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NISOURCE POST-65 RETIREE MEDICAL PLAN 401k Plan overview

Plan NameNISOURCE POST-65 RETIREE MEDICAL PLAN
Plan identification number 538

NISOURCE POST-65 RETIREE MEDICAL PLAN Benefits

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

401k Sponsoring company profile

NISOURCE INC. has sponsored the creation of one or more 401k plans.

Company Name:NISOURCE INC.
Employer identification number (EIN):352108964
NAIC Classification:221210
NAIC Description:Natural Gas Distribution

Additional information about NISOURCE INC.

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 3003476

More information about NISOURCE INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NISOURCE POST-65 RETIREE MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5382022-01-01JILLIAN HANSEN2023-10-13
5382021-01-01JILLIAN HANSEN2022-10-14
5382020-01-01WENDY L. BOWLIN2021-10-15
5382019-01-01WENDY BOWLIN2020-10-14
5382018-01-01WENDY BOWLIN2019-10-14
5382017-01-01
5382016-01-01
5382016-01-01RICHARD L. BOND2017-10-10
5382015-01-01RICHARD L. BOND
5382014-01-01RICHARD L. BOND
5382013-01-01RICHARD BOND
5382012-01-01RICHARD L. BOND
5382011-01-01RICHARD BOND

Plan Statistics for NISOURCE POST-65 RETIREE MEDICAL PLAN

401k plan membership statisitcs for NISOURCE POST-65 RETIREE MEDICAL PLAN

Measure Date Value
2022: NISOURCE POST-65 RETIREE MEDICAL PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-013,851
Total number of active participants reported on line 7a of the Form 55002022-01-010
Number of retired or separated participants receiving benefits2022-01-013,863
Number of other retired or separated participants entitled to future benefits2022-01-01202
Total of all active and inactive participants2022-01-014,065
2021: NISOURCE POST-65 RETIREE MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-013,806
Total number of active participants reported on line 7a of the Form 55002021-01-010
Number of retired or separated participants receiving benefits2021-01-013,795
Number of other retired or separated participants entitled to future benefits2021-01-01207
Total of all active and inactive participants2021-01-014,002
2020: NISOURCE POST-65 RETIREE MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-013,760
Total number of active participants reported on line 7a of the Form 55002020-01-010
Number of retired or separated participants receiving benefits2020-01-013,744
Number of other retired or separated participants entitled to future benefits2020-01-01209
Total of all active and inactive participants2020-01-013,953
2019: NISOURCE POST-65 RETIREE MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-013,766
Total number of active participants reported on line 7a of the Form 55002019-01-010
Number of retired or separated participants receiving benefits2019-01-013,699
Number of other retired or separated participants entitled to future benefits2019-01-0170
Total of all active and inactive participants2019-01-013,769
2018: NISOURCE POST-65 RETIREE MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-013,754
Total number of active participants reported on line 7a of the Form 55002018-01-010
Number of retired or separated participants receiving benefits2018-01-013,716
Number of other retired or separated participants entitled to future benefits2018-01-0169
Total of all active and inactive participants2018-01-013,785
2017: NISOURCE POST-65 RETIREE MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-013,697
Total number of active participants reported on line 7a of the Form 55002017-01-010
Number of retired or separated participants receiving benefits2017-01-013,683
Number of other retired or separated participants entitled to future benefits2017-01-0115
Total of all active and inactive participants2017-01-013,698
2016: NISOURCE POST-65 RETIREE MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-013,704
Total number of active participants reported on line 7a of the Form 55002016-01-010
Number of retired or separated participants receiving benefits2016-01-013,638
Number of other retired or separated participants entitled to future benefits2016-01-018
Total of all active and inactive participants2016-01-013,646
2015: NISOURCE POST-65 RETIREE MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-014,511
Total number of active participants reported on line 7a of the Form 55002015-01-010
Number of retired or separated participants receiving benefits2015-01-013,648
Number of other retired or separated participants entitled to future benefits2015-01-017
Total of all active and inactive participants2015-01-013,655
2014: NISOURCE POST-65 RETIREE MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-015,570
Total number of active participants reported on line 7a of the Form 55002014-01-014
Number of retired or separated participants receiving benefits2014-01-015,620
Number of other retired or separated participants entitled to future benefits2014-01-013,075
Total of all active and inactive participants2014-01-018,699
2013: NISOURCE POST-65 RETIREE MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-014,499
Total number of active participants reported on line 7a of the Form 55002013-01-010
Number of retired or separated participants receiving benefits2013-01-014,499
Number of other retired or separated participants entitled to future benefits2013-01-014,625
Total of all active and inactive participants2013-01-019,124
2012: NISOURCE POST-65 RETIREE MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-014,409
Total number of active participants reported on line 7a of the Form 55002012-01-010
Number of retired or separated participants receiving benefits2012-01-014,472
Number of other retired or separated participants entitled to future benefits2012-01-014,489
Total of all active and inactive participants2012-01-018,961
2011: NISOURCE POST-65 RETIREE MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-014,365
Total number of active participants reported on line 7a of the Form 55002011-01-010
Number of retired or separated participants receiving benefits2011-01-014,386
Number of other retired or separated participants entitled to future benefits2011-01-014,178
Total of all active and inactive participants2011-01-018,564

Financial Data on NISOURCE POST-65 RETIREE MEDICAL PLAN

Measure Date Value
2022 : NISOURCE POST-65 RETIREE MEDICAL PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$14,753,084
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$4,374,326
Total income from all sources (including contributions)2022-12-31$-12,555,439
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$23,272,265
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$20,216,541
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$14,976,401
Value of total assets at end of year2022-12-31$128,059,552
Value of total assets at beginning of year2022-12-31$153,508,498
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$3,055,724
Total interest from all sources2022-12-31$-6,269
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$1,967,187
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$1,967,187
Administrative expenses professional fees incurred2022-12-31$229,722
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$50,000,000
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$2,086,574
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2022-12-31$3,315,158
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-12-31$1,879,863
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-12-31$479,779
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$11,696,771
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2022-12-31$1,082,631
Administrative expenses (other) incurred2022-12-31$21,666
Liabilities. Value of operating payables at end of year2022-12-31$1,256,313
Liabilities. Value of operating payables at beginning of year2022-12-31$1,791,695
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-35,827,704
Value of net assets at end of year (total assets less liabilities)2022-12-31$113,306,468
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$149,134,172
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$88,863,750
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$120,901,797
Value of interest in master investment trust accounts at end of year2022-12-31$3,210,810
Value of interest in master investment trust accounts at beginning of year2022-12-31$4,124,801
Value of interest in common/collective trusts at end of year2022-12-31$32,336,301
Value of interest in common/collective trusts at beginning of year2022-12-31$26,200,235
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-12-31$-6,269
Expenses. Payments to insurance carriers foe the provision of benefits2022-12-31$57,961
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-23,768,757
Net investment gain or loss from common/collective trusts2022-12-31$-4,776,953
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31Yes
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$12,889,827
Employer contributions (assets) at end of year2022-12-31$1,768,828
Employer contributions (assets) at beginning of year2022-12-31$1,801,886
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$16,843,422
Contract administrator fees2022-12-31$2,804,336
Liabilities. Value of benefit claims payable at end of year2022-12-31$1,800,000
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$1,500,000
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31MCCONNELL & JONES LLP
Accountancy firm EIN2022-12-31760488832
2021 : NISOURCE POST-65 RETIREE MEDICAL PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$4,374,326
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$3,983,078
Total income from all sources (including contributions)2021-12-31$28,817,076
Total loss/gain on sale of assets2021-12-31$3
Total of all expenses incurred2021-12-31$23,233,943
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$20,283,984
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$13,643,126
Value of total assets at end of year2021-12-31$153,508,498
Value of total assets at beginning of year2021-12-31$147,534,117
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$2,949,959
Total interest from all sources2021-12-31$-1
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$2,045,503
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2021-12-31$2,045,503
Administrative expenses professional fees incurred2021-12-31$223,287
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$50,000,000
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$2,307,219
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2021-12-31$5,334,814
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-12-31$479,779
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-12-31$443,549
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$1,082,631
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$1,234,586
Administrative expenses (other) incurred2021-12-31$20,232
Liabilities. Value of operating payables at end of year2021-12-31$1,791,695
Liabilities. Value of operating payables at beginning of year2021-12-31$1,148,492
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$5,583,133
Value of net assets at end of year (total assets less liabilities)2021-12-31$149,134,172
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$143,551,039
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$120,901,797
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$115,799,479
Value of interest in master investment trust accounts at end of year2021-12-31$4,124,801
Value of interest in master investment trust accounts at beginning of year2021-12-31$5,176,271
Value of interest in common/collective trusts at end of year2021-12-31$26,200,235
Value of interest in common/collective trusts at beginning of year2021-12-31$26,114,818
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-12-31$-1
Expenses. Payments to insurance carriers foe the provision of benefits2021-12-31$67,809
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$9,041,553
Net investment gain or loss from common/collective trusts2021-12-31$3,336,476
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31Yes
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$11,335,907
Employer contributions (assets) at end of year2021-12-31$1,801,886
Employer contributions (assets) at beginning of year2021-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$14,881,361
Contract administrator fees2021-12-31$2,706,440
Liabilities. Value of benefit claims payable at end of year2021-12-31$1,500,000
Liabilities. Value of benefit claims payable at beginning of year2021-12-31$1,600,000
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Aggregate proceeds on sale of assets2021-12-31$3
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31DELOITTE & TOUCHE LLP
Accountancy firm EIN2021-12-31133891517
2020 : NISOURCE POST-65 RETIREE MEDICAL PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$3,983,078
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$2,671,525
Total income from all sources (including contributions)2020-12-31$36,080,552
Total loss/gain on sale of assets2020-12-31$71
Total of all expenses incurred2020-12-31$21,878,127
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$19,026,939
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$13,643,667
Value of total assets at end of year2020-12-31$147,534,117
Value of total assets at beginning of year2020-12-31$132,020,139
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$2,851,188
Total interest from all sources2020-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$1,926,116
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2020-12-31$1,926,116
Administrative expenses professional fees incurred2020-12-31$238,368
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$50,000,000
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$2,327,697
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2020-12-31$5,346,316
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-12-31$443,549
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-12-31$906,553
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$1,234,586
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$158,783
Administrative expenses (other) incurred2020-12-31$19,138
Liabilities. Value of operating payables at end of year2020-12-31$1,148,492
Liabilities. Value of operating payables at beginning of year2020-12-31$1,112,742
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$14,202,425
Value of net assets at end of year (total assets less liabilities)2020-12-31$143,551,039
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$129,348,614
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$115,799,479
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$104,309,150
Value of interest in master investment trust accounts at end of year2020-12-31$5,176,271
Value of interest in master investment trust accounts at beginning of year2020-12-31$4,597,603
Value of interest in common/collective trusts at end of year2020-12-31$26,114,818
Value of interest in common/collective trusts at beginning of year2020-12-31$18,266,829
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2020-12-31$3,940,004
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2020-12-31$3,940,004
Expenses. Payments to insurance carriers foe the provision of benefits2020-12-31$72,040
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$16,357,036
Net investment gain or loss from common/collective trusts2020-12-31$3,574,994
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31Yes
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Contributions received in cash from employer2020-12-31$11,315,970
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$13,608,583
Contract administrator fees2020-12-31$2,593,682
Liabilities. Value of benefit claims payable at end of year2020-12-31$1,600,000
Liabilities. Value of benefit claims payable at beginning of year2020-12-31$1,400,000
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Aggregate proceeds on sale of assets2020-12-31$71
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31DELOITTE & TOUCHE LLP
Accountancy firm EIN2020-12-31133891517
2019 : NISOURCE POST-65 RETIREE MEDICAL PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$2,671,525
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$2,671,525
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$2,659,284
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$2,659,284
Total income from all sources (including contributions)2019-12-31$38,707,921
Total income from all sources (including contributions)2019-12-31$38,707,921
Total loss/gain on sale of assets2019-12-31$561
Total loss/gain on sale of assets2019-12-31$561
Total of all expenses incurred2019-12-31$21,911,992
Total of all expenses incurred2019-12-31$21,911,992
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$19,112,926
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$19,112,926
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$15,196,890
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$15,196,890
Value of total assets at end of year2019-12-31$132,020,139
Value of total assets at end of year2019-12-31$132,020,139
Value of total assets at beginning of year2019-12-31$115,211,969
Value of total assets at beginning of year2019-12-31$115,211,969
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$2,799,066
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$2,799,066
Total interest from all sources2019-12-31$-353
Total interest from all sources2019-12-31$-353
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$2,220,655
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$2,220,655
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$2,220,655
Total dividends received from registered investment company shares (eg mutual funds)2019-12-31$2,220,655
Administrative expenses professional fees incurred2019-12-31$199,293
Administrative expenses professional fees incurred2019-12-31$199,293
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$50,000,000
Value of fidelity bond cover2019-12-31$50,000,000
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$2,370,924
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-12-31$4,461,881
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-12-31$4,461,881
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$906,553
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-12-31$906,553
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$938,127
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-12-31$938,127
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$158,783
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$168,472
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$168,472
Administrative expenses (other) incurred2019-12-31$18,185
Administrative expenses (other) incurred2019-12-31$18,185
Liabilities. Value of operating payables at end of year2019-12-31$1,112,742
Liabilities. Value of operating payables at beginning of year2019-12-31$1,090,812
Liabilities. Value of operating payables at beginning of year2019-12-31$1,090,812
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$16,795,929
Value of net income/loss2019-12-31$16,795,929
Value of net assets at end of year (total assets less liabilities)2019-12-31$129,348,614
Value of net assets at end of year (total assets less liabilities)2019-12-31$129,348,614
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$112,552,685
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$112,552,685
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$104,309,150
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$104,309,150
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$92,701,101
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$92,701,101
Value of interest in master investment trust accounts at end of year2019-12-31$4,597,603
Value of interest in master investment trust accounts at end of year2019-12-31$4,597,603
Value of interest in master investment trust accounts at beginning of year2019-12-31$3,845,861
Value of interest in master investment trust accounts at beginning of year2019-12-31$3,845,861
Value of interest in common/collective trusts at end of year2019-12-31$18,266,829
Value of interest in common/collective trusts at end of year2019-12-31$18,266,829
Value of interest in common/collective trusts at beginning of year2019-12-31$15,192,390
Value of interest in common/collective trusts at beginning of year2019-12-31$15,192,390
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$3,940,004
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2019-12-31$3,940,004
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$2,534,490
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$2,534,490
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2019-12-31$2,534,490
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2019-12-31$2,534,490
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$-353
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2019-12-31$-353
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$92,736
Expenses. Payments to insurance carriers foe the provision of benefits2019-12-31$92,736
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$16,405,069
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$16,405,069
Net investment gain or loss from common/collective trusts2019-12-31$4,126,259
Net investment gain or loss from common/collective trusts2019-12-31$4,126,259
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31Yes
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31Yes
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Contributions received in cash from employer2019-12-31$12,825,966
Contributions received in cash from employer2019-12-31$12,825,966
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$14,558,309
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$14,558,309
Contract administrator fees2019-12-31$2,581,588
Contract administrator fees2019-12-31$2,581,588
Liabilities. Value of benefit claims payable at end of year2019-12-31$1,400,000
Liabilities. Value of benefit claims payable at end of year2019-12-31$1,400,000
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$1,400,000
Liabilities. Value of benefit claims payable at beginning of year2019-12-31$1,400,000
Did the plan have assets held for investment2019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Aggregate proceeds on sale of assets2019-12-31$561
Aggregate proceeds on sale of assets2019-12-31$561
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31DELOITTE & TOUCHE LLP
Accountancy firm EIN2019-12-31133891517
Accountancy firm EIN2019-12-31133891517
2018 : NISOURCE POST-65 RETIREE MEDICAL PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$2,659,284
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$2,566,133
Total income from all sources (including contributions)2018-12-31$4,747,242
Total loss/gain on sale of assets2018-12-31$75
Total of all expenses incurred2018-12-31$20,429,717
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$19,424,450
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$12,452,201
Value of total assets at end of year2018-12-31$115,211,969
Value of total assets at beginning of year2018-12-31$130,801,293
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$1,005,267
Total interest from all sources2018-12-31$-1,033
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$2,159,624
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$2,159,624
Administrative expenses professional fees incurred2018-12-31$198,010
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$50,000,000
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$2,903,631
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-12-31$4,180,277
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-12-31$938,127
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-12-31$580,603
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$168,472
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$151,970
Other income not declared elsewhere2018-12-31$27,000
Administrative expenses (other) incurred2018-12-31$17,501
Liabilities. Value of operating payables at end of year2018-12-31$1,090,812
Liabilities. Value of operating payables at beginning of year2018-12-31$1,114,163
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-15,682,475
Value of net assets at end of year (total assets less liabilities)2018-12-31$112,552,685
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$128,235,160
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$92,701,101
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$114,207,662
Value of interest in master investment trust accounts at end of year2018-12-31$3,845,861
Value of interest in master investment trust accounts at beginning of year2018-12-31$3,847,950
Value of interest in common/collective trusts at end of year2018-12-31$15,192,390
Value of interest in common/collective trusts at beginning of year2018-12-31$6,864,996
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2018-12-31$2,534,490
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2018-12-31$5,300,082
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2018-12-31$5,300,082
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$-1,033
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$110,619
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-9,611,567
Net investment gain or loss from common/collective trusts2018-12-31$-169,868
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31Yes
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$9,548,570
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$15,133,554
Contract administrator fees2018-12-31$789,756
Liabilities. Value of benefit claims payable at end of year2018-12-31$1,400,000
Liabilities. Value of benefit claims payable at beginning of year2018-12-31$1,300,000
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Aggregate proceeds on sale of assets2018-12-31$75
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31DELOITTE & TOUCHE LLP
Accountancy firm EIN2018-12-31133891517
2017 : NISOURCE POST-65 RETIREE MEDICAL PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$2,566,133
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$4,649,570
Total income from all sources (including contributions)2017-12-31$35,792,461
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$18,712,405
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$16,712,424
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$17,826,114
Value of total assets at end of year2017-12-31$130,801,293
Value of total assets at beginning of year2017-12-31$115,804,674
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$1,999,981
Total interest from all sources2017-12-31$-4
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$2,005,164
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2017-12-31$2,005,164
Administrative expenses professional fees incurred2017-12-31$236,418
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$50,000,000
Were there any nonexempt tranactions with any party-in-interest2017-12-31Yes
Amount of non-exempt transactions with any party-in-interest2017-12-31$40,000
Contributions received from participants2017-12-31$2,883,760
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2017-12-31$3,837,517
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-12-31$580,603
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-12-31$1,357,339
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$151,970
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$2,427,784
Other income not declared elsewhere2017-12-31$0
Administrative expenses (other) incurred2017-12-31$16,907
Liabilities. Value of operating payables at end of year2017-12-31$1,114,163
Liabilities. Value of operating payables at beginning of year2017-12-31$1,021,786
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$17,080,056
Value of net assets at end of year (total assets less liabilities)2017-12-31$128,235,160
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$111,155,104
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$114,207,662
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$101,567,185
Value of interest in master investment trust accounts at end of year2017-12-31$3,847,950
Value of interest in master investment trust accounts at beginning of year2017-12-31$3,372,581
Value of interest in common/collective trusts at end of year2017-12-31$6,864,996
Value of interest in common/collective trusts at beginning of year2017-12-31$5,973,200
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$5,300,082
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$3,534,369
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$3,534,369
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$-4
Expenses. Payments to insurance carriers foe the provision of benefits2017-12-31$65,380
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$14,186,348
Net investment gain or loss from common/collective trusts2017-12-31$1,300,782
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31Yes
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Contributions received in cash from employer2017-12-31$14,942,354
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$12,809,527
Contract administrator fees2017-12-31$1,746,656
Liabilities. Value of benefit claims payable at end of year2017-12-31$1,300,000
Liabilities. Value of benefit claims payable at beginning of year2017-12-31$1,200,000
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31DELOITTE & TOUCHE LLP
Accountancy firm EIN2017-12-31133891517
2016 : NISOURCE POST-65 RETIREE MEDICAL PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$4,649,570
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$2,532,924
Total income from all sources (including contributions)2016-12-31$21,374,532
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$16,751,280
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$14,887,105
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$14,077,101
Value of total assets at end of year2016-12-31$115,804,674
Value of total assets at beginning of year2016-12-31$109,064,776
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$1,864,175
Total interest from all sources2016-12-31$-250
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$1,604,647
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2016-12-31$1,604,647
Administrative expenses professional fees incurred2016-12-31$183,200
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$50,000,000
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Amount of non-exempt transactions with any party-in-interest2016-12-31$85,000
Contributions received from participants2016-12-31$2,904,285
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2016-12-31$2,798,535
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-12-31$1,357,339
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-12-31$817,382
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-12-31$2,427,784
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-12-31$291,663
Administrative expenses (other) incurred2016-12-31$15,827
Liabilities. Value of operating payables at end of year2016-12-31$1,021,786
Liabilities. Value of operating payables at beginning of year2016-12-31$841,261
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$4,623,252
Value of net assets at end of year (total assets less liabilities)2016-12-31$111,155,104
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$106,531,852
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-12-31$101,567,185
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-12-31$96,187,639
Value of interest in master investment trust accounts at end of year2016-12-31$3,372,581
Value of interest in master investment trust accounts at beginning of year2016-12-31$3,591,543
Value of interest in common/collective trusts at end of year2016-12-31$5,973,200
Value of interest in common/collective trusts at beginning of year2016-12-31$7,088,056
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2016-12-31$3,534,369
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2016-12-31$1,380,156
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2016-12-31$1,380,156
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2016-12-31$-250
Expenses. Payments to insurance carriers foe the provision of benefits2016-12-31$69,116
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-12-31$4,642,431
Net investment gain or loss from common/collective trusts2016-12-31$794,408
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31Yes
Was there a failure to transmit to the plan any participant contributions2016-12-31No
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Contributions received in cash from employer2016-12-31$11,172,816
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$12,019,454
Contract administrator fees2016-12-31$1,665,148
Liabilities. Value of benefit claims payable at end of year2016-12-31$1,200,000
Liabilities. Value of benefit claims payable at beginning of year2016-12-31$1,400,000
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31DELOITTE & TOUCHE LLP
Accountancy firm EIN2016-12-31133891517
2015 : NISOURCE POST-65 RETIREE MEDICAL PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total transfer of assets from this plan2015-12-31$82,042,599
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$2,532,924
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$2,968,808
Total income from all sources (including contributions)2015-12-31$14,048,164
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$18,858,774
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$16,897,687
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$13,106,531
Value of total assets at end of year2015-12-31$109,064,776
Value of total assets at beginning of year2015-12-31$196,353,869
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$1,961,087
Total interest from all sources2015-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$2,090,805
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2015-12-31$2,090,805
Administrative expenses professional fees incurred2015-12-31$165,823
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$50,000,000
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$3,782,743
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2015-12-31$4,169,669
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-12-31$817,382
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-12-31$297,883
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-12-31$291,663
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-12-31$183,566
Other income not declared elsewhere2015-12-31$33,502
Administrative expenses (other) incurred2015-12-31$16,689
Liabilities. Value of operating payables at end of year2015-12-31$841,261
Liabilities. Value of operating payables at beginning of year2015-12-31$785,242
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$-4,810,610
Value of net assets at end of year (total assets less liabilities)2015-12-31$106,531,852
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$193,385,061
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Investment advisory and management fees2015-12-31$1,778,575
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-12-31$96,187,639
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-12-31$177,770,645
Value of interest in master investment trust accounts at end of year2015-12-31$3,591,543
Value of interest in master investment trust accounts at beginning of year2015-12-31$4,014,498
Value of interest in common/collective trusts at end of year2015-12-31$7,088,056
Value of interest in common/collective trusts at beginning of year2015-12-31$12,648,024
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2015-12-31$1,380,156
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2015-12-31$1,009,677
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2015-12-31$1,009,677
Expenses. Payments to insurance carriers foe the provision of benefits2015-12-31$90,768
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-12-31$-1,364,032
Net investment gain or loss from common/collective trusts2015-12-31$146,654
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31Yes
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Contributions received in cash from employer2015-12-31$9,323,788
Employer contributions (assets) at end of year2015-12-31$0
Employer contributions (assets) at beginning of year2015-12-31$613,142
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$12,637,250
Liabilities. Value of benefit claims payable at end of year2015-12-31$1,400,000
Liabilities. Value of benefit claims payable at beginning of year2015-12-31$2,000,000
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31DELOITTE & TOUCHE LLP
Accountancy firm EIN2015-12-31133891517
2014 : NISOURCE POST-65 RETIREE MEDICAL PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total transfer of assets from this plan2014-12-31$250,500
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$2,968,808
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$3,662,780
Total income from all sources (including contributions)2014-12-31$30,621,337
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$25,542,383
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$22,665,962
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$19,917,107
Value of total assets at end of year2014-12-31$196,353,869
Value of total assets at beginning of year2014-12-31$192,219,387
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$2,876,421
Total interest from all sources2014-12-31$-105
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$2,789,416
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2014-12-31$2,789,416
Administrative expenses professional fees incurred2014-12-31$195,813
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$50,000,000
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$4,941,647
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2014-12-31$6,113,088
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-12-31$297,883
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-12-31$183,566
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-12-31$0
Other income not declared elsewhere2014-12-31$254,488
Administrative expenses (other) incurred2014-12-31$30,795
Liabilities. Value of operating payables at end of year2014-12-31$785,242
Liabilities. Value of operating payables at beginning of year2014-12-31$1,862,780
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$5,078,954
Value of net assets at end of year (total assets less liabilities)2014-12-31$193,385,061
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$188,556,607
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-12-31$177,770,645
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-12-31$0
Value of interest in master investment trust accounts at end of year2014-12-31$4,014,498
Value of interest in master investment trust accounts at beginning of year2014-12-31$191,328,573
Value of interest in common/collective trusts at end of year2014-12-31$12,648,024
Value of interest in common/collective trusts at beginning of year2014-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2014-12-31$1,009,677
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2014-12-31$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2014-12-31$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2014-12-31$-105
Expenses. Payments to insurance carriers foe the provision of benefits2014-12-31$180,072
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-12-31$5,642,522
Net investment gain or loss from common/collective trusts2014-12-31$1,678,543
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31Yes
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Contributions received in cash from employer2014-12-31$14,975,460
Employer contributions (assets) at end of year2014-12-31$613,142
Employer contributions (assets) at beginning of year2014-12-31$890,814
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$16,372,802
Contract administrator fees2014-12-31$2,649,813
Liabilities. Value of benefit claims payable at end of year2014-12-31$2,000,000
Liabilities. Value of benefit claims payable at beginning of year2014-12-31$1,800,000
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31DELOITTE & TOUCHE LLP
Accountancy firm EIN2014-12-31133891517
2013 : NISOURCE POST-65 RETIREE MEDICAL PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$3,662,780
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$2,304,183
Total income from all sources (including contributions)2013-12-31$57,727,655
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$21,283,910
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$19,076,257
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$30,267,854
Value of total assets at end of year2013-12-31$192,219,387
Value of total assets at beginning of year2013-12-31$154,417,045
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$2,207,653
Total interest from all sources2013-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Administrative expenses professional fees incurred2013-12-31$87,496
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$50,000,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$2,955,459
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2013-12-31$5,720,850
Liabilities. Value of operating payables at end of year2013-12-31$1,862,780
Liabilities. Value of operating payables at beginning of year2013-12-31$904,183
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$36,443,745
Value of net assets at end of year (total assets less liabilities)2013-12-31$188,556,607
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$152,112,862
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in master investment trust accounts at end of year2013-12-31$191,328,573
Value of interest in master investment trust accounts at beginning of year2013-12-31$153,607,032
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$111,840
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$27,312,395
Employer contributions (assets) at end of year2013-12-31$890,814
Employer contributions (assets) at beginning of year2013-12-31$810,013
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$13,243,567
Contract administrator fees2013-12-31$2,120,157
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-12-31No
Liabilities. Value of benefit claims payable at end of year2013-12-31$1,800,000
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$1,400,000
Did the plan have assets held for investment2013-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31DELOITTE & TOUCHE LLP
Accountancy firm EIN2013-12-31133891517
2012 : NISOURCE POST-65 RETIREE MEDICAL PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$2,304,183
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$2,619,958
Total income from all sources (including contributions)2012-12-31$39,439,047
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$18,971,696
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$16,817,634
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$20,295,165
Value of total assets at end of year2012-12-31$154,417,045
Value of total assets at beginning of year2012-12-31$134,265,469
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$2,154,062
Total interest from all sources2012-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Administrative expenses professional fees incurred2012-12-31$73,028
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$50,000,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$3,037,414
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2012-12-31$4,390,061
Other income not declared elsewhere2012-12-31$356,148
Liabilities. Value of operating payables at end of year2012-12-31$904,183
Liabilities. Value of operating payables at beginning of year2012-12-31$1,219,958
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$20,467,351
Value of net assets at end of year (total assets less liabilities)2012-12-31$152,112,862
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$131,645,511
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in master investment trust accounts at end of year2012-12-31$153,607,032
Value of interest in master investment trust accounts at beginning of year2012-12-31$134,265,469
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$12,314,485
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$17,257,751
Employer contributions (assets) at end of year2012-12-31$810,013
Employer contributions (assets) at beginning of year2012-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$113,088
Contract administrator fees2012-12-31$2,081,034
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-12-31No
Liabilities. Value of benefit claims payable at end of year2012-12-31$1,400,000
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$1,400,000
Did the plan have assets held for investment2012-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31DELOITTE & TOUCHE LLP
Accountancy firm EIN2012-12-31133891517
2011 : NISOURCE POST-65 RETIREE MEDICAL PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$2,619,958
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$1,760,123
Total income from all sources (including contributions)2011-12-31$22,294,563
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$16,433,146
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$16,433,146
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$24,326,568
Value of total assets at end of year2011-12-31$134,265,469
Value of total assets at beginning of year2011-12-31$127,544,217
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$0
Total interest from all sources2011-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$50,000,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$4,749,785
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2011-12-31$4,217,281
Liabilities. Value of operating payables at end of year2011-12-31$1,219,958
Liabilities. Value of operating payables at beginning of year2011-12-31$460,123
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$5,861,417
Value of net assets at end of year (total assets less liabilities)2011-12-31$131,645,511
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$125,784,094
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in master investment trust accounts at end of year2011-12-31$134,265,469
Value of interest in master investment trust accounts at beginning of year2011-12-31$127,361,417
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$12,028,300
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$19,576,783
Employer contributions (assets) at end of year2011-12-31$0
Employer contributions (assets) at beginning of year2011-12-31$182,800
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$187,565
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-12-31No
Liabilities. Value of benefit claims payable at end of year2011-12-31$1,400,000
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$1,300,000
Did the plan have assets held for investment2011-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31DELOITTE & TOUCHE LLP
Accountancy firm EIN2011-12-31133891517
2010 : NISOURCE POST-65 RETIREE MEDICAL PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total transfer of assets to this plan2010-12-31$109,560,219
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$1,760,123
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total income from all sources (including contributions)2010-12-31$22,740,036
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$6,516,161
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$6,516,161
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$7,255,080
Value of total assets at end of year2010-12-31$127,544,217
Value of total assets at beginning of year2010-12-31$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$0
Total interest from all sources2010-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$50,000,000
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$1,248,950
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2010-12-31$1,427,548
Liabilities. Value of operating payables at end of year2010-12-31$460,123
Liabilities. Value of operating payables at beginning of year2010-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$16,223,875
Value of net assets at end of year (total assets less liabilities)2010-12-31$125,784,094
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in master investment trust accounts at end of year2010-12-31$127,361,417
Value of interest in master investment trust accounts at beginning of year2010-12-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$5,005,821
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$6,006,130
Employer contributions (assets) at end of year2010-12-31$182,800
Employer contributions (assets) at beginning of year2010-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$82,792
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32010-12-31No
Liabilities. Value of benefit claims payable at end of year2010-12-31$1,300,000
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$0
Did the plan have assets held for investment2010-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31DELOITTE & TOUCHE LLP
Accountancy firm EIN2010-12-31133891517

Form 5500 Responses for NISOURCE POST-65 RETIREE MEDICAL PLAN

2022: NISOURCE POST-65 RETIREE 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 planYes
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: NISOURCE POST-65 RETIREE MEDICAL PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
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 planYes
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: NISOURCE POST-65 RETIREE 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 planYes
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: NISOURCE POST-65 RETIREE 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 planYes
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: NISOURCE POST-65 RETIREE 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 planYes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: NISOURCE POST-65 RETIREE 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 planYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: NISOURCE POST-65 RETIREE MEDICAL PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedYes
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 planYes
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: NISOURCE POST-65 RETIREE 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 planYes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: NISOURCE POST-65 RETIREE MEDICAL PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
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 planYes
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: NISOURCE POST-65 RETIREE 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 planYes
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: NISOURCE POST-65 RETIREE 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 planYes
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: NISOURCE POST-65 RETIREE MEDICAL PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedYes
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 planYes
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number05821210
Policy instance 1
Insurance contract or identification number05821210
Number of Individuals Covered11
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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
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 CarrierUSD $55,627
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number05821210
Policy instance 1
Insurance contract or identification number05821210
Number of Individuals Covered13
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
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 CarrierUSD $65,954
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number05821210
Policy instance 1
Insurance contract or identification number05821210
Number of Individuals Covered15
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
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
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 CarrierUSD $71,370
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number05821210
Policy instance 1
Insurance contract or identification number05821210
Number of Individuals Covered17
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
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
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 CarrierUSD $99,603
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number05821210
Policy instance 1
Insurance contract or identification number05821210
Number of Individuals Covered20
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
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
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 CarrierUSD $112,080
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number05821210
Policy instance 1
Insurance contract or identification number05821210
Number of Individuals Covered20
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
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 BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $114,882
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number05821210
Policy instance 1
Insurance contract or identification number05821210
Number of Individuals Covered29
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
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 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 BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $173,793
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number05821210
Policy instance 1
Insurance contract or identification number05821210
Number of Individuals Covered32
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $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 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 BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $194,844
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number05821210
Policy instance 1
Insurance contract or identification number05821210
Number of Individuals Covered34
Insurance policy start date2012-01-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $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 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 BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $194,472
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number08840472
Policy instance 1
Insurance contract or identification number08840472
Number of Individuals Covered36
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $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 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 BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $200,640
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KEYSTONE HEALTH PLAN WEST, INC (National Association of Insurance Commissioners NAIC id number: 95048 )
Policy contract number*584222
Policy instance 1
Insurance contract or identification number*584222
Number of Individuals Covered40
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $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 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 BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $214,130
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
KEYSTONE HEALTH PLAN WEST, INC (National Association of Insurance Commissioners NAIC id number: 95048 )
Policy contract number584222(5-9)
Policy instance 1
Insurance contract or identification number584222(5-9)
Number of Individuals Covered41
Insurance policy start date2009-07-01
Insurance policy end date2010-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $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 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 BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $146,616
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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