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| Plan Name | KECK MEDICINE OF USC COMMUNITY EMPLOYEE HEALTH & WELFARE BENEFIT PLAN |
| Plan identification number | 528 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | UNIVERSITY OF SOUTHERN CALIFORNIA |
| Employer identification number (EIN): | 951642394 |
| NAIC Classification: | 611000 |
Additional information about UNIVERSITY OF SOUTHERN CALIFORNIA
| Jurisdiction of Incorporation: | California Department of State |
| Incorporation Date: | |
| Company Identification Number: | C0024916 |
More information about UNIVERSITY OF SOUTHERN CALIFORNIA
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 528 | 2024-01-01 | ERIK BRINK | |||
| 528 | 2023-01-01 | ||||
| 528 | 2023-01-01 | ERIK BRINK | |||
| 528 | 2022-01-01 | ||||
| 528 | 2022-01-01 | ERIK BRINK |
| Measure | Date | Value |
|---|---|---|
| 2023: KECK MEDICINE OF USC COMMUNITY EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2023 401k membership | ||
| Total participants, beginning-of-year | 2023-01-01 | 829 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-01-01 | 1,092 |
| Number of retired or separated participants receiving benefits | 2023-01-01 | 4 |
| Total of all active and inactive participants | 2023-01-01 | 1,096 |
| Total participants | 2023-01-01 | 1,096 |
| 2022: KECK MEDICINE OF USC COMMUNITY EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-01-01 | 737 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 803 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 26 |
| Total of all active and inactive participants | 2022-01-01 | 829 |
| Total participants | 2022-01-01 | 829 |
| 2023: KECK MEDICINE OF USC COMMUNITY EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2023 form 5500 responses | ||
|---|---|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Submission has been amended | No |
| 2023-01-01 | This submission is the final filing | No |
| 2023-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2023-01-01 | Plan is a collectively bargained plan | No |
| 2023-01-01 | Plan funding arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: KECK MEDICINE OF USC COMMUNITY EMPLOYEE HEALTH & WELFARE BENEFIT PLAN 2022 form 5500 responses | ||
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Submission has been amended | Yes |
| 2022-01-01 | This submission is the final filing | No |
| 2022-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-01-01 | Plan is a collectively bargained plan | No |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | E7079346 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
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| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 30016721 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
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| ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. (National Association of Insurance Commissioners NAIC id number: 11011 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 196964 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
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| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 768475G | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 4 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| |||||||||||||||||||||||||||||||||||||||||||||||||||||
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 30016721 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | E7079346 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. (National Association of Insurance Commissioners NAIC id number: 11011 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 196964 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 768475G | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 4 | ||||||||||||||||||||||||||||||||||||||||||||||||||||