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NORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN 401k Plan overview

Plan NameNORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN
Plan identification number 506

NORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN Benefits

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

401k Sponsoring company profile

NORTHWESTERN UNIVERSITY has sponsored the creation of one or more 401k plans.

Company Name:NORTHWESTERN UNIVERSITY
Employer identification number (EIN):362167817
NAIC Classification:611000

Additional information about NORTHWESTERN UNIVERSITY

Jurisdiction of Incorporation: Louisiana Secretary Of State, Commercial Division
Incorporation Date:
Company Identification Number: 34259176N

More information about NORTHWESTERN UNIVERSITY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5062017-09-01
5062016-09-01ANNE FISH
5062015-09-01ANNE FISH ANNE FISH2017-03-23
5062014-09-01ANNE FISH
5062013-09-01ANNE FISH ANNE FISH2015-03-17
5062012-09-01ANNE FISH ANNE FISH2014-09-02
5062011-09-01ANNE N FISH, DIRECTOR OF BENEFITS ANNE N FISH, DIRECTOR OF BENEFITS2014-06-25
5062009-09-01 ANNE FISH2011-06-15
5062009-09-01

Plan Statistics for NORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN

401k plan membership statisitcs for NORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN

Measure Date Value
2017: NORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-09-017,711
Total number of active participants reported on line 7a of the Form 55002017-09-010
Number of retired or separated participants receiving benefits2017-09-010
Number of other retired or separated participants entitled to future benefits2017-09-010
Total of all active and inactive participants2017-09-010
2016: NORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-09-017,197
Total number of active participants reported on line 7a of the Form 55002016-09-017,383
Number of retired or separated participants receiving benefits2016-09-01328
Number of other retired or separated participants entitled to future benefits2016-09-010
Total of all active and inactive participants2016-09-017,711
2015: NORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-09-016,665
Total number of active participants reported on line 7a of the Form 55002015-09-016,861
Number of retired or separated participants receiving benefits2015-09-01336
Number of other retired or separated participants entitled to future benefits2015-09-010
Total of all active and inactive participants2015-09-017,197
2014: NORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-09-016,396
Total number of active participants reported on line 7a of the Form 55002014-09-016,252
Number of retired or separated participants receiving benefits2014-09-01413
Number of other retired or separated participants entitled to future benefits2014-09-010
Total of all active and inactive participants2014-09-016,665
2013: NORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-09-016,335
Total number of active participants reported on line 7a of the Form 55002013-09-015,983
Number of retired or separated participants receiving benefits2013-09-01413
Number of other retired or separated participants entitled to future benefits2013-09-010
Total of all active and inactive participants2013-09-016,396
2012: NORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-09-016,081
Total number of active participants reported on line 7a of the Form 55002012-09-015,894
Number of retired or separated participants receiving benefits2012-09-01441
Number of other retired or separated participants entitled to future benefits2012-09-010
Total of all active and inactive participants2012-09-016,335
2011: NORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-09-015,858
Total number of active participants reported on line 7a of the Form 55002011-09-015,682
Number of retired or separated participants receiving benefits2011-09-01399
Total of all active and inactive participants2011-09-016,081
2009: NORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-09-014,535
Total number of active participants reported on line 7a of the Form 55002009-09-014,571
Number of retired or separated participants receiving benefits2009-09-0132
Number of other retired or separated participants entitled to future benefits2009-09-010
Total of all active and inactive participants2009-09-014,603

Financial Data on NORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN

Measure Date Value
2018 : NORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-01-01$0
Total transfer of assets from this plan2018-01-01$13,108,315
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-01-01$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-01-01$5,782,418
Total income from all sources (including contributions)2018-01-01$30,981,608
Total loss/gain on sale of assets2018-01-01$0
Total of all expenses incurred2018-01-01$33,324,059
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-01-01$31,737,423
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-01-01$30,905,641
Value of total assets at end of year2018-01-01$0
Value of total assets at beginning of year2018-01-01$21,233,184
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-01-01$1,586,636
Total interest from all sources2018-01-01$0
Total dividends received (eg from common stock, registered investment company shares)2018-01-01$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-01-01No
Administrative expenses professional fees incurred2018-01-01$57,951
Was this plan covered by a fidelity bond2018-01-01Yes
Value of fidelity bond cover2018-01-01$10,000,000
Were there any nonexempt tranactions with any party-in-interest2018-01-01No
Contributions received from participants2018-01-01$7,834,217
Participant contributions at end of year2018-01-01$0
Participant contributions at beginning of year2018-01-01$315,878
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-01-01$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-01-01$864,674
Liabilities. Value of operating payables at end of year2018-01-01$0
Liabilities. Value of operating payables at beginning of year2018-01-01$372,684
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-01-01No
Value of net income/loss2018-01-01$-2,342,451
Value of net assets at end of year (total assets less liabilities)2018-01-01$0
Value of net assets at beginning of year (total assets less liabilities)2018-01-01$15,450,766
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-01-01No
Were any loans by the plan or fixed income obligations due to the plan in default2018-01-01No
Were any leases to which the plan was party in default or uncollectible2018-01-01No
Value of interest in common/collective trusts at end of year2018-01-01$0
Value of interest in common/collective trusts at beginning of year2018-01-01$20,025,467
Expenses. Payments to insurance carriers foe the provision of benefits2018-01-01$223,897
Net investment gain or loss from common/collective trusts2018-01-01$75,967
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-01-01Yes
Was there a failure to transmit to the plan any participant contributions2018-01-01No
Has the plan failed to provide any benefit when due under the plan2018-01-01No
Contributions received in cash from employer2018-01-01$23,071,424
Employer contributions (assets) at end of year2018-01-01$0
Employer contributions (assets) at beginning of year2018-01-01$27,165
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-01-01$31,513,526
Contract administrator fees2018-01-01$1,528,685
Liabilities. Value of benefit claims payable at end of year2018-01-01$0
Liabilities. Value of benefit claims payable at beginning of year2018-01-01$5,409,734
Did the plan have assets held for investment2018-01-01No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-01-01No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-01-01Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-01-01Yes
Opinion of an independent qualified public accountant for this plan2018-01-01Disclaimer
Accountancy firm name2018-01-01PLANTE & MORAN, PLLC
Accountancy firm EIN2018-01-01381357951
2017 : NORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-08-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-08-31$5,782,418
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-08-31$6,146,180
Total income from all sources (including contributions)2017-08-31$89,034,314
Total loss/gain on sale of assets2017-08-31$0
Total of all expenses incurred2017-08-31$85,075,812
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-08-31$80,839,121
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-08-31$88,893,914
Value of total assets at end of year2017-08-31$21,233,184
Value of total assets at beginning of year2017-08-31$17,638,444
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-08-31$4,236,691
Total interest from all sources2017-08-31$0
Total dividends received (eg from common stock, registered investment company shares)2017-08-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-08-31No
Administrative expenses professional fees incurred2017-08-31$87,911
Was this plan covered by a fidelity bond2017-08-31Yes
Value of fidelity bond cover2017-08-31$10,000,000
Were there any nonexempt tranactions with any party-in-interest2017-08-31No
Contributions received from participants2017-08-31$22,707,943
Participant contributions at end of year2017-08-31$315,878
Participant contributions at beginning of year2017-08-31$292,867
Value of other receiveables (less allowance for doubtful accounts) at end of year2017-08-31$864,674
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-08-31$589,545
Liabilities. Value of operating payables at end of year2017-08-31$372,684
Liabilities. Value of operating payables at beginning of year2017-08-31$343,460
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-08-31No
Value of net income/loss2017-08-31$3,958,502
Value of net assets at end of year (total assets less liabilities)2017-08-31$15,450,766
Value of net assets at beginning of year (total assets less liabilities)2017-08-31$11,492,264
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-08-31No
Were any leases to which the plan was party in default or uncollectible2017-08-31No
Value of interest in common/collective trusts at end of year2017-08-31$20,025,467
Value of interest in common/collective trusts at beginning of year2017-08-31$16,704,539
Expenses. Payments to insurance carriers foe the provision of benefits2017-08-31$582,491
Net investment gain or loss from common/collective trusts2017-08-31$140,400
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-08-31Yes
Was there a failure to transmit to the plan any participant contributions2017-08-31No
Has the plan failed to provide any benefit when due under the plan2017-08-31No
Contributions received in cash from employer2017-08-31$66,185,971
Employer contributions (assets) at end of year2017-08-31$27,165
Employer contributions (assets) at beginning of year2017-08-31$51,493
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-08-31$80,256,630
Contract administrator fees2017-08-31$4,148,780
Liabilities. Value of benefit claims payable at end of year2017-08-31$5,409,734
Liabilities. Value of benefit claims payable at beginning of year2017-08-31$5,802,720
Did the plan have assets held for investment2017-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-08-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-08-31Yes
Opinion of an independent qualified public accountant for this plan2017-08-31Disclaimer
Accountancy firm name2017-08-31PLANTE & MORAN, PLLC
Accountancy firm EIN2017-08-31381357951
2016 : NORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-08-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-08-31$6,146,180
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-08-31$4,820,540
Total income from all sources (including contributions)2016-08-31$79,050,737
Total loss/gain on sale of assets2016-08-31$0
Total of all expenses incurred2016-08-31$75,611,750
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-08-31$71,577,569
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-08-31$78,997,228
Value of total assets at end of year2016-08-31$17,638,444
Value of total assets at beginning of year2016-08-31$12,873,817
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-08-31$4,034,181
Total interest from all sources2016-08-31$0
Total dividends received (eg from common stock, registered investment company shares)2016-08-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-08-31No
Administrative expenses professional fees incurred2016-08-31$76,436
Was this plan covered by a fidelity bond2016-08-31Yes
Value of fidelity bond cover2016-08-31$10,000,000
Were there any nonexempt tranactions with any party-in-interest2016-08-31No
Contributions received from participants2016-08-31$21,196,729
Participant contributions at end of year2016-08-31$292,867
Participant contributions at beginning of year2016-08-31$305,927
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-08-31$589,545
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-08-31$755,272
Liabilities. Value of operating payables at end of year2016-08-31$343,460
Liabilities. Value of operating payables at beginning of year2016-08-31$303,475
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-08-31No
Value of net income/loss2016-08-31$3,438,987
Value of net assets at end of year (total assets less liabilities)2016-08-31$11,492,264
Value of net assets at beginning of year (total assets less liabilities)2016-08-31$8,053,277
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-08-31No
Were any leases to which the plan was party in default or uncollectible2016-08-31No
Value of interest in common/collective trusts at end of year2016-08-31$16,704,539
Value of interest in common/collective trusts at beginning of year2016-08-31$11,772,228
Expenses. Payments to insurance carriers foe the provision of benefits2016-08-31$487,352
Net investment gain or loss from common/collective trusts2016-08-31$53,509
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-08-31Yes
Was there a failure to transmit to the plan any participant contributions2016-08-31No
Has the plan failed to provide any benefit when due under the plan2016-08-31No
Contributions received in cash from employer2016-08-31$57,800,499
Employer contributions (assets) at end of year2016-08-31$51,493
Employer contributions (assets) at beginning of year2016-08-31$40,390
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-08-31$71,090,217
Contract administrator fees2016-08-31$3,957,745
Liabilities. Value of benefit claims payable at end of year2016-08-31$5,802,720
Liabilities. Value of benefit claims payable at beginning of year2016-08-31$4,517,065
Did the plan have assets held for investment2016-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-08-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-08-31Yes
Opinion of an independent qualified public accountant for this plan2016-08-31Disclaimer
Accountancy firm name2016-08-31PLANTE & MORAN, PLLC
Accountancy firm EIN2016-08-31381357951
2015 : NORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-08-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-08-31$4,820,540
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-08-31$3,789,044
Total income from all sources (including contributions)2015-08-31$68,146,756
Total loss/gain on sale of assets2015-08-31$0
Total of all expenses incurred2015-08-31$70,861,466
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-08-31$67,190,106
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-08-31$68,128,948
Value of total assets at end of year2015-08-31$12,873,817
Value of total assets at beginning of year2015-08-31$14,557,031
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-08-31$3,671,360
Total interest from all sources2015-08-31$0
Total dividends received (eg from common stock, registered investment company shares)2015-08-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-08-31No
Administrative expenses professional fees incurred2015-08-31$24,000
Was this plan covered by a fidelity bond2015-08-31Yes
Value of fidelity bond cover2015-08-31$10,000,000
Were there any nonexempt tranactions with any party-in-interest2015-08-31No
Contributions received from participants2015-08-31$18,287,139
Participant contributions at end of year2015-08-31$305,927
Participant contributions at beginning of year2015-08-31$286,437
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-08-31$755,272
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-08-31$581,865
Liabilities. Value of operating payables at end of year2015-08-31$303,475
Liabilities. Value of operating payables at beginning of year2015-08-31$328,611
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-08-31No
Value of net income/loss2015-08-31$-2,714,710
Value of net assets at end of year (total assets less liabilities)2015-08-31$8,053,277
Value of net assets at beginning of year (total assets less liabilities)2015-08-31$10,767,987
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-08-31No
Were any leases to which the plan was party in default or uncollectible2015-08-31No
Investment advisory and management fees2015-08-31$52,880
Value of interest in common/collective trusts at end of year2015-08-31$11,772,228
Value of interest in common/collective trusts at beginning of year2015-08-31$13,645,223
Expenses. Payments to insurance carriers foe the provision of benefits2015-08-31$572,355
Net investment gain or loss from common/collective trusts2015-08-31$17,808
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-08-31Yes
Was there a failure to transmit to the plan any participant contributions2015-08-31No
Has the plan failed to provide any benefit when due under the plan2015-08-31No
Contributions received in cash from employer2015-08-31$49,841,809
Employer contributions (assets) at end of year2015-08-31$40,390
Employer contributions (assets) at beginning of year2015-08-31$43,506
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-08-31$66,617,751
Contract administrator fees2015-08-31$3,594,480
Liabilities. Value of benefit claims payable at end of year2015-08-31$4,517,065
Liabilities. Value of benefit claims payable at beginning of year2015-08-31$3,460,433
Did the plan have assets held for investment2015-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-08-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-08-31Yes
Opinion of an independent qualified public accountant for this plan2015-08-31Disclaimer
Accountancy firm name2015-08-31PLANTE & MORAN, PLLC
Accountancy firm EIN2015-08-31381357951
2014 : NORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-08-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-08-31$3,789,044
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-08-31$4,961,532
Total income from all sources (including contributions)2014-08-31$63,134,749
Total loss/gain on sale of assets2014-08-31$0
Total of all expenses incurred2014-08-31$62,499,495
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-08-31$59,509,729
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-08-31$63,116,359
Value of total assets at end of year2014-08-31$14,557,031
Value of total assets at beginning of year2014-08-31$15,094,265
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-08-31$2,989,766
Total interest from all sources2014-08-31$0
Total dividends received (eg from common stock, registered investment company shares)2014-08-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-08-31No
Administrative expenses professional fees incurred2014-08-31$23,500
Was this plan covered by a fidelity bond2014-08-31Yes
Value of fidelity bond cover2014-08-31$10,000,000
If this is an individual account plan, was there a blackout period2014-08-31No
Were there any nonexempt tranactions with any party-in-interest2014-08-31No
Contributions received from participants2014-08-31$17,822,439
Participant contributions at end of year2014-08-31$286,437
Participant contributions at beginning of year2014-08-31$294,780
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-08-31$581,865
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-08-31$707,674
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-08-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-08-31$161,508
Liabilities. Value of operating payables at end of year2014-08-31$328,611
Liabilities. Value of operating payables at beginning of year2014-08-31$357,829
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-08-31No
Value of net income/loss2014-08-31$635,254
Value of net assets at end of year (total assets less liabilities)2014-08-31$10,767,987
Value of net assets at beginning of year (total assets less liabilities)2014-08-31$10,132,733
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-08-31No
Were any leases to which the plan was party in default or uncollectible2014-08-31No
Investment advisory and management fees2014-08-31$56,088
Value of interest in common/collective trusts at end of year2014-08-31$13,645,223
Value of interest in common/collective trusts at beginning of year2014-08-31$14,058,005
Expenses. Payments to insurance carriers foe the provision of benefits2014-08-31$653,944
Net investment gain or loss from common/collective trusts2014-08-31$18,390
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-08-31Yes
Was there a failure to transmit to the plan any participant contributions2014-08-31No
Has the plan failed to provide any benefit when due under the plan2014-08-31No
Contributions received in cash from employer2014-08-31$45,293,920
Employer contributions (assets) at end of year2014-08-31$43,506
Employer contributions (assets) at beginning of year2014-08-31$33,806
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-08-31$58,855,785
Contract administrator fees2014-08-31$2,910,178
Liabilities. Value of benefit claims payable at end of year2014-08-31$3,460,433
Liabilities. Value of benefit claims payable at beginning of year2014-08-31$4,442,195
Did the plan have assets held for investment2014-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-08-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-08-31Yes
Opinion of an independent qualified public accountant for this plan2014-08-31Disclaimer
Accountancy firm name2014-08-31PLANTE & MORAN, PLLC
Accountancy firm EIN2014-08-31381357951
2013 : NORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-08-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-08-31$4,961,532
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-08-31$4,699,551
Total income from all sources (including contributions)2013-08-31$57,349,473
Total loss/gain on sale of assets2013-08-31$0
Total of all expenses incurred2013-08-31$57,554,943
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-08-31$54,412,420
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-08-31$57,324,284
Value of total assets at end of year2013-08-31$15,094,265
Value of total assets at beginning of year2013-08-31$15,037,754
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-08-31$3,142,523
Total interest from all sources2013-08-31$0
Total dividends received (eg from common stock, registered investment company shares)2013-08-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-08-31No
Administrative expenses professional fees incurred2013-08-31$51,022
Was this plan covered by a fidelity bond2013-08-31Yes
Value of fidelity bond cover2013-08-31$10,000,000
Were there any nonexempt tranactions with any party-in-interest2013-08-31No
Contributions received from participants2013-08-31$16,458,306
Participant contributions at end of year2013-08-31$294,780
Participant contributions at beginning of year2013-08-31$245,108
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-08-31$707,674
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-08-31$794,845
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-08-31$161,508
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-08-31$226,502
Administrative expenses (other) incurred2013-08-31$3,091,501
Liabilities. Value of operating payables at end of year2013-08-31$357,829
Liabilities. Value of operating payables at beginning of year2013-08-31$1,210,494
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-08-31No
Value of net income/loss2013-08-31$-205,470
Value of net assets at end of year (total assets less liabilities)2013-08-31$10,132,733
Value of net assets at beginning of year (total assets less liabilities)2013-08-31$10,338,203
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-08-31No
Were any leases to which the plan was party in default or uncollectible2013-08-31No
Value of interest in common/collective trusts at end of year2013-08-31$14,058,005
Value of interest in common/collective trusts at beginning of year2013-08-31$13,987,626
Expenses. Payments to insurance carriers foe the provision of benefits2013-08-31$559,523
Net investment gain or loss from common/collective trusts2013-08-31$25,189
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-08-31Yes
Was there a failure to transmit to the plan any participant contributions2013-08-31No
Has the plan failed to provide any benefit when due under the plan2013-08-31No
Contributions received in cash from employer2013-08-31$40,865,978
Employer contributions (assets) at end of year2013-08-31$33,806
Employer contributions (assets) at beginning of year2013-08-31$10,175
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-08-31$53,852,897
Liabilities. Value of benefit claims payable at end of year2013-08-31$4,442,195
Liabilities. Value of benefit claims payable at beginning of year2013-08-31$3,262,555
Did the plan have assets held for investment2013-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-08-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-08-31Yes
Opinion of an independent qualified public accountant for this plan2013-08-31Disclaimer
Accountancy firm name2013-08-31PLANTE & MORAN, PLLC
Accountancy firm EIN2013-08-31381357951
2012 : NORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-08-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-08-31$3,820,737
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-08-31$4,147,378
Total income from all sources (including contributions)2012-08-31$46,947,144
Total loss/gain on sale of assets2012-08-31$0
Total of all expenses incurred2012-08-31$55,823,062
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-08-31$52,984,478
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-08-31$46,254,733
Value of total assets at end of year2012-08-31$14,534,208
Value of total assets at beginning of year2012-08-31$23,736,767
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-08-31$2,838,584
Total interest from all sources2012-08-31$0
Total dividends received (eg from common stock, registered investment company shares)2012-08-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-08-31No
Administrative expenses professional fees incurred2012-08-31$208,659
Was this plan covered by a fidelity bond2012-08-31Yes
Value of fidelity bond cover2012-08-31$10,000,000
Were there any nonexempt tranactions with any party-in-interest2012-08-31No
Contributions received from participants2012-08-31$13,470,039
Participant contributions at end of year2012-08-31$245,108
Participant contributions at beginning of year2012-08-31$262,741
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-08-31$291,299
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-08-31$474,354
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-08-31$229,873
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-08-31$474,610
Liabilities. Value of operating payables at end of year2012-08-31$222,553
Liabilities. Value of operating payables at beginning of year2012-08-31$209,496
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-08-31No
Value of net income/loss2012-08-31$-8,875,918
Value of net assets at end of year (total assets less liabilities)2012-08-31$10,713,471
Value of net assets at beginning of year (total assets less liabilities)2012-08-31$19,589,389
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-08-31No
Were any leases to which the plan was party in default or uncollectible2012-08-31No
Investment advisory and management fees2012-08-31$33,784
Value of interest in common/collective trusts at end of year2012-08-31$13,987,626
Value of interest in common/collective trusts at beginning of year2012-08-31$22,988,050
Expenses. Payments to insurance carriers foe the provision of benefits2012-08-31$533,916
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-08-31$653,359
Net investment gain/loss from pooled separate accounts2012-08-31$39,052
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-08-31Yes
Was there a failure to transmit to the plan any participant contributions2012-08-31No
Has the plan failed to provide any benefit when due under the plan2012-08-31No
Contributions received in cash from employer2012-08-31$32,784,694
Employer contributions (assets) at end of year2012-08-31$10,175
Employer contributions (assets) at beginning of year2012-08-31$11,622
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-08-31$52,450,562
Contract administrator fees2012-08-31$2,596,141
Liabilities. Value of benefit claims payable at end of year2012-08-31$3,368,311
Liabilities. Value of benefit claims payable at beginning of year2012-08-31$3,463,272
Did the plan have assets held for investment2012-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-08-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-08-31Yes
Opinion of an independent qualified public accountant for this plan2012-08-31Disclaimer
Accountancy firm name2012-08-31PRICE WATERHOUSE COOPERS, LLP
Accountancy firm EIN2012-08-31134008324
2011 : NORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-08-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-08-31$4,147,378
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-08-31$2,354,776
Total income from all sources (including contributions)2011-08-31$47,245,901
Total loss/gain on sale of assets2011-08-31$0
Total of all expenses incurred2011-08-31$51,367,779
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-08-31$48,753,156
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-08-31$46,961,665
Value of total assets at end of year2011-08-31$23,736,767
Value of total assets at beginning of year2011-08-31$26,066,043
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-08-31$2,614,623
Total interest from all sources2011-08-31$0
Total dividends received (eg from common stock, registered investment company shares)2011-08-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-08-31No
Administrative expenses professional fees incurred2011-08-31$38,624
Was this plan covered by a fidelity bond2011-08-31Yes
Value of fidelity bond cover2011-08-31$10,000,000
Were there any nonexempt tranactions with any party-in-interest2011-08-31No
Contributions received from participants2011-08-31$13,505,893
Participant contributions at end of year2011-08-31$262,741
Participant contributions at beginning of year2011-08-31$343,424
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-08-31$474,354
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-08-31$469,271
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-08-31$474,610
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-08-31$132,489
Other income not declared elsewhere2011-08-31$223,592
Administrative expenses (other) incurred2011-08-31$1,230,398
Liabilities. Value of operating payables at end of year2011-08-31$209,496
Liabilities. Value of operating payables at beginning of year2011-08-31$182,558
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-08-31No
Value of net income/loss2011-08-31$-4,121,878
Value of net assets at end of year (total assets less liabilities)2011-08-31$19,589,389
Value of net assets at beginning of year (total assets less liabilities)2011-08-31$23,711,267
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-08-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-08-31No
Were any leases to which the plan was party in default or uncollectible2011-08-31No
Investment advisory and management fees2011-08-31$83,159
Value of interest in common/collective trusts at end of year2011-08-31$22,988,050
Value of interest in common/collective trusts at beginning of year2011-08-31$25,249,410
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2011-08-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2011-08-31$0
Expenses. Payments to insurance carriers foe the provision of benefits2011-08-31$588,422
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-08-31$255,552
Net investment gain/loss from pooled separate accounts2011-08-31$28,684
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-08-31Yes
Was there a failure to transmit to the plan any participant contributions2011-08-31No
Has the plan failed to provide any benefit when due under the plan2011-08-31No
Contributions received in cash from employer2011-08-31$33,455,772
Employer contributions (assets) at end of year2011-08-31$11,622
Employer contributions (assets) at beginning of year2011-08-31$3,938
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-08-31$48,164,734
Contract administrator fees2011-08-31$2,492,840
Liabilities. Value of benefit claims payable at end of year2011-08-31$3,463,272
Liabilities. Value of benefit claims payable at beginning of year2011-08-31$2,039,729
Did the plan have assets held for investment2011-08-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-08-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-08-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-08-31Yes
Opinion of an independent qualified public accountant for this plan2011-08-31Disclaimer
Accountancy firm name2011-08-31PRICE WATERHOUSE COOPERS, LLP
Accountancy firm EIN2011-08-31134008324

Form 5500 Responses for NORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN

2017: NORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN 2017 form 5500 responses
2017-09-01Type of plan entitySingle employer plan
2017-09-01Submission has been amendedNo
2017-09-01This submission is the final filingYes
2017-09-01This return/report is a short plan year return/report (less than 12 months)Yes
2017-09-01Plan is a collectively bargained planYes
2017-09-01Plan funding arrangement – InsuranceYes
2017-09-01Plan funding arrangement – TrustYes
2017-09-01Plan benefit arrangement – InsuranceYes
2017-09-01Plan benefit arrangement - TrustYes
2016: NORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN 2016 form 5500 responses
2016-09-01Type of plan entitySingle employer plan
2016-09-01Submission has been amendedNo
2016-09-01This submission is the final filingNo
2016-09-01This return/report is a short plan year return/report (less than 12 months)No
2016-09-01Plan is a collectively bargained planYes
2016-09-01Plan funding arrangement – InsuranceYes
2016-09-01Plan funding arrangement – TrustYes
2016-09-01Plan benefit arrangement – InsuranceYes
2016-09-01Plan benefit arrangement - TrustYes
2015: NORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN 2015 form 5500 responses
2015-09-01Type of plan entitySingle employer plan
2015-09-01Submission has been amendedNo
2015-09-01This submission is the final filingNo
2015-09-01This return/report is a short plan year return/report (less than 12 months)No
2015-09-01Plan is a collectively bargained planYes
2015-09-01Plan funding arrangement – InsuranceYes
2015-09-01Plan funding arrangement – TrustYes
2015-09-01Plan benefit arrangement – InsuranceYes
2015-09-01Plan benefit arrangement - TrustYes
2014: NORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN 2014 form 5500 responses
2014-09-01Type of plan entitySingle employer plan
2014-09-01Submission has been amendedNo
2014-09-01This submission is the final filingNo
2014-09-01This return/report is a short plan year return/report (less than 12 months)No
2014-09-01Plan is a collectively bargained planYes
2014-09-01Plan funding arrangement – InsuranceYes
2014-09-01Plan funding arrangement – TrustYes
2014-09-01Plan benefit arrangement – InsuranceYes
2014-09-01Plan benefit arrangement - TrustYes
2013: NORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN 2013 form 5500 responses
2013-09-01Type of plan entitySingle employer plan
2013-09-01Submission has been amendedNo
2013-09-01This submission is the final filingNo
2013-09-01This return/report is a short plan year return/report (less than 12 months)No
2013-09-01Plan is a collectively bargained planNo
2013-09-01Plan funding arrangement – InsuranceYes
2013-09-01Plan funding arrangement – TrustYes
2013-09-01Plan benefit arrangement – InsuranceYes
2013-09-01Plan benefit arrangement - TrustYes
2012: NORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN 2012 form 5500 responses
2012-09-01Type of plan entitySingle employer plan
2012-09-01Submission has been amendedNo
2012-09-01This submission is the final filingNo
2012-09-01This return/report is a short plan year return/report (less than 12 months)No
2012-09-01Plan is a collectively bargained planNo
2012-09-01Plan funding arrangement – InsuranceYes
2012-09-01Plan funding arrangement – TrustYes
2012-09-01Plan benefit arrangement – InsuranceYes
2012-09-01Plan benefit arrangement - TrustYes
2011: NORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN 2011 form 5500 responses
2011-09-01Type of plan entitySingle employer plan
2011-09-01Submission has been amendedYes
2011-09-01This submission is the final filingNo
2011-09-01This return/report is a short plan year return/report (less than 12 months)No
2011-09-01Plan is a collectively bargained planNo
2011-09-01Plan funding arrangement – TrustYes
2011-09-01Plan benefit arrangement – InsuranceYes
2011-09-01Plan benefit arrangement - TrustYes
2009: NORTHWESTERN UNIVERSITY MEDICAL HOSPITALIZATION INSURANCE PLAN 2009 form 5500 responses
2009-09-01Type of plan entitySingle employer plan
2009-09-01Submission has been amendedYes
2009-09-01This submission is the final filingNo
2009-09-01This return/report is a short plan year return/report (less than 12 months)No
2009-09-01Plan is a collectively bargained planNo
2009-09-01Plan funding arrangement – TrustYes
2009-09-01Plan benefit arrangement – InsuranceYes
2009-09-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number16-012736-000
Policy instance 1
Insurance contract or identification number16-012736-000
Number of Individuals Covered8755
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $33,187
Total amount of fees paid to insurance companyUSD $9,379
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 BenefitNo
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 $663,748
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number16-012736-000
Policy instance 1
Insurance contract or identification number16-012736-000
Number of Individuals Covered7901
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $30,881
Total amount of fees paid to insurance companyUSD $8,155
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 BenefitNo
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 $617,618
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,881
Amount paid for insurance broker fees8155
Additional information about fees paid to insurance brokerGROUP VOLUME BONUS
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS LLC
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number06161
Policy instance 1
Insurance contract or identification number06161
Number of Individuals Covered12451
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 $16,557
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 BenefitNo
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 $677,666
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees16557
Additional information about fees paid to insurance brokerSPECIAL PROGRAMS
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS LLC
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number006161
Policy instance 1
Insurance contract or identification number006161
Number of Individuals Covered12278
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $20,900
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 BenefitNo
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 $603,294
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees20900
Additional information about fees paid to insurance brokerSPECIAL PROGRAMS
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS LLC
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number006161
Policy instance 1
Insurance contract or identification number006161
Number of Individuals Covered11555
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 $21,231
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 BenefitNo
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 $469,016
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees21231
Additional information about fees paid to insurance brokerSPECIAL PROGRAMS
Insurance broker organization code?3
Insurance broker nameMERCER HEALTH & BENEFITS LLC
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number90161
Policy instance 1
Insurance contract or identification number90161
Number of Individuals Covered10802
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $21,287
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 $740,778
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number90161
Policy instance 1
Insurance contract or identification number90161
Number of Individuals Covered9858
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $39,505
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 $364,798

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