401k Plan data: INDEPENDENCE MISSION SCHOOLS EMPLOYEE BENEFIT PLAN plan

INDEPENDENCE MISSION SCHOOLS EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan Name	INDEPENDENCE MISSION SCHOOLS EMPLOYEE BENEFIT PLAN
Plan identification number	510

INDEPENDENCE MISSION SCHOOLS EMPLOYEE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Other welfare benefit cover

401k Sponsoring company profile

PHILADELPHIA INDEPENDENT MISSION SCHOOLS has sponsored the creation of one or more 401k plans.

Company Name: PHILADELPHIA INDEPENDENT MISSION SCHOOLS

Employer identification number (EIN): 454720688

NAIC Classification: 611000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan INDEPENDENCE MISSION SCHOOLS EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
510 2016-07-01
510 2015-07-01 RICHARD MILLER
510 2014-07-01 RICHARD MILLER
510 2013-07-01 ANNE MCGOLDRICK

Plan Statistics for INDEPENDENCE MISSION SCHOOLS EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for INDEPENDENCE MISSION SCHOOLS EMPLOYEE BENEFIT PLAN

Measure Date Value
2016: INDEPENDENCE MISSION SCHOOLS EMPLOYEE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-07-01 392
Total number of active participants reported on line 7a of the Form 5500 2016-07-01 439
Number of retired or separated participants receiving benefits 2016-07-01 0
Number of other retired or separated participants entitled to future benefits 2016-07-01 0
Total of all active and inactive participants 2016-07-01 439
2015: INDEPENDENCE MISSION SCHOOLS EMPLOYEE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 301
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 392
Number of retired or separated participants receiving benefits 2015-07-01 0
Number of other retired or separated participants entitled to future benefits 2015-07-01 0
Total of all active and inactive participants 2015-07-01 392
2014: INDEPENDENCE MISSION SCHOOLS EMPLOYEE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-07-01 289
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 301
Number of retired or separated participants receiving benefits 2014-07-01 0
Number of other retired or separated participants entitled to future benefits 2014-07-01 0
Total of all active and inactive participants 2014-07-01 301
2013: INDEPENDENCE MISSION SCHOOLS EMPLOYEE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-07-01 29
Total number of active participants reported on line 7a of the Form 5500 2013-07-01 185
Number of retired or separated participants receiving benefits 2013-07-01 0
Number of other retired or separated participants entitled to future benefits 2013-07-01 0
Total of all active and inactive participants 2013-07-01 185

Measure	Date	Value
2016: INDEPENDENCE MISSION SCHOOLS EMPLOYEE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-07-01	392
Total number of active participants reported on line 7a of the Form 5500	2016-07-01	439
Number of retired or separated participants receiving benefits	2016-07-01	0
Number of other retired or separated participants entitled to future benefits	2016-07-01	0
Total of all active and inactive participants	2016-07-01	439
2015: INDEPENDENCE MISSION SCHOOLS EMPLOYEE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	301
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	392
Number of retired or separated participants receiving benefits	2015-07-01	0
Number of other retired or separated participants entitled to future benefits	2015-07-01	0
Total of all active and inactive participants	2015-07-01	392
2014: INDEPENDENCE MISSION SCHOOLS EMPLOYEE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-07-01	289
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	301
Number of retired or separated participants receiving benefits	2014-07-01	0
Number of other retired or separated participants entitled to future benefits	2014-07-01	0
Total of all active and inactive participants	2014-07-01	301
2013: INDEPENDENCE MISSION SCHOOLS EMPLOYEE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-07-01	29
Total number of active participants reported on line 7a of the Form 5500	2013-07-01	185
Number of retired or separated participants receiving benefits	2013-07-01	0
Number of other retired or separated participants entitled to future benefits	2013-07-01	0
Total of all active and inactive participants	2013-07-01	185

Form 5500 Responses for INDEPENDENCE MISSION SCHOOLS EMPLOYEE BENEFIT PLAN

2016: INDEPENDENCE MISSION SCHOOLS EMPLOYEE BENEFIT PLAN 2016 form 5500 responses
2016-07-01	Type of plan entity	Single employer plan
2016-07-01	Submission has been amended	No
2016-07-01	This submission is the final filing	No
2016-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-07-01	Plan is a collectively bargained plan	No
2016-07-01	Plan funding arrangement – Insurance	Yes
2016-07-01	Plan benefit arrangement – Insurance	Yes
2015: INDEPENDENCE MISSION SCHOOLS EMPLOYEE BENEFIT PLAN 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	Submission has been amended	No
2015-07-01	This submission is the final filing	No
2015-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-07-01	Plan is a collectively bargained plan	No
2015-07-01	Plan funding arrangement – Insurance	Yes
2015-07-01	Plan benefit arrangement – Insurance	Yes
2014: INDEPENDENCE MISSION SCHOOLS EMPLOYEE BENEFIT PLAN 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	Submission has been amended	No
2014-07-01	This submission is the final filing	No
2014-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-07-01	Plan is a collectively bargained plan	No
2014-07-01	Plan funding arrangement – Insurance	Yes
2014-07-01	Plan benefit arrangement – Insurance	Yes
2013: INDEPENDENCE MISSION SCHOOLS EMPLOYEE BENEFIT PLAN 2013 form 5500 responses
2013-07-01	Type of plan entity	Single employer plan
2013-07-01	First time form 5500 has been submitted	Yes
2013-07-01	Submission has been amended	No
2013-07-01	This submission is the final filing	No
2013-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-07-01	Plan is a collectively bargained plan	No
2013-07-01	Plan funding arrangement – Insurance	Yes
2013-07-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 )
Policy contract number	1718602
Policy instance	1
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number	5468094
Policy instance	2
KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 )
Policy contract number	1718602
Policy instance	2
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number	5468094
Policy instance	1
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number	5468094
Policy instance	1
KEYSTONE HEALTH PLAN EAST (National Association of Insurance Commissioners NAIC id number: 95056 )
Policy contract number	0001718602
Policy instance	2
AMERIHEALTH HMO, INC. (National Association of Insurance Commissioners NAIC id number: 95044 )
Policy contract number	0001718602
Policy instance	3

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Company Name:	PHILADELPHIA INDEPENDENT MISSION SCHOOLS
Employer identification number (EIN):	454720688
NAIC Classification:	611000

Plan id#	Filing Submission Date	Name of Administrator
510	2016-07-01
510	2015-07-01	RICHARD MILLER
510	2014-07-01	RICHARD MILLER
510	2013-07-01	ANNE MCGOLDRICK