401k Plan data: PEARSON RETIREE MEDICAL PLAN plan

PEARSON RETIREE MEDICAL PLAN 401k Plan overview

Plan Name	PEARSON RETIREE MEDICAL PLAN
Plan identification number	515

PEARSON RETIREE MEDICAL PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision)

401k Sponsoring company profile

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

Company Name: PEARSON INC.

Employer identification number (EIN): 510261654

NAIC Classification: 511130
NAIC Description: Book Publishers

Additional information about PEARSON INC.

Jurisdiction of Incorporation: California Department of State

Incorporation Date: 2014-11-21

Company Identification Number: C3729157

Legal Registered Office Address: 10641 Willow Glen Cir

Stockton
United States of America (USA)
95209

More information about PEARSON INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PEARSON RETIREE MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
515 2017-01-01 STACEY RODGERS
515 2016-01-01 STACEY RODGERS
515 2015-01-01 STACEY RODGERS
515 2014-01-01 ROBERT B. ARTHUR
515 2013-01-01 ROBERT ARTHUR ROBERT ARTHUR 2014-07-28
515 2012-01-01 ROBERT B. ARTHUR
515 2011-01-01 ROBERT ARTHUR

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
515	2017-01-01	STACEY RODGERS
515	2016-01-01	STACEY RODGERS
515	2015-01-01	STACEY RODGERS
515	2014-01-01	ROBERT B. ARTHUR
515	2013-01-01	ROBERT ARTHUR	ROBERT ARTHUR	2014-07-28
515	2012-01-01	ROBERT B. ARTHUR
515	2011-01-01	ROBERT ARTHUR

Plan Statistics for PEARSON RETIREE MEDICAL PLAN

401k plan membership statisitcs for PEARSON RETIREE MEDICAL PLAN

Measure Date Value
2017: PEARSON RETIREE MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 1,137
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 1,088
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 1,088
2016: PEARSON RETIREE MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 1,231
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 1,159
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 1,159
2015: PEARSON RETIREE MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 1,293
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 0
Number of retired or separated participants receiving benefits 2015-01-01 1,217
Number of other retired or separated participants entitled to future benefits 2015-01-01 19
Total of all active and inactive participants 2015-01-01 1,236
2014: PEARSON RETIREE MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 1,323
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 0
Number of retired or separated participants receiving benefits 2014-01-01 1,261
Number of other retired or separated participants entitled to future benefits 2014-01-01 34
Total of all active and inactive participants 2014-01-01 1,295
2013: PEARSON RETIREE MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1,332
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 0
Number of retired or separated participants receiving benefits 2013-01-01 1,304
Total of all active and inactive participants 2013-01-01 1,304
2012: PEARSON RETIREE MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1,406
Number of retired or separated participants receiving benefits 2012-01-01 1,340
Total of all active and inactive participants 2012-01-01 1,340
2011: PEARSON RETIREE MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,622
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 0
Number of retired or separated participants receiving benefits 2011-01-01 1,406
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 1,406

Measure	Date	Value
2017: PEARSON RETIREE MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	1,137
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	1,088
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	1,088
2016: PEARSON RETIREE MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	1,231
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	1,159
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	1,159
2015: PEARSON RETIREE MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	1,293
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	0
Number of retired or separated participants receiving benefits	2015-01-01	1,217
Number of other retired or separated participants entitled to future benefits	2015-01-01	19
Total of all active and inactive participants	2015-01-01	1,236
2014: PEARSON RETIREE MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	1,323
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	0
Number of retired or separated participants receiving benefits	2014-01-01	1,261
Number of other retired or separated participants entitled to future benefits	2014-01-01	34
Total of all active and inactive participants	2014-01-01	1,295
2013: PEARSON RETIREE MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,332
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	0
Number of retired or separated participants receiving benefits	2013-01-01	1,304
Total of all active and inactive participants	2013-01-01	1,304
2012: PEARSON RETIREE MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,406
Number of retired or separated participants receiving benefits	2012-01-01	1,340
Total of all active and inactive participants	2012-01-01	1,340
2011: PEARSON RETIREE MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,622
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	0
Number of retired or separated participants receiving benefits	2011-01-01	1,406
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	1,406

Form 5500 Responses for PEARSON RETIREE MEDICAL PLAN

2017: PEARSON RETIREE MEDICAL PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: PEARSON RETIREE MEDICAL PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: PEARSON RETIREE MEDICAL PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: PEARSON RETIREE MEDICAL PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: PEARSON RETIREE MEDICAL PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: PEARSON RETIREE MEDICAL PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: PEARSON RETIREE MEDICAL PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 )

Policy contract number

94120

Policy instance

Insurance contract or identification number	94120
Number of Individuals Covered	7
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	MEDICARE ADVANTAGE PRIVATE FEE FOR SERVICE
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 Carrier	USD $26,306
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

Potentially related plans

PEARSON RETIREE MEDICAL PLAN [EIN = 221603684]

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Company Name:	PEARSON INC.
Employer identification number (EIN):	510261654
NAIC Classification:	511130
NAIC Description:	Book Publishers

Jurisdiction of Incorporation:	California Department of State
Incorporation Date:	2014-11-21
Company Identification Number:	C3729157
Legal Registered Office Address:	10641 Willow Glen Cir Stockton United States of America (USA) 95209