401k Plan data: PRAXAIR PUERTO RICO MEDICAL PLAN plan

PRAXAIR PUERTO RICO MEDICAL PLAN 401k Plan overview

Plan Name	PRAXAIR PUERTO RICO MEDICAL PLAN
Plan identification number	501

PRAXAIR PUERTO RICO MEDICAL PLAN Benefits

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

401k Sponsoring company profile

PRAXAIR PUERTO RICO BV has sponsored the creation of one or more 401k plans.

Company Name: PRAXAIR PUERTO RICO BV

Employer identification number (EIN): 660605193

NAIC Classification: 221210
NAIC Description: Natural Gas Distribution

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PRAXAIR PUERTO RICO MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2020-08-01
501 2019-08-01
501 2014-08-01 YVELISSE DE JESUS DIAZ YVELISSE DE JESUS DIAZ 2016-02-25
501 2013-08-01 MELISSA ECHEGARAY MELISSA ECHEGARAY 2015-02-27
501 2012-08-01 ADRIANA DEMELLO
501 2011-08-01 ADRIANA DEMELLO
501 2009-08-01 ADRIANA DEMELLO

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2020-08-01
501	2019-08-01
501	2014-08-01	YVELISSE DE JESUS DIAZ	YVELISSE DE JESUS DIAZ	2016-02-25
501	2013-08-01	MELISSA ECHEGARAY	MELISSA ECHEGARAY	2015-02-27
501	2012-08-01	ADRIANA DEMELLO
501	2011-08-01	ADRIANA DEMELLO
501	2009-08-01	ADRIANA DEMELLO

Plan Statistics for PRAXAIR PUERTO RICO MEDICAL PLAN

401k plan membership statisitcs for PRAXAIR PUERTO RICO MEDICAL PLAN

Measure Date Value
2020: PRAXAIR PUERTO RICO MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year 2020-08-01 90
Total number of active participants reported on line 7a of the Form 5500 2020-08-01 90
Number of retired or separated participants receiving benefits 2020-08-01 13
Number of other retired or separated participants entitled to future benefits 2020-08-01 0
Total of all active and inactive participants 2020-08-01 103
2019: PRAXAIR PUERTO RICO MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year 2019-08-01 88
Total number of active participants reported on line 7a of the Form 5500 2019-08-01 73
Number of retired or separated participants receiving benefits 2019-08-01 15
Number of other retired or separated participants entitled to future benefits 2019-08-01 0
Total of all active and inactive participants 2019-08-01 88
2014: PRAXAIR PUERTO RICO MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year 2014-08-01 97
Total number of active participants reported on line 7a of the Form 5500 2014-08-01 73
Number of retired or separated participants receiving benefits 2014-08-01 15
Number of other retired or separated participants entitled to future benefits 2014-08-01 0
Total of all active and inactive participants 2014-08-01 88
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-08-01 0
2013: PRAXAIR PUERTO RICO MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year 2013-08-01 108
Total number of active participants reported on line 7a of the Form 5500 2013-08-01 80
Number of retired or separated participants receiving benefits 2013-08-01 17
Number of other retired or separated participants entitled to future benefits 2013-08-01 0
Total of all active and inactive participants 2013-08-01 97
2012: PRAXAIR PUERTO RICO MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year 2012-08-01 99
Total number of active participants reported on line 7a of the Form 5500 2012-08-01 84
Number of retired or separated participants receiving benefits 2012-08-01 22
Number of other retired or separated participants entitled to future benefits 2012-08-01 2
Total of all active and inactive participants 2012-08-01 108
2011: PRAXAIR PUERTO RICO MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year 2011-08-01 100
Total number of active participants reported on line 7a of the Form 5500 2011-08-01 76
Number of retired or separated participants receiving benefits 2011-08-01 21
Number of other retired or separated participants entitled to future benefits 2011-08-01 2
Total of all active and inactive participants 2011-08-01 99
2009: PRAXAIR PUERTO RICO MEDICAL PLAN 2009 401k membership
Total participants, beginning-of-year 2009-08-01 119
Total number of active participants reported on line 7a of the Form 5500 2009-08-01 85
Number of retired or separated participants receiving benefits 2009-08-01 16
Number of other retired or separated participants entitled to future benefits 2009-08-01 1
Total of all active and inactive participants 2009-08-01 102

Measure	Date	Value
2020: PRAXAIR PUERTO RICO MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year	2020-08-01	90
Total number of active participants reported on line 7a of the Form 5500	2020-08-01	90
Number of retired or separated participants receiving benefits	2020-08-01	13
Number of other retired or separated participants entitled to future benefits	2020-08-01	0
Total of all active and inactive participants	2020-08-01	103
2019: PRAXAIR PUERTO RICO MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year	2019-08-01	88
Total number of active participants reported on line 7a of the Form 5500	2019-08-01	73
Number of retired or separated participants receiving benefits	2019-08-01	15
Number of other retired or separated participants entitled to future benefits	2019-08-01	0
Total of all active and inactive participants	2019-08-01	88
2014: PRAXAIR PUERTO RICO MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year	2014-08-01	97
Total number of active participants reported on line 7a of the Form 5500	2014-08-01	73
Number of retired or separated participants receiving benefits	2014-08-01	15
Number of other retired or separated participants entitled to future benefits	2014-08-01	0
Total of all active and inactive participants	2014-08-01	88
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-08-01	0
2013: PRAXAIR PUERTO RICO MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year	2013-08-01	108
Total number of active participants reported on line 7a of the Form 5500	2013-08-01	80
Number of retired or separated participants receiving benefits	2013-08-01	17
Number of other retired or separated participants entitled to future benefits	2013-08-01	0
Total of all active and inactive participants	2013-08-01	97
2012: PRAXAIR PUERTO RICO MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year	2012-08-01	99
Total number of active participants reported on line 7a of the Form 5500	2012-08-01	84
Number of retired or separated participants receiving benefits	2012-08-01	22
Number of other retired or separated participants entitled to future benefits	2012-08-01	2
Total of all active and inactive participants	2012-08-01	108
2011: PRAXAIR PUERTO RICO MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year	2011-08-01	100
Total number of active participants reported on line 7a of the Form 5500	2011-08-01	76
Number of retired or separated participants receiving benefits	2011-08-01	21
Number of other retired or separated participants entitled to future benefits	2011-08-01	2
Total of all active and inactive participants	2011-08-01	99
2009: PRAXAIR PUERTO RICO MEDICAL PLAN 2009 401k membership
Total participants, beginning-of-year	2009-08-01	119
Total number of active participants reported on line 7a of the Form 5500	2009-08-01	85
Number of retired or separated participants receiving benefits	2009-08-01	16
Number of other retired or separated participants entitled to future benefits	2009-08-01	1
Total of all active and inactive participants	2009-08-01	102

Form 5500 Responses for PRAXAIR PUERTO RICO MEDICAL PLAN

2020: PRAXAIR PUERTO RICO MEDICAL PLAN 2020 form 5500 responses
2020-08-01	Type of plan entity	Single employer plan
2020-08-01	Submission has been amended	No
2020-08-01	This submission is the final filing	No
2020-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-08-01	Plan is a collectively bargained plan	No
2020-08-01	Plan funding arrangement – Insurance	Yes
2020-08-01	Plan benefit arrangement – Insurance	Yes
2019: PRAXAIR PUERTO RICO MEDICAL PLAN 2019 form 5500 responses
2019-08-01	Type of plan entity	Single employer plan
2019-08-01	Submission has been amended	No
2019-08-01	This submission is the final filing	No
2019-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-08-01	Plan is a collectively bargained plan	No
2019-08-01	Plan funding arrangement – Insurance	Yes
2019-08-01	Plan benefit arrangement – Insurance	Yes
2014: PRAXAIR PUERTO RICO MEDICAL PLAN 2014 form 5500 responses
2014-08-01	Type of plan entity	Single employer plan
2014-08-01	Submission has been amended	No
2014-08-01	This submission is the final filing	No
2014-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-08-01	Plan is a collectively bargained plan	No
2014-08-01	Plan funding arrangement – Insurance	Yes
2014-08-01	Plan benefit arrangement – Insurance	Yes
2013: PRAXAIR PUERTO RICO MEDICAL PLAN 2013 form 5500 responses
2013-08-01	Type of plan entity	Single employer plan
2013-08-01	Submission has been amended	No
2013-08-01	This submission is the final filing	No
2013-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-08-01	Plan is a collectively bargained plan	No
2013-08-01	Plan funding arrangement – Insurance	Yes
2013-08-01	Plan benefit arrangement – Insurance	Yes
2012: PRAXAIR PUERTO RICO MEDICAL PLAN 2012 form 5500 responses
2012-08-01	Type of plan entity	Single employer plan
2012-08-01	Submission has been amended	No
2012-08-01	This submission is the final filing	No
2012-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-08-01	Plan is a collectively bargained plan	No
2012-08-01	Plan funding arrangement – Insurance	Yes
2012-08-01	Plan benefit arrangement – Insurance	Yes
2011: PRAXAIR PUERTO RICO MEDICAL PLAN 2011 form 5500 responses
2011-08-01	Type of plan entity	Single employer plan
2011-08-01	Submission has been amended	No
2011-08-01	This submission is the final filing	No
2011-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-08-01	Plan is a collectively bargained plan	No
2011-08-01	Plan funding arrangement – Insurance	Yes
2011-08-01	Plan benefit arrangement – Insurance	Yes
2009: PRAXAIR PUERTO RICO MEDICAL PLAN 2009 form 5500 responses
2009-08-01	Type of plan entity	Single employer plan
2009-08-01	Submission has been amended	No
2009-08-01	This submission is the final filing	No
2009-08-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-08-01	Plan is a collectively bargained plan	No
2009-08-01	Plan funding arrangement – Insurance	Yes
2009-08-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

MCS LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60030 )
Policy contract number	79-791527
Policy instance	1
MCS LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60030 )
Policy contract number	79-791527
Policy instance	1

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Company Name:	PRAXAIR PUERTO RICO BV
Employer identification number (EIN):	660605193
NAIC Classification:	221210
NAIC Description:	Natural Gas Distribution