401k Plan data: MACK UAW RETIREE MEDICAL PLAN plan

MACK UAW RETIREE MEDICAL PLAN 401k Plan overview

Plan Name	MACK UAW RETIREE MEDICAL PLAN
Plan identification number	515

MACK UAW RETIREE MEDICAL PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance) Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

MACK TRUCKS, INC. has sponsored the creation of one or more 401k plans.

Company Name: MACK TRUCKS, INC.

Employer identification number (EIN): 221582040

NAIC Classification: 336100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MACK UAW RETIREE MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
515 2011-01-01 KAREN W HALL, CONTROLLER, HR KAREN W HALL, CONTROLLER, HR 2012-08-29
515 2010-01-01 KAREN W HALL, CONTROLLER, HR KAREN W HALL, CONTROLLER, HR 2011-11-03
515 2009-01-01 KAREN W HALL, CONTROLLER, HR KAREN W HALL, CONTROLLER, HR 2010-10-12

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
515	2011-01-01	KAREN W HALL, CONTROLLER, HR	KAREN W HALL, CONTROLLER, HR	2012-08-29
515	2010-01-01	KAREN W HALL, CONTROLLER, HR	KAREN W HALL, CONTROLLER, HR	2011-11-03
515	2009-01-01	KAREN W HALL, CONTROLLER, HR	KAREN W HALL, CONTROLLER, HR	2010-10-12

Plan Statistics for MACK UAW RETIREE MEDICAL PLAN

401k plan membership statisitcs for MACK UAW RETIREE MEDICAL PLAN

Measure Date Value
2011: MACK UAW RETIREE MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 7,202
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 0
Number of retired or separated participants receiving benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 0
2010: MACK UAW RETIREE MEDICAL PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 7,231
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 1,915
Number of retired or separated participants receiving benefits 2010-01-01 5,287
Total of all active and inactive participants 2010-01-01 7,202
2009: MACK UAW RETIREE MEDICAL PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 7,698
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 1,942
Number of retired or separated participants receiving benefits 2009-01-01 5,289
Total of all active and inactive participants 2009-01-01 7,231

Measure	Date	Value
2011: MACK UAW RETIREE MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	7,202
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	0
Number of retired or separated participants receiving benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	0
2010: MACK UAW RETIREE MEDICAL PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	7,231
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	1,915
Number of retired or separated participants receiving benefits	2010-01-01	5,287
Total of all active and inactive participants	2010-01-01	7,202
2009: MACK UAW RETIREE MEDICAL PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	7,698
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	1,942
Number of retired or separated participants receiving benefits	2009-01-01	5,289
Total of all active and inactive participants	2009-01-01	7,231

Form 5500 Responses for MACK UAW RETIREE MEDICAL PLAN

2011: MACK UAW RETIREE MEDICAL PLAN 2011 form 5500 responses
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	Yes
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	Yes
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: MACK UAW RETIREE MEDICAL PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	Yes
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	Yes
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: MACK UAW RETIREE MEDICAL PLAN 2009 form 5500 responses
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	Yes
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

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Company Name:	MACK TRUCKS, INC.
Employer identification number (EIN):	221582040
NAIC Classification:	336100