401k Plan data: RTI INTERNATIONAL METALS, INC WELFARE BENEFIT PLAN plan

RTI INTERNATIONAL METALS, INC WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	RTI INTERNATIONAL METALS, INC WELFARE BENEFIT PLAN
Plan identification number	501

RTI INTERNATIONAL METALS, INC WELFARE 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

401k Sponsoring company profile

RTI INTERNATIONAL METALS, INC. has sponsored the creation of one or more 401k plans.

Company Name: RTI INTERNATIONAL METALS, INC.

Employer identification number (EIN): 522115953

NAIC Classification: 551112
NAIC Description: Offices of Other Holding Companies

Additional information about RTI INTERNATIONAL METALS, INC.

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division

Incorporation Date: 1997-12-08

Company Identification Number: 998766

Legal Registered Office Address: 50 W. BROAD ST
SUITE 1800
COLUMBUS
United States of America (USA)
43215

More information about RTI INTERNATIONAL METALS, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan RTI INTERNATIONAL METALS, INC WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2016-01-01 SCOTT M ZAHORCHAK SCOTT M ZAHORCHAK 2017-10-11
501 2015-01-01 JOHN KENNA JOHN KENNA 2016-10-13
501 2014-01-01 JOHN KENNA JOHN KENNA 2015-10-05
501 2013-01-01 DARCY KISH JUDITH WATTS 2014-10-13
501 2012-01-01 MICHAEL B. SHAUGHNESSY JOHN ROWLAND 2013-10-14
501 2011-01-01 MICHAEL B. SHAUGHNESSY JOHN ROWLAND 2012-10-11
501 2010-01-01 MICHAEL B. SHAUGHNESSY JOHN ROWLAND 2011-10-12
501 2009-01-01 MICHAEL B. SHAUGHNESSY JOHN ROWLAND 2010-10-12

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2016-01-01	SCOTT M ZAHORCHAK	SCOTT M ZAHORCHAK	2017-10-11
501	2015-01-01	JOHN KENNA	JOHN KENNA	2016-10-13
501	2014-01-01	JOHN KENNA	JOHN KENNA	2015-10-05
501	2013-01-01	DARCY KISH	JUDITH WATTS	2014-10-13
501	2012-01-01	MICHAEL B. SHAUGHNESSY	JOHN ROWLAND	2013-10-14
501	2011-01-01	MICHAEL B. SHAUGHNESSY	JOHN ROWLAND	2012-10-11
501	2010-01-01	MICHAEL B. SHAUGHNESSY	JOHN ROWLAND	2011-10-12
501	2009-01-01	MICHAEL B. SHAUGHNESSY	JOHN ROWLAND	2010-10-12

Plan Statistics for RTI INTERNATIONAL METALS, INC WELFARE BENEFIT PLAN

401k plan membership statisitcs for RTI INTERNATIONAL METALS, INC WELFARE BENEFIT PLAN

Measure Date Value
2016: RTI INTERNATIONAL METALS, INC WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 1,447
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
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 0
2015: RTI INTERNATIONAL METALS, INC WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 1,450
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 1,209
Number of retired or separated participants receiving benefits 2015-01-01 238
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 1,447
2014: RTI INTERNATIONAL METALS, INC WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 986
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 1,244
Number of retired or separated participants receiving benefits 2014-01-01 206
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 1,450
2013: RTI INTERNATIONAL METALS, INC WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1,023
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 784
Number of retired or separated participants receiving benefits 2013-01-01 202
Total of all active and inactive participants 2013-01-01 986
2012: RTI INTERNATIONAL METALS, INC WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 902
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 806
Number of retired or separated participants receiving benefits 2012-01-01 217
Total of all active and inactive participants 2012-01-01 1,023
2011: RTI INTERNATIONAL METALS, INC WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,002
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 725
Number of retired or separated participants receiving benefits 2011-01-01 177
Total of all active and inactive participants 2011-01-01 902
2010: RTI INTERNATIONAL METALS, INC WELFARE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 1,258
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 822
Number of retired or separated participants receiving benefits 2010-01-01 180
Total of all active and inactive participants 2010-01-01 1,002
2009: RTI INTERNATIONAL METALS, INC WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 486
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 434
Total of all active and inactive participants 2009-01-01 434

Measure	Date	Value
2016: RTI INTERNATIONAL METALS, INC WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	1,447
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
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	0
2015: RTI INTERNATIONAL METALS, INC WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	1,450
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	1,209
Number of retired or separated participants receiving benefits	2015-01-01	238
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	1,447
2014: RTI INTERNATIONAL METALS, INC WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	986
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	1,244
Number of retired or separated participants receiving benefits	2014-01-01	206
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	1,450
2013: RTI INTERNATIONAL METALS, INC WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,023
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	784
Number of retired or separated participants receiving benefits	2013-01-01	202
Total of all active and inactive participants	2013-01-01	986
2012: RTI INTERNATIONAL METALS, INC WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	902
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	806
Number of retired or separated participants receiving benefits	2012-01-01	217
Total of all active and inactive participants	2012-01-01	1,023
2011: RTI INTERNATIONAL METALS, INC WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,002
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	725
Number of retired or separated participants receiving benefits	2011-01-01	177
Total of all active and inactive participants	2011-01-01	902
2010: RTI INTERNATIONAL METALS, INC WELFARE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	1,258
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	822
Number of retired or separated participants receiving benefits	2010-01-01	180
Total of all active and inactive participants	2010-01-01	1,002
2009: RTI INTERNATIONAL METALS, INC WELFARE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	486
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	434
Total of all active and inactive participants	2009-01-01	434

Form 5500 Responses for RTI INTERNATIONAL METALS, INC WELFARE BENEFIT PLAN

2016: RTI INTERNATIONAL METALS, INC WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	This submission is the final filing	Yes
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: RTI INTERNATIONAL METALS, INC WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: RTI INTERNATIONAL METALS, INC WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: RTI INTERNATIONAL METALS, INC WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: RTI INTERNATIONAL METALS, INC WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: RTI INTERNATIONAL METALS, INC WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: RTI INTERNATIONAL METALS, INC WELFARE BENEFIT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: RTI INTERNATIONAL METALS, INC WELFARE BENEFIT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )

Policy contract number

GF388003546601

Policy instance

Insurance contract or identification number	GF388003546601
Number of Individuals Covered	1363
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $18,331
Total amount of fees paid to insurance company	USD $3,014
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $266,631
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $18,331
Amount paid for insurance broker fees	3014
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3
Insurance broker name	TENTH DOT BENEFIT SOLUTIONS, LLC

COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )

Policy contract number

000003852

Policy instance

Insurance contract or identification number	000003852
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $122
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )

Policy contract number

00081588

Policy instance

Insurance contract or identification number	00081588
Number of Individuals Covered	39
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $2,580
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $111,417
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,580
Insurance broker organization code?	3
Insurance broker name	COMMUNITY INSURANCE COMPANY

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

33951-G

Policy instance

Insurance contract or identification number	33951-G
Number of Individuals Covered	1366
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $16,480
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $235,427
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $16,480
Insurance broker organization code?	3
Insurance broker name	TENTH DOT BENEFITS SOLUTIONS LLC

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

33951-G

Policy instance

Insurance contract or identification number	33951-G
Number of Individuals Covered	764
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $12,355
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $176,506
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $12,355
Insurance broker organization code?	3
Insurance broker name	TENTH DOT BENEFITS SOLUTIONS LLC

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

34340

Policy instance

Insurance contract or identification number	34340
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $23
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $327
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $23
Insurance broker organization code?	3
Insurance broker name	TENTH DOT BENEFITS SOLUTIONS LLC

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

33951-G

Policy instance

Insurance contract or identification number	33951-G
Number of Individuals Covered	763
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $7,874
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $112,488
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,874
Insurance broker organization code?	3
Insurance broker name	TENTH DOT BENEFITS SOLUTIONS LLC

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

33951-G

Policy instance

Insurance contract or identification number	33951-G
Number of Individuals Covered	1188
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $13,429
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $191,847
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,429
Insurance broker organization code?	3
Insurance broker name	TENTH DOT BENEFITS SOLUTIONS LLC

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )

Policy contract number

GF388003546601

Policy instance

Insurance contract or identification number	GF388003546601
Number of Individuals Covered	856
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $13,883
Total amount of fees paid to insurance company	USD $1,983
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $198,300
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,883
Amount paid for insurance broker fees	1983
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3
Insurance broker name	TENTH DOT BENEFIT SOLUTIONS, LLC

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )

Policy contract number

PD3-88003546604

Policy instance

Insurance contract or identification number	PD3-88003546604
Number of Individuals Covered	725
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $1,807
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $25,773
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,807
Insurance broker organization code?	3
Insurance broker name	TENTH DOT BENEFIT SOLUTIONS, LLC

COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )

Policy contract number

000003852

Policy instance

Insurance contract or identification number	000003852
Number of Individuals Covered	1410
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $9,914
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $665,822
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,820
Insurance broker organization code?	3
Insurance broker name	AON RISK SERVICES NORTHEAST INC.

COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )

Policy contract number

00081588

Policy instance

Insurance contract or identification number	00081588
Number of Individuals Covered	40
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $105,102
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )

Policy contract number

GF388003546601

Policy instance

Insurance contract or identification number	GF388003546601
Number of Individuals Covered	886
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $13,722
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $180,123
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,722
Insurance broker organization code?	3
Insurance broker name	TENTH DOT BENEFIT SOLUTIONS

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

33951-G

Policy instance

Insurance contract or identification number	33951-G
Number of Individuals Covered	405
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $6,044
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $86,342
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,044
Insurance broker organization code?	3
Insurance broker name	TENTH DOT BENEFITS SOLUTIONS LLC

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

33951-G

Policy instance

Insurance contract or identification number	33951-G
Number of Individuals Covered	906
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $12,476
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $178,235
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $12,476
Insurance broker organization code?	3
Insurance broker name	TENTH DOT BENEFITS SOLUTIONS LLC

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )

Policy contract number

PD3-88003546601

Policy instance

Insurance contract or identification number	PD3-88003546601
Number of Individuals Covered	763
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $1,872
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $24,486
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,872
Insurance broker organization code?	3
Insurance broker name	TENTH DOT BENEFIT SOLUTIONS

COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )

Policy contract number

00081588

Policy instance

Insurance contract or identification number	00081588
Number of Individuals Covered	35
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $85,789
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )

Policy contract number

000003852

Policy instance

Insurance contract or identification number	000003852
Number of Individuals Covered	948
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $14,108
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $331,756
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,108
Insurance broker organization code?	3
Insurance broker name	MERCER HEALTH & BENEFITS LLC

COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )

Policy contract number

000003852

Policy instance

Insurance contract or identification number	000003852
Number of Individuals Covered	982
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $13,455
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $272,904
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,455
Insurance broker organization code?	3
Insurance broker name	MERCER HEALTH & BENEFITS LLC

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

33951-G

Policy instance

Insurance contract or identification number	33951-G
Number of Individuals Covered	400
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $5,918
Other welfare benefits provided	GROUP LIFE INS PLAN - SUPPLEMENTAL
Welfare Benefit Premiums Paid to Carrier	USD $84,536
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,918
Insurance broker organization code?	3
Insurance broker name	TENTH DOT BENEFITS SOLUTIONS LLC

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

33951-G

Policy instance

Insurance contract or identification number	33951-G
Number of Individuals Covered	905
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $11,466
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $163,796
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $11,466
Insurance broker organization code?	3
Insurance broker name	TENTH DOT BENEFITS SOLUTIONS LLC

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )

Policy contract number

GF388003546601

Policy instance

Insurance contract or identification number	GF388003546601
Number of Individuals Covered	901
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $11,504
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $180,237
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $11,504
Insurance broker organization code?	3
Insurance broker name	TENTH DOT BENEFIT SOLUTIONS

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )

Policy contract number

PD3-88003546601

Policy instance

Insurance contract or identification number	PD3-88003546601
Number of Individuals Covered	794
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $1,705
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $26,643
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,705
Insurance broker organization code?	3
Insurance broker name	TENTH DOT BENEFIT SOLUTIONS

COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )

Policy contract number

00081588

Policy instance

Insurance contract or identification number	00081588
Number of Individuals Covered	41
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $86,884
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

645557

Policy instance

Insurance contract or identification number	645557
Number of Individuals Covered	705
Insurance policy start date	2011-01-01
Insurance policy end date	2011-05-31
Total amount of commissions paid to insurance broker	USD $6,197
Long Term Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )

Policy contract number

00081588

Policy instance

Insurance contract or identification number	00081588
Number of Individuals Covered	48
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $94,105
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

645557

Policy instance

Insurance contract or identification number	645557
Number of Individuals Covered	895
Insurance policy start date	2011-01-01
Insurance policy end date	2011-05-31
Total amount of commissions paid to insurance broker	USD $7,118
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )

Policy contract number

PD3-88003546601

Policy instance

Insurance contract or identification number	PD3-88003546601
Number of Individuals Covered	721
Insurance policy start date	2011-06-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $983
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $14,040
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIBERTY LIFE ASSURANCE COMPANY OF BOSTON (National Association of Insurance Commissioners NAIC id number: 65315 )

Policy contract number

GF388003546601

Policy instance

Insurance contract or identification number	GF388003546601
Number of Individuals Covered	823
Insurance policy start date	2011-06-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $8,189
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $94,445
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

33951-G

Policy instance

Insurance contract or identification number	33951-G
Number of Individuals Covered	853
Insurance policy start date	2011-06-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $8,989
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $87,261
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

645556

Policy instance

Insurance contract or identification number	645556
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Temporary Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )

Policy contract number

000003852

Policy instance

Insurance contract or identification number	000003852
Number of Individuals Covered	854
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $176
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $239,754
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

33951-G

Policy instance

Insurance contract or identification number	33951-G
Number of Individuals Covered	427
Insurance policy start date	2011-06-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $4,890
Other welfare benefits provided	SUPPLEMENTAL LIFE INSURANCE
Welfare Benefit Premiums Paid to Carrier	USD $47,466
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )

Policy contract number

00081588

Policy instance

Insurance contract or identification number	00081588
Number of Individuals Covered	49
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $90,531
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

TM05599355

Policy instance

Insurance contract or identification number	TM05599355
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $96
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

645556

Policy instance

Insurance contract or identification number	645556
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Temporary Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

645557

Policy instance

Insurance contract or identification number	645557
Number of Individuals Covered	684
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $11,043
Long Term Disability Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

645557

Policy instance

Insurance contract or identification number	645557
Number of Individuals Covered	1062
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $12,046
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )

Policy contract number

001003366

Policy instance

Insurance contract or identification number	001003366
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $5,899
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,183
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )

Policy contract number

000003852

Policy instance

Insurance contract or identification number	000003852
Number of Individuals Covered	953
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $215
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $241,590
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

Potentially related plans

RTI INTERNATIONAL RETIREE HEALTH PLAN [EIN = 560686338]

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Company Name:	RTI INTERNATIONAL METALS, INC.
Employer identification number (EIN):	522115953
NAIC Classification:	551112
NAIC Description:	Offices of Other Holding Companies

Jurisdiction of Incorporation:	Ohio Secretary of State Business Services Division
Incorporation Date:	1997-12-08
Company Identification Number:	998766
Legal Registered Office Address:	50 W. BROAD ST SUITE 1800 COLUMBUS United States of America (USA) 43215