
Was there a failure to transmit to the plan any participant contributions2012-06-30No
Has the plan failed to provide any benefit when due under the plan2012-06-30No
Contributions received in cash from employer2012-06-30$45,564,565
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-06-30$22,648,401
Contract administrator fees2012-06-30$1,157,090
Liabilities. Value of benefit claims payable at end of year2012-06-30$1,410,826
Liabilities. Value of benefit claims payable at beginning of year2012-06-30$1,162,137
Did the plan have assets held for investment2012-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-06-30No
Opinion of an independent qualified public accountant for this plan2012-06-30Unqualified
Accountancy firm name2012-06-30WASHINGTON, PITTMAN & MCKEEVER, LLC
Accountancy firm EIN2012-06-30364189747
2011 : THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-06-30$1,222,037
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-06-30$1,495,221
Total income from all sources (including contributions)2011-06-30$58,079,666
Total loss/gain on sale of assets2011-06-30$0
Total of all expenses incurred2011-06-30$56,040,626
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-06-30$54,801,311
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-06-30$58,079,666
Value of total assets at end of year2011-06-30$2,635,361
Value of total assets at beginning of year2011-06-30$869,505
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-06-30$1,239,315
Total interest from all sources2011-06-30$0
Total dividends received (eg from common stock, registered investment company shares)2011-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-06-30No
Was this plan covered by a fidelity bond2011-06-30Yes
Value of fidelity bond cover2011-06-30$500,000
Were there any nonexempt tranactions with any party-in-interest2011-06-30No
Contributions received from participants2011-06-30$11,701,337
Income. Received or receivable in cash from other sources (including rollovers)2011-06-30$97,060
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-06-30$2,635,361
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-06-30$869,505
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-06-30$59,900
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-06-30$75,534
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-06-30No
Value of net income/loss2011-06-30$2,039,040
Value of net assets at end of year (total assets less liabilities)2011-06-30$1,413,324
Value of net assets at beginning of year (total assets less liabilities)2011-06-30$-625,716
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2011-06-30No
Were any leases to which the plan was party in default or uncollectible2011-06-30No
Expenses. Payments to insurance carriers foe the provision of benefits2011-06-30$34,064,855
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-06-30No
Was there a failure to transmit to the plan any participant contributions2011-06-30No
Has the plan failed to provide any benefit when due under the plan2011-06-30No
Contributions received in cash from employer2011-06-30$46,281,269
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-06-30$20,736,456
Contract administrator fees2011-06-30$1,239,315
Liabilities. Value of benefit claims payable at end of year2011-06-30$1,162,137
Liabilities. Value of benefit claims payable at beginning of year2011-06-30$1,419,687
Did the plan have assets held for investment2011-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-06-30No
Opinion of an independent qualified public accountant for this plan2011-06-30Unqualified
Accountancy firm name2011-06-30WASHINGTON, PITTMAN & MCKEEVER, LLC
Accountancy firm EIN2011-06-30364189747

Form 5500 Responses for THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN

2021: THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan funding arrangement – General assets of the sponsorYes
2021-07-01Plan benefit arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – General assets of the sponsorYes
2020: THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan funding arrangement – General assets of the sponsorYes
2020-07-01Plan benefit arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – General assets of the sponsorYes
2019: THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan funding arrangement – General assets of the sponsorYes
2019-07-01Plan benefit arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – General assets of the sponsorYes
2018: THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan funding arrangement – General assets of the sponsorYes
2018-07-01Plan benefit arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – General assets of the sponsorYes
2017: THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Submission has been amendedNo
2017-07-01This submission is the final filingNo
2017-07-01This return/report is a short plan year return/report (less than 12 months)No
2017-07-01Plan is a collectively bargained planNo
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan funding arrangement – General assets of the sponsorYes
2017-07-01Plan benefit arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – General assets of the sponsorYes
2016: THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Submission has been amendedNo
2016-07-01This submission is the final filingNo
2016-07-01This return/report is a short plan year return/report (less than 12 months)No
2016-07-01Plan is a collectively bargained planNo
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan funding arrangement – General assets of the sponsorYes
2016-07-01Plan benefit arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – General assets of the sponsorYes
2015: THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Submission has been amendedNo
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)No
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan funding arrangement – General assets of the sponsorYes
2015-07-01Plan benefit arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – General assets of the sponsorYes
2014: THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
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)No
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
2013: THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan funding arrangement – TrustYes
2013-07-01Plan benefit arrangement – InsuranceYes
2013-07-01Plan benefit arrangement - TrustYes
2012: THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan funding arrangement – TrustYes
2012-07-01Plan benefit arrangement – InsuranceYes
2012-07-01Plan benefit arrangement - TrustYes
2011: THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan funding arrangement – TrustYes
2011-07-01Plan benefit arrangement – InsuranceYes
2011-07-01Plan benefit arrangement - TrustYes
2010: THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2010 form 5500 responses
2010-07-01Type of plan entitySingle employer plan
2010-07-01Submission has been amendedNo
2010-07-01This submission is the final filingNo
2010-07-01This return/report is a short plan year return/report (less than 12 months)No
2010-07-01Plan is a collectively bargained planNo
2010-07-01Plan funding arrangement – InsuranceYes
2010-07-01Plan funding arrangement – TrustYes
2010-07-01Plan benefit arrangement – InsuranceYes
2010-07-01Plan benefit arrangement - TrustYes
2009: THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan funding arrangement – TrustYes
2009-07-01Plan benefit arrangement – InsuranceYes
2009-07-01Plan benefit arrangement - TrustYes
2008: THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2008 form 5500 responses
2008-07-01Type of plan entitySingle employer plan
2008-07-01Submission has been amendedYes
2008-07-01This submission is the final filingNo
2008-07-01This return/report is a short plan year return/report (less than 12 months)No
2008-07-01Plan is a collectively bargained planNo
2008-07-01Plan funding arrangement – InsuranceYes
2008-07-01Plan funding arrangement – TrustYes
2008-07-01Plan benefit arrangement – InsuranceYes
2008-07-01Plan benefit arrangement - TrustYes
2007: THE UNIVERSITY OF CHICAGO MEDICAL CENTER EMPLOYEE HEALTH BENEFIT PLAN 2007 form 5500 responses
2007-07-01Type of plan entitySingle employer plan
2007-07-01Submission has been amendedYes
2007-07-01This submission is the final filingNo
2007-07-01This return/report is a short plan year return/report (less than 12 months)No
2007-07-01Plan is a collectively bargained planNo
2007-07-01Plan funding arrangement – InsuranceYes
2007-07-01Plan funding arrangement – TrustYes
2007-07-01Plan benefit arrangement – InsuranceYes
2007-07-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL36060
Policy instance 6
Insurance contract or identification numberHCL36060
Number of Individuals Covered928
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $64,292
Total amount of fees paid to insurance companyUSD $12,891
Welfare Benefit Premiums Paid to CarrierUSD $803,647
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $64,292
Amount paid for insurance broker fees0
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL35896
Policy instance 5
Insurance contract or identification numberHCL35896
Number of Individuals Covered5843
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $148,903
Total amount of fees paid to insurance companyUSD $29,824
Welfare Benefit Premiums Paid to CarrierUSD $1,861,287
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $148,903
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerADMINISTRATION
CVS PHARMACY, INC. (National Association of Insurance Commissioners NAIC id number: 44611 )
Policy contract numberA2154
Policy instance 4
Insurance contract or identification numberA2154
Number of Individuals Covered1800
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $42,457
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees42457
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number256660
Policy instance 3
Insurance contract or identification number256660
Number of Individuals Covered11645
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $10,524
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees10524
Insurance broker organization code?3
UNIVERSITY OF CHICAGO HEALTH CARE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number7
Policy instance 2
Insurance contract or identification number7
Number of Individuals Covered3762
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,896,292
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CVS PHARMACY, INC. (National Association of Insurance Commissioners NAIC id number: 44611 )
Policy contract numberA6791
Policy instance 1
Insurance contract or identification numberA6791
Number of Individuals Covered10996
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $254,963
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNIVERSITY OF CHICAGO HEALTH CARE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number7
Policy instance 2
Insurance contract or identification number7
Number of Individuals Covered4699
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,031,541
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number256660
Policy instance 3
Insurance contract or identification number256660
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $6,649
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,649
Amount paid for insurance broker fees0
Insurance broker organization code?3
CVS PHARMACY, INC. (National Association of Insurance Commissioners NAIC id number: 44611 )
Policy contract numberA2154
Policy instance 4
Insurance contract or identification numberA2154
Number of Individuals Covered1923
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL35896
Policy instance 5
Insurance contract or identification numberHCL35896
Number of Individuals Covered5083
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $120,555
Total amount of fees paid to insurance companyUSD $26,341
Welfare Benefit Premiums Paid to CarrierUSD $1,506,938
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $120,555
Amount paid for insurance broker fees17413
Insurance broker organization code?3
Additional information about fees paid to insurance brokerADMINISTRATION
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract numberHCL36060
Policy instance 6
Insurance contract or identification numberHCL36060
Number of Individuals Covered1003
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $65,900
Total amount of fees paid to insurance companyUSD $14,399
Welfare Benefit Premiums Paid to CarrierUSD $823,721
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $65,900
Amount paid for insurance broker fees8650
Additional information about fees paid to insurance brokerADMINISTRATION
Insurance broker organization code?3
CVS PHARMACY, INC. (National Association of Insurance Commissioners NAIC id number: 44611 )
Policy contract numberA6791
Policy instance 1
Insurance contract or identification numberA6791
Number of Individuals Covered10164
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CVS PHARMACY, INC. (National Association of Insurance Commissioners NAIC id number: 44611 )
Policy contract numberA2154
Policy instance 5
Insurance contract or identification numberA2154
Number of Individuals Covered2131
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number256660
Policy instance 4
Insurance contract or identification number256660
Number of Individuals Covered9977
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BCS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 38245 )
Policy contract numberESL-30369
Policy instance 3
Insurance contract or identification numberESL-30369
Number of Individuals Covered5813
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $177,969
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $2,224,623
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $177,969
Insurance broker organization code?3
UNIVERSITY OF CHICAGO HEALTH CARE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number7
Policy instance 2
Insurance contract or identification number7
Number of Individuals Covered5033
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,054,022
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CVS PHARMACY, INC. (National Association of Insurance Commissioners NAIC id number: 44611 )
Policy contract numberA6791
Policy instance 1
Insurance contract or identification numberA6791
Number of Individuals Covered9242
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CVS PHARMACY, INC. (National Association of Insurance Commissioners NAIC id number: 44611 )
Policy contract numberA6791
Policy instance 1
Insurance contract or identification numberA6791
Number of Individuals Covered7180
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNIVERSITY OF CHICAGO HEALTH CARE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number7
Policy instance 2
Insurance contract or identification number7
Number of Individuals Covered5309
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $38,266,557
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BCS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 38245 )
Policy contract numberESL-30369
Policy instance 3
Insurance contract or identification numberESL-30369
Number of Individuals Covered3856
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $81,734
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $1,021,675
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $81,734
Amount paid for insurance broker fees0
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number256660
Policy instance 4
Insurance contract or identification number256660
Number of Individuals Covered9617
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number256660
Policy instance 4
Insurance contract or identification number256660
Number of Individuals Covered8475
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BCS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 38245 )
Policy contract numberEXL-30300
Policy instance 3
Insurance contract or identification numberEXL-30300
Number of Individuals Covered3609
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $81,842
Total amount of fees paid to insurance companyUSD $0
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 $1,023,028
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNIVERSITY OF CHICAGO HEALTH CARE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number7
Policy instance 2
Insurance contract or identification number7
Number of Individuals Covered5265
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
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 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 $38,174,812
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CVS PHARMACY, INC. (National Association of Insurance Commissioners NAIC id number: 44611 )
Policy contract numberA6791
Policy instance 1
Insurance contract or identification numberA6791
Number of Individuals Covered7180
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
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
Other welfare benefits providedPRESCRIPTION SERVICES
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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