401k Plan data: EXECUTIVE RETIREE HEALTH CARE PLAN plan

EXECUTIVE RETIREE HEALTH CARE PLAN 401k Plan overview

Plan Name	EXECUTIVE RETIREE HEALTH CARE PLAN
Plan identification number	523

EXECUTIVE RETIREE HEALTH CARE 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

GOLDMAN SACHS & CO. LLC has sponsored the creation of one or more 401k plans.

Company Name: GOLDMAN SACHS & CO. LLC

Employer identification number (EIN): 135108880

NAIC Classification: 523110
NAIC Description: Investment Banking and Securities Dealing

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EXECUTIVE RETIREE HEALTH CARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
523 2022-01-01 LAURA YOUNG 2023-10-12
523 2021-01-01 LAURA YOUNG 2022-10-06
523 2020-01-01 LAURA YOUNG 2021-10-13
523 2019-01-01 EDINA JUNG 2020-10-13
523 2018-01-01 EDINA JUNG 2019-10-10
523 2017-01-01
523 2016-01-01 MICHAEL RENDEL
523 2015-01-01
523 2014-01-01
523 2013-01-01
523 2012-01-01 MICHAEL RENDEL

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
523	2022-01-01	LAURA YOUNG	2023-10-12
523	2021-01-01	LAURA YOUNG	2022-10-06
523	2020-01-01	LAURA YOUNG	2021-10-13
523	2019-01-01	EDINA JUNG	2020-10-13
523	2018-01-01	EDINA JUNG	2019-10-10
523	2017-01-01
523	2016-01-01	MICHAEL RENDEL
523	2015-01-01
523	2014-01-01
523	2013-01-01
523	2012-01-01	MICHAEL RENDEL

Plan Statistics for EXECUTIVE RETIREE HEALTH CARE PLAN

401k plan membership statisitcs for EXECUTIVE RETIREE HEALTH CARE PLAN

Measure Date Value
2022: EXECUTIVE RETIREE HEALTH CARE PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 357
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 0
Number of retired or separated participants receiving benefits 2022-01-01 334
Total of all active and inactive participants 2022-01-01 334
Total participants 2022-01-01 0
2021: EXECUTIVE RETIREE HEALTH CARE PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 393
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 0
Number of retired or separated participants receiving benefits 2021-01-01 357
Total of all active and inactive participants 2021-01-01 357
Total participants 2021-01-01 0
2020: EXECUTIVE RETIREE HEALTH CARE PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 383
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 0
Number of retired or separated participants receiving benefits 2020-01-01 393
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 393
Total participants 2020-01-01 0
2019: EXECUTIVE RETIREE HEALTH CARE PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 367
Number of retired or separated participants receiving benefits 2019-01-01 383
Total of all active and inactive participants 2019-01-01 383
Total participants 2019-01-01 0
2018: EXECUTIVE RETIREE HEALTH CARE PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 359
Number of retired or separated participants receiving benefits 2018-01-01 367
Total of all active and inactive participants 2018-01-01 367
Total participants 2018-01-01 0
2017: EXECUTIVE RETIREE HEALTH CARE PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 356
Number of retired or separated participants receiving benefits 2017-01-01 359
Total of all active and inactive participants 2017-01-01 359
Total participants 2017-01-01 359
2016: EXECUTIVE RETIREE HEALTH CARE PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 353
Number of retired or separated participants receiving benefits 2016-01-01 356
Total of all active and inactive participants 2016-01-01 356
Total participants 2016-01-01 356
2015: EXECUTIVE RETIREE HEALTH CARE PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 352
Number of retired or separated participants receiving benefits 2015-01-01 353
Total of all active and inactive participants 2015-01-01 353
Total participants 2015-01-01 353
2014: EXECUTIVE RETIREE HEALTH CARE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 359
Number of retired or separated participants receiving benefits 2014-01-01 352
Total of all active and inactive participants 2014-01-01 352
Total participants 2014-01-01 352
2013: EXECUTIVE RETIREE HEALTH CARE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 322
Number of retired or separated participants receiving benefits 2013-01-01 359
Total of all active and inactive participants 2013-01-01 359
Total participants 2013-01-01 359
2012: EXECUTIVE RETIREE HEALTH CARE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 351
Number of retired or separated participants receiving benefits 2012-01-01 322
Total of all active and inactive participants 2012-01-01 322
Total participants 2012-01-01 322

Measure	Date	Value
2022: EXECUTIVE RETIREE HEALTH CARE PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	357
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	0
Number of retired or separated participants receiving benefits	2022-01-01	334
Total of all active and inactive participants	2022-01-01	334
Total participants	2022-01-01	0
2021: EXECUTIVE RETIREE HEALTH CARE PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	393
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	0
Number of retired or separated participants receiving benefits	2021-01-01	357
Total of all active and inactive participants	2021-01-01	357
Total participants	2021-01-01	0
2020: EXECUTIVE RETIREE HEALTH CARE PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	383
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	0
Number of retired or separated participants receiving benefits	2020-01-01	393
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	393
Total participants	2020-01-01	0
2019: EXECUTIVE RETIREE HEALTH CARE PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	367
Number of retired or separated participants receiving benefits	2019-01-01	383
Total of all active and inactive participants	2019-01-01	383
Total participants	2019-01-01	0
2018: EXECUTIVE RETIREE HEALTH CARE PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	359
Number of retired or separated participants receiving benefits	2018-01-01	367
Total of all active and inactive participants	2018-01-01	367
Total participants	2018-01-01	0
2017: EXECUTIVE RETIREE HEALTH CARE PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	356
Number of retired or separated participants receiving benefits	2017-01-01	359
Total of all active and inactive participants	2017-01-01	359
Total participants	2017-01-01	359
2016: EXECUTIVE RETIREE HEALTH CARE PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	353
Number of retired or separated participants receiving benefits	2016-01-01	356
Total of all active and inactive participants	2016-01-01	356
Total participants	2016-01-01	356
2015: EXECUTIVE RETIREE HEALTH CARE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	352
Number of retired or separated participants receiving benefits	2015-01-01	353
Total of all active and inactive participants	2015-01-01	353
Total participants	2015-01-01	353
2014: EXECUTIVE RETIREE HEALTH CARE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	359
Number of retired or separated participants receiving benefits	2014-01-01	352
Total of all active and inactive participants	2014-01-01	352
Total participants	2014-01-01	352
2013: EXECUTIVE RETIREE HEALTH CARE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	322
Number of retired or separated participants receiving benefits	2013-01-01	359
Total of all active and inactive participants	2013-01-01	359
Total participants	2013-01-01	359
2012: EXECUTIVE RETIREE HEALTH CARE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	351
Number of retired or separated participants receiving benefits	2012-01-01	322
Total of all active and inactive participants	2012-01-01	322
Total participants	2012-01-01	322

Form 5500 Responses for EXECUTIVE RETIREE HEALTH CARE PLAN

2022: EXECUTIVE RETIREE HEALTH CARE PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2021: EXECUTIVE RETIREE HEALTH CARE PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2020: EXECUTIVE RETIREE HEALTH CARE PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2019: EXECUTIVE RETIREE HEALTH CARE PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: EXECUTIVE RETIREE HEALTH CARE PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: EXECUTIVE RETIREE HEALTH CARE PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: EXECUTIVE RETIREE HEALTH CARE PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: EXECUTIVE RETIREE HEALTH CARE PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: EXECUTIVE RETIREE HEALTH CARE PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: EXECUTIVE RETIREE HEALTH CARE PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: EXECUTIVE RETIREE HEALTH CARE PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	First time form 5500 has been submitted	Yes
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3174776-RETIRED

Policy instance

Insurance contract or identification number	3174776-RETIRED
Number of Individuals Covered	1030
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $788,025
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 number

0877121-RETIRED

Policy instance

Insurance contract or identification number	0877121-RETIRED
Number of Individuals Covered	829
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $15,002,738
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA GLOBAL BENEFITS (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

299536-RETIRED

Policy instance

Insurance contract or identification number	299536-RETIRED
Number of Individuals Covered	207
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $688,695
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

890812-RETIRED

Policy instance

Insurance contract or identification number	890812-RETIRED
Number of Individuals Covered	65
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $500,014
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA GLOBAL BENEFITS (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

299536-RETIRED

Policy instance

Insurance contract or identification number	299536-RETIRED
Number of Individuals Covered	199
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $590,439
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 number

0877121-RETIRED

Policy instance

Insurance contract or identification number	0877121-RETIRED
Number of Individuals Covered	867
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $14,649,762
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

890812-RETIRED

Policy instance

Insurance contract or identification number	890812-RETIRED
Number of Individuals Covered	89
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $619,808
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3174776-RETIRED

Policy instance

Insurance contract or identification number	3174776-RETIRED
Number of Individuals Covered	1042
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $786,915
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA GLOBAL BENEFITS (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

299536-RETIRED

Policy instance

Insurance contract or identification number	299536-RETIRED
Number of Individuals Covered	172
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $310,256
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 number

0877121-RETIRED

Policy instance

Insurance contract or identification number	0877121-RETIRED
Number of Individuals Covered	926
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $15,122,772
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3174776-RETIRED

Policy instance

Insurance contract or identification number	3174776-RETIRED
Number of Individuals Covered	1023
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $711,238
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA LIFE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

890812

Policy instance

Insurance contract or identification number	890812
Number of Individuals Covered	86
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $539,456
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 number

890812

Policy instance

Insurance contract or identification number	890812
Number of Individuals Covered	81
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $493,054
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3174776-RETIRED

Policy instance

Insurance contract or identification number	3174776-RETIRED
Number of Individuals Covered	1014
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $744,941
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 number

0877121-RETIRED

Policy instance

Insurance contract or identification number	0877121-RETIRED
Number of Individuals Covered	927
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $16,338,345
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA GLOBAL BENEFITS (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

299536-RETIRED

Policy instance

Insurance contract or identification number	299536-RETIRED
Number of Individuals Covered	156
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $336,031
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 number

0877121-RETIRED

Policy instance

Insurance contract or identification number	0877121-RETIRED
Number of Individuals Covered	917
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $16,189,590
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 number

890812

Policy instance

Insurance contract or identification number	890812
Number of Individuals Covered	73
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $369,447
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3174776-RETIRED

Policy instance

Insurance contract or identification number	3174776-RETIRED
Number of Individuals Covered	956
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $643,152
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA GLOBAL BENEFITS (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

299536-RETIRED

Policy instance

Insurance contract or identification number	299536-RETIRED
Number of Individuals Covered	113
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $652,106
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3174776-RETIRED

Policy instance

Insurance contract or identification number	3174776-RETIRED
Number of Individuals Covered	943
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $684,862
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA GLOBAL BENEFITS (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

299536-RETIRED

Policy instance

Insurance contract or identification number	299536-RETIRED
Number of Individuals Covered	147
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $898,581
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 number

0877121-RETIRED

Policy instance

Insurance contract or identification number	0877121-RETIRED
Number of Individuals Covered	929
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $15,635,263
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3174776-1

Policy instance

Insurance contract or identification number	3174776-1
Number of Individuals Covered	887
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $634,181
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 number

0877121-RETIRED

Policy instance

Insurance contract or identification number	0877121-RETIRED
Number of Individuals Covered	935
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $14,754,609
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA GLOBAL BENEFITS (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

299536

Policy instance

Insurance contract or identification number	299536
Number of Individuals Covered	115
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $801,805
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA GLOBAL BENEFITS (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

299536

Policy instance

Insurance contract or identification number	299536
Number of Individuals Covered	126
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $699,051
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 number

0877121-RETIRED

Policy instance

Insurance contract or identification number	0877121-RETIRED
Number of Individuals Covered	889
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $14,362,508
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3174776-1

Policy instance

Insurance contract or identification number	3174776-1
Number of Individuals Covered	301
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $788,384
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3174776-1

Policy instance

Insurance contract or identification number	3174776-1
Number of Individuals Covered	305
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $733,285
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 number

877121

Policy instance

Insurance contract or identification number	877121
Number of Individuals Covered	873
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $13,012,040
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA GLOBAL BENEFITS (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

299536

Policy instance

Insurance contract or identification number	299536
Number of Individuals Covered	113
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $711,714
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )

Policy contract number

3174776-1

Policy instance

Insurance contract or identification number	3174776-1
Number of Individuals Covered	402
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,152,708
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 number

877121

Policy instance

Insurance contract or identification number	877121
Number of Individuals Covered	916
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Health Insurance Welfare Benefit	Yes
Were dividends or retroactive rate refunds paid as a credit?	Yes
Welfare Benefit Premiums Paid to Carrier	USD $12,219,056
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA GLOBAL BENEFITS (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

299536-020-002

Policy instance

Insurance contract or identification number	299536-020-002
Number of Individuals Covered	258
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $971,191
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA GLOBAL BENEFITS (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

299536-020-001

Policy instance

Insurance contract or identification number	299536-020-001
Number of Individuals Covered	372
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,375,864
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	GOLDMAN SACHS & CO. LLC
Employer identification number (EIN):	135108880
NAIC Classification:	523110
NAIC Description:	Investment Banking and Securities Dealing