401k Plan data: PHILIPS ELECTRONICS NORTH AMERICA CORP BUSINESS TRAVEL ACCIDENT PLAN plan

PHILIPS ELECTRONICS NORTH AMERICA CORP BUSINESS TRAVEL ACCIDENT PLAN 401k Plan overview

Plan Name	PHILIPS ELECTRONICS NORTH AMERICA CORP BUSINESS TRAVEL ACCIDENT PLAN
Plan identification number	541

PHILIPS ELECTRONICS NORTH AMERICA CORP BUSINESS TRAVEL ACCIDENT PLAN Benefits

401k Plan Type
Plan Features/Benefits

401k Sponsoring company profile

PHILIPS NORTH AMERICA LLC has sponsored the creation of one or more 401k plans.

Company Name: PHILIPS NORTH AMERICA LLC

Employer identification number (EIN): 133429115

NAIC Classification: 339900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PHILIPS ELECTRONICS NORTH AMERICA CORP BUSINESS TRAVEL ACCIDENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
541 2012-01-01 ELIZABETH A. GRELLA
541 2012-01-01 JULIE THIBODEAU
541 2011-01-01 ELIZABETH A. GRELLA
541 2009-01-01 ELIZABETH A GRELLA

Plan id#	Filing Submission Date	Name of Administrator
541	2012-01-01	ELIZABETH A. GRELLA
541	2012-01-01	JULIE THIBODEAU
541	2011-01-01	ELIZABETH A. GRELLA
541	2009-01-01	ELIZABETH A GRELLA

Plan Statistics for PHILIPS ELECTRONICS NORTH AMERICA CORP BUSINESS TRAVEL ACCIDENT PLAN

401k plan membership statisitcs for PHILIPS ELECTRONICS NORTH AMERICA CORP BUSINESS TRAVEL ACCIDENT PLAN

Measure Date Value
2012
Total participants, beginning-of-year 2012-01-01 23,869
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 23,309
Total of all active and inactive participants 2012-01-01 23,309
2011
Total participants, beginning-of-year 2011-01-01 23,253
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 23,869
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 23,869
2009
Total participants, beginning-of-year 2009-01-01 21,571
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 22,126
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 22,126

Measure	Date	Value
2012
Total participants, beginning-of-year	2012-01-01	23,869
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	23,309
Total of all active and inactive participants	2012-01-01	23,309
2011
Total participants, beginning-of-year	2011-01-01	23,253
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	23,869
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	23,869
2009
Total participants, beginning-of-year	2009-01-01	21,571
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	22,126
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	22,126

Form 5500 Responses

2012
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )

Policy contract number

GTP 9128688

Policy instance

Insurance contract or identification number	GTP 9128688
Number of Individuals Covered	23309
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $8,787
Total amount of fees paid to insurance company	USD $0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
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 Carrier	USD $58,582
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,787
Insurance broker organization code?	3
Insurance broker name	MERCER HEALTH AND BENEFITS

NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )

Policy contract number

GTP 9128688

Policy instance

Insurance contract or identification number	GTP 9128688
Number of Individuals Covered	23869
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $10,203
Total amount of fees paid to insurance company	USD $0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
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 Carrier	USD $68,022
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )

Policy contract number

GTP 9128688

Policy instance

Insurance contract or identification number	GTP 9128688
Number of Individuals Covered	23253
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $9,610
Total amount of fees paid to insurance company	USD $0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
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 Carrier	USD $64,068
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,610
Insurance broker organization code?	3
Insurance broker name	MERCER HEALTH AND BENEFITS

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Company Name:	PHILIPS NORTH AMERICA LLC
Employer identification number (EIN):	133429115
NAIC Classification:	339900