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BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN 401k Plan overview

Plan NameBRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN
Plan identification number 519

BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN Benefits

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

401k Sponsoring company profile

BRISTOL-MYERS SQUIBB COMPANY SENIOR VP, TOTAL REWARDS has sponsored the creation of one or more 401k plans.

Company Name:BRISTOL-MYERS SQUIBB COMPANY SENIOR VP, TOTAL REWARDS
Employer identification number (EIN):220790350
NAIC Classification:325410

Additional information about BRISTOL-MYERS SQUIBB COMPANY SENIOR VP, TOTAL REWARDS

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 0326501

More information about BRISTOL-MYERS SQUIBB COMPANY SENIOR VP, TOTAL REWARDS

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5192023-01-01
5192022-01-01
5192021-01-01
5192020-01-01
5192019-01-01
5192018-01-01LISA GOLDEY LISA GOLDEY2019-07-17
5192017-01-01LISA GOLDEY LISA GOLDEY2018-07-24
5192016-01-01LISA GOLDEY LISA GOLDEY2017-07-14
5192015-01-01LISA GOLDEY LISA GOLDEY2016-07-20
5192014-01-01LISA GOLDEY LISA GOLDEY2015-10-30
5192014-01-01LISA GOLDEY LISA GOLDEY2015-10-08
5192013-01-01LISA GOLDEY LISA GOLDEY2014-09-22
5192012-01-01SUSAN KUNREUTHER SUSAN KUNREUTHER2013-06-18
5192011-01-01SUSAN KUNREUTHER SUSAN KUNREUTHER2012-07-27
5192010-01-01RICHARD LODATO RICHARD LODATO2011-05-04
5192009-01-01RICHARD LODATO RICHARD LODATO2010-09-20

Plan Statistics for BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN

401k plan membership statisitcs for BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN

Measure Date Value
2023: BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-011,291
Total number of active participants reported on line 7a of the Form 55002023-01-011,237
Number of retired or separated participants receiving benefits2023-01-0151
Total of all active and inactive participants2023-01-011,288
Total participants2023-01-011,288
2022: BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-011,244
Total number of active participants reported on line 7a of the Form 55002022-01-011,228
Number of retired or separated participants receiving benefits2022-01-0163
Total of all active and inactive participants2022-01-011,291
Total participants2022-01-011,291
2021: BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-011,178
Total number of active participants reported on line 7a of the Form 55002021-01-011,171
Number of retired or separated participants receiving benefits2021-01-0173
Total of all active and inactive participants2021-01-011,244
Total participants2021-01-011,244
2020: BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-011,119
Total number of active participants reported on line 7a of the Form 55002020-01-011,078
Number of retired or separated participants receiving benefits2020-01-01100
Total of all active and inactive participants2020-01-011,178
Total participants2020-01-011,178
2019: BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-011,129
Total number of active participants reported on line 7a of the Form 55002019-01-01959
Number of retired or separated participants receiving benefits2019-01-01160
Total of all active and inactive participants2019-01-011,119
Total participants2019-01-011,119
2018: BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-011,145
Total number of active participants reported on line 7a of the Form 55002018-01-01946
Number of other retired or separated participants entitled to future benefits2018-01-01183
Total of all active and inactive participants2018-01-011,129
Total participants2018-01-011,129
2017: BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-011,112
Total number of active participants reported on line 7a of the Form 55002017-01-01944
Number of retired or separated participants receiving benefits2017-01-01201
Total of all active and inactive participants2017-01-011,145
Total participants2017-01-011,145
2016: BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-011,008
Total number of active participants reported on line 7a of the Form 55002016-01-01899
Number of retired or separated participants receiving benefits2016-01-01213
Total of all active and inactive participants2016-01-011,112
Total participants2016-01-011,112
2015: BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-011,002
Total number of active participants reported on line 7a of the Form 55002015-01-01762
Number of retired or separated participants receiving benefits2015-01-01246
Total of all active and inactive participants2015-01-011,008
Total participants2015-01-011,008
2014: BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-011,294
Total number of active participants reported on line 7a of the Form 55002014-01-01721
Number of retired or separated participants receiving benefits2014-01-01281
Total of all active and inactive participants2014-01-011,002
Total participants2014-01-011,002
2013: BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-011,131
Total number of active participants reported on line 7a of the Form 55002013-01-01883
Number of retired or separated participants receiving benefits2013-01-01411
Total of all active and inactive participants2013-01-011,294
2012: BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-011,148
Total number of active participants reported on line 7a of the Form 55002012-01-01719
Number of retired or separated participants receiving benefits2012-01-01412
Total of all active and inactive participants2012-01-011,131
2011: BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-011,136
Total number of active participants reported on line 7a of the Form 55002011-01-01682
Number of retired or separated participants receiving benefits2011-01-01466
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-011,148
2010: BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-011,350
Total number of active participants reported on line 7a of the Form 55002010-01-01670
Number of retired or separated participants receiving benefits2010-01-01466
Total of all active and inactive participants2010-01-011,136
2009: BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-011,780
Total number of active participants reported on line 7a of the Form 55002009-01-01846
Number of retired or separated participants receiving benefits2009-01-01504
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-011,350
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010

Form 5500 Responses for BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN

2023: BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Submission has been amendedNo
2023-01-01This submission is the final filingNo
2023-01-01This return/report is a short plan year return/report (less than 12 months)No
2023-01-01Plan is a collectively bargained planNo
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – InsuranceYes
2022: BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedYes
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedYes
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: BRISTOL-MYERS SQUIBB PUERTO RICO, INC. MEDICAL PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 )
Policy contract numberSP0004064
Policy instance 1
Insurance contract or identification numberSP0004064
Number of Individuals Covered1320
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $45,067
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 BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedMAJOR MEDICAL MM-MAT-OOA ORGAN AND TISSUE TRANSPLANT V61-MA
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
TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 )
Policy contract numberSP0004064
Policy instance 1
Insurance contract or identification numberSP0004064
Number of Individuals Covered1322
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $45,099
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 BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedMAJOR MEDICAL MM-MAT-OOA ORGAN AND TISSUE TRANSPLANT V61-MA
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
TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 )
Policy contract numberSP0004064
Policy instance 1
Insurance contract or identification numberSP0004064
Number of Individuals Covered1317
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedINDEMNITY CONTRACT MM-MAT-OOA ORGAN AND TISSUE TRANSPLANT V61-MA
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
Commission paid to Insurance BrokerUSD $43,696

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