401k Plan data: EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE plan

EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 401k Plan overview

Plan Name	EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE
Plan identification number	528

EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE Benefits

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

401k Sponsoring company profile

HARVEY MUDD COLLEGE has sponsored the creation of one or more 401k plans.

Company Name: HARVEY MUDD COLLEGE

Employer identification number (EIN): 951911219

NAIC Classification: 611000

Additional information about HARVEY MUDD COLLEGE

Jurisdiction of Incorporation: California Department of State

Incorporation Date:

Company Identification Number: C0313129

More information about HARVEY MUDD COLLEGE

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
528 2017-01-01 ANDREW DORANTES HEATHER CLARK 2018-03-10
528 2016-01-01 ANDREW DORANTES HEATHER CLARK 2017-10-16
528 2015-01-01 HEATHER CLARK
528 2014-01-01 HEATHER CLARK
528 2013-01-01 HEATHER CLARK
528 2012-01-01 HEATHER CLARK
528 2011-01-01 A BROWN A BROWN 2012-10-11
528 2009-01-01 SCOTT MARTIN

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
528	2017-01-01	ANDREW DORANTES	HEATHER CLARK	2018-03-10
528	2016-01-01	ANDREW DORANTES	HEATHER CLARK	2017-10-16
528	2015-01-01	HEATHER CLARK
528	2014-01-01	HEATHER CLARK
528	2013-01-01	HEATHER CLARK
528	2012-01-01	HEATHER CLARK
528	2011-01-01	A BROWN	A BROWN	2012-10-11
528	2009-01-01	SCOTT MARTIN

Plan Statistics for EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE

401k plan membership statisitcs for EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE

Measure Date Value
2017: EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 2017 401k membership
Total participants, beginning-of-year 2017-01-01 265
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 0
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 0
2016: EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 2016 401k membership
Total participants, beginning-of-year 2016-01-01 265
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 177
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 2016-01-01 177
2015: EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 2015 401k membership
Total participants, beginning-of-year 2015-01-01 387
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 188
Number of retired or separated participants receiving benefits 2015-01-01 79
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 267
2014: EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 2014 401k membership
Total participants, beginning-of-year 2014-01-01 380
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 331
Number of retired or separated participants receiving benefits 2014-01-01 56
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 387
2013: EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 2013 401k membership
Total participants, beginning-of-year 2013-01-01 359
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 325
Number of retired or separated participants receiving benefits 2013-01-01 55
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 380
2012: EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 2012 401k membership
Total participants, beginning-of-year 2012-01-01 315
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 313
Number of retired or separated participants receiving benefits 2012-01-01 45
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 358
2011: EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 2011 401k membership
Total participants, beginning-of-year 2011-01-01 349
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 305
Number of retired or separated participants receiving benefits 2011-01-01 51
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 356
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 356
Number of participants with account balances 2011-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 2009 401k membership
Total participants, beginning-of-year 2009-01-01 317
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 299
Number of retired or separated participants receiving benefits 2009-01-01 27
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 326
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 326
Number of participants with account balances 2009-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2017: EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 2017 401k membership
Total participants, beginning-of-year	2017-01-01	265
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	0
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	0
2016: EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 2016 401k membership
Total participants, beginning-of-year	2016-01-01	265
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	177
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	177
2015: EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 2015 401k membership
Total participants, beginning-of-year	2015-01-01	387
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	188
Number of retired or separated participants receiving benefits	2015-01-01	79
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	267
2014: EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 2014 401k membership
Total participants, beginning-of-year	2014-01-01	380
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	331
Number of retired or separated participants receiving benefits	2014-01-01	56
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	387
2013: EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 2013 401k membership
Total participants, beginning-of-year	2013-01-01	359
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	325
Number of retired or separated participants receiving benefits	2013-01-01	55
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	380
2012: EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 2012 401k membership
Total participants, beginning-of-year	2012-01-01	315
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	313
Number of retired or separated participants receiving benefits	2012-01-01	45
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	358
2011: EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 2011 401k membership
Total participants, beginning-of-year	2011-01-01	349
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	305
Number of retired or separated participants receiving benefits	2011-01-01	51
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	356
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	356
Number of participants with account balances	2011-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 2009 401k membership
Total participants, beginning-of-year	2009-01-01	317
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	299
Number of retired or separated participants receiving benefits	2009-01-01	27
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	326
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	326
Number of participants with account balances	2009-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE

Measure	Date	Value
2017 : EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 2017 401k financial data
Total transfer of assets from this plan	2017-07-31	$290,148
Total income from all sources (including contributions)	2017-07-31	$229
Total of all expenses incurred	2017-07-31	$20,950
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-07-31	$19,450
Value of total assets at beginning of year	2017-07-31	$310,869
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-07-31	$1,500
Total interest from all sources	2017-07-31	$229
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-07-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2017-07-31	$290,148
Administrative expenses professional fees incurred	2017-07-31	$1,500
Was this plan covered by a fidelity bond	2017-07-31	Yes
Value of fidelity bond cover	2017-07-31	$2,000,000
If this is an individual account plan, was there a blackout period	2017-07-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-07-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-07-31	No
Value of net income/loss	2017-07-31	$-20,721
Value of net assets at end of year (total assets less liabilities)	2017-07-31	$0
Value of net assets at beginning of year (total assets less liabilities)	2017-07-31	$310,869
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-07-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-07-31	No
Were any leases to which the plan was party in default or uncollectible	2017-07-31	No
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-07-31	$310,869
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-07-31	$229
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-07-31	No
Was there a failure to transmit to the plan any participant contributions	2017-07-31	No
Has the plan failed to provide any benefit when due under the plan	2017-07-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-07-31	$19,450
Did the plan have assets held for investment	2017-07-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-07-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-07-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-07-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-07-31	Disclaimer
Accountancy firm name	2017-07-31	INSERO & CO. CPAS, LLP
Accountancy firm EIN	2017-07-31	475324570
2016 : EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 2016 401k financial data
Total income from all sources (including contributions)	2016-12-31	$-41,348
Total of all expenses incurred	2016-12-31	$485,288
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$473,707
Value of total assets at end of year	2016-12-31	$310,869
Value of total assets at beginning of year	2016-12-31	$837,505
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$11,581
Total interest from all sources	2016-12-31	$3,027
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2016-12-31	$0
Administrative expenses professional fees incurred	2016-12-31	$11,581
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$2,000,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$-526,636
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$310,869
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$837,505
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$310,869
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$726,107
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$111,398
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$111,398
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2016-12-31	$3,027
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$-44,375
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$473,707
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	INSERO & CO. CPAS, LLP
Accountancy firm EIN	2016-12-31	475324570
2015 : EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$149,654
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$98,486
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$65,476
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$150,849
Value of total assets at end of year	2015-12-31	$837,505
Value of total assets at beginning of year	2015-12-31	$786,337
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$33,010
Total interest from all sources	2015-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$48,731
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$48,731
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$2,000,000
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$49,017
Administrative expenses (other) incurred	2015-12-31	$33,010
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$51,168
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$837,505
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$786,337
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$726,107
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$756,553
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-12-31	$111,398
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-12-31	$27,939
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-12-31	$27,939
Expenses. Payments to insurance carriers foe the provision of benefits	2015-12-31	$48,515
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-49,926
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Contributions received in cash from employer	2015-12-31	$101,832
Employer contributions (assets) at end of year	2015-12-31	$0
Employer contributions (assets) at beginning of year	2015-12-31	$1,845
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$16,961
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	INSERO & CO. CPAS, LLP
Accountancy firm EIN	2015-12-31	475324570
2014 : EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 2014 401k financial data
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$186,387
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$80,337
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$47,614
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$155,349
Value of total assets at end of year	2014-12-31	$786,337
Value of total assets at beginning of year	2014-12-31	$680,287
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$32,723
Total interest from all sources	2014-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$42,209
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$42,209
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$2,000,000
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$43,197
Administrative expenses (other) incurred	2014-12-31	$32,723
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Value of net income/loss	2014-12-31	$106,050
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$786,337
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$680,287
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$756,553
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$673,715
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-12-31	$27,939
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-12-31	$4,784
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-12-31	$4,784
Expenses. Payments to insurance carriers foe the provision of benefits	2014-12-31	$42,454
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$-11,171
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Contributions received in cash from employer	2014-12-31	$112,152
Employer contributions (assets) at end of year	2014-12-31	$1,845
Employer contributions (assets) at beginning of year	2014-12-31	$1,788
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$5,160
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	INSERO & COMPANY CPAS, P.C.
Accountancy firm EIN	2014-12-31	161016457
2013 : EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 2013 401k financial data
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$228,935
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$78,715
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$47,792
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$125,845
Value of total assets at end of year	2013-12-31	$680,287
Value of total assets at beginning of year	2013-12-31	$530,067
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$30,923
Total interest from all sources	2013-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$34,901
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$34,901
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$2,000,000
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$41,701
Administrative expenses (other) incurred	2013-12-31	$30,923
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Value of net income/loss	2013-12-31	$150,220
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$680,287
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$530,067
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$673,715
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$503,049
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$4,784
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$23,404
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$23,404
Expenses. Payments to insurance carriers foe the provision of benefits	2013-12-31	$39,872
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$68,189
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Contributions received in cash from employer	2013-12-31	$84,144
Employer contributions (assets) at end of year	2013-12-31	$1,788
Employer contributions (assets) at beginning of year	2013-12-31	$3,614
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$7,920
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	INSERO & COMPANY CPAS, P.C.
Accountancy firm EIN	2013-12-31	161016457
2012 : EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$0
Total income from all sources (including contributions)	2012-12-31	$165,932
Total loss/gain on sale of assets	2012-12-31	$0
Total of all expenses incurred	2012-12-31	$75,438
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$43,714
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$104,235
Value of total assets at end of year	2012-12-31	$530,067
Value of total assets at beginning of year	2012-12-31	$439,573
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$31,724
Total interest from all sources	2012-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2012-12-31	$18,669
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2012-12-31	$18,669
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$2,000,000
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$29,956
Participant contributions at end of year	2012-12-31	$0
Participant contributions at beginning of year	2012-12-31	$0
Administrative expenses (other) incurred	2012-12-31	$31,724
Liabilities. Value of operating payables at end of year	2012-12-31	$0
Liabilities. Value of operating payables at beginning of year	2012-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$90,494
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$530,067
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$439,573
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2012-12-31	$503,049
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2012-12-31	$408,104
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2012-12-31	$23,404
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2012-12-31	$31,469
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2012-12-31	$31,469
Expenses. Payments to insurance carriers foe the provision of benefits	2012-12-31	$34,138
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2012-12-31	$43,028
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$74,279
Employer contributions (assets) at end of year	2012-12-31	$3,614
Employer contributions (assets) at beginning of year	2012-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$9,576
Did the plan have assets held for investment	2012-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	INSERO & COMPANY CPAS, P.C.
Accountancy firm EIN	2012-12-31	161016457
2011 : EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-29	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-29	$3,598
Total income from all sources (including contributions)	2011-12-29	$95,796
Total of all expenses incurred	2011-12-29	$41,477
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-29	$14,502
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-29	$105,565
Value of total assets at end of year	2011-12-29	$439,573
Value of total assets at beginning of year	2011-12-29	$388,852
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-29	$26,975
Total dividends received (eg from common stock, registered investment company shares)	2011-12-29	$14,195
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-29	No
Total dividends received from registered investment company shares (eg mutual funds)	2011-12-29	$14,195
Was this plan covered by a fidelity bond	2011-12-29	Yes
Value of fidelity bond cover	2011-12-29	$2,000,000
If this is an individual account plan, was there a blackout period	2011-12-29	Yes
Were there any nonexempt tranactions with any party-in-interest	2011-12-29	No
Contributions received from participants	2011-12-29	$11,633
Participant contributions at end of year	2011-12-29	$0
Participant contributions at beginning of year	2011-12-29	$72
Administrative expenses (other) incurred	2011-12-29	$26,975
Liabilities. Value of operating payables at end of year	2011-12-29	$0
Liabilities. Value of operating payables at beginning of year	2011-12-29	$3,598
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-29	No
Value of net income/loss	2011-12-29	$54,319
Value of net assets at end of year (total assets less liabilities)	2011-12-29	$439,573
Value of net assets at beginning of year (total assets less liabilities)	2011-12-29	$385,254
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-29	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-29	No
Were any leases to which the plan was party in default or uncollectible	2011-12-29	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-29	$408,104
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-29	$359,143
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-29	$31,469
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-29	$22,036
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-29	$22,036
Expenses. Payments to insurance carriers foe the provision of benefits	2011-12-29	$12,014
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2011-12-29	$-23,964
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-29	No
Was there a failure to transmit to the plan any participant contributions	2011-12-29	No
Has the plan failed to provide any benefit when due under the plan	2011-12-29	No
Contributions received in cash from employer	2011-12-29	$93,932
Employer contributions (assets) at end of year	2011-12-29	$0
Employer contributions (assets) at beginning of year	2011-12-29	$7,601
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-29	$2,488
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2011-12-29	Yes
Did the plan have assets held for investment	2011-12-29	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-29	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-29	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-29	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-29	Disclaimer
Accountancy firm name	2011-12-29	INSERO & COMPANY CPAS, P.C.
Accountancy firm EIN	2011-12-29	161016457
2010 : EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 2010 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$3,598
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$1,703
Total income from all sources (including contributions)	2010-12-31	$141,872
Total of all expenses incurred	2010-12-31	$35,217
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$7,630
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$101,379
Value of total assets at end of year	2010-12-31	$388,852
Value of total assets at beginning of year	2010-12-31	$280,302
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$27,587
Total interest from all sources	2010-12-31	$280
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$8,479
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2010-12-31	$8,479
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$2,000,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$9,253
Participant contributions at end of year	2010-12-31	$72
Participant contributions at beginning of year	2010-12-31	$193
Administrative expenses (other) incurred	2010-12-31	$27,587
Liabilities. Value of operating payables at end of year	2010-12-31	$3,598
Liabilities. Value of operating payables at beginning of year	2010-12-31	$1,703
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$106,655
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$385,254
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$278,599
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2010-12-31	$359,143
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2010-12-31	$269,974
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2010-12-31	$22,036
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2010-12-31	$2,895
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2010-12-31	$2,895
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2010-12-31	$280
Expenses. Payments to insurance carriers foe the provision of benefits	2010-12-31	$7,049
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2010-12-31	$31,734
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$92,126
Employer contributions (assets) at end of year	2010-12-31	$7,601
Employer contributions (assets) at beginning of year	2010-12-31	$7,240
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$581
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2010-12-31	No
Did the plan have assets held for investment	2010-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	INSERO & COMPANY CPAS, P.C.
Accountancy firm EIN	2010-12-31	161016457

Form 5500 Responses for EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE

2017: EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	This submission is the final filing	Yes
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 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 – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 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 – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 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 – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 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 – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	First time form 5500 has been submitted	Yes
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)	Yes
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: EMERITI RETIREE HEALTH PLAN FOR HARVEY MUDD COLLEGE 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

82036382036338

Policy instance

Insurance contract or identification number	82036382036338
Number of Individuals Covered	2
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
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
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 $39,417
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

820363

Policy instance

Insurance contract or identification number	820363
Number of Individuals Covered	4
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
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
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 $9,700
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

820363

Policy instance

Insurance contract or identification number	820363
Number of Individuals Covered	4
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
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
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 $3,816
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

82036382036338

Policy instance

Insurance contract or identification number	82036382036338
Number of Individuals Covered	6
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
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	Yes
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
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 $39,135
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

AE351468

Policy instance

Insurance contract or identification number	AE351468
Number of Individuals Covered	5
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
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
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 $3,457
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

82036382036338

Policy instance

Insurance contract or identification number	82036382036338
Number of Individuals Covered	6
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
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	Yes
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
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 $36,754
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

AE351468

Policy instance

Insurance contract or identification number	AE351468
Number of Individuals Covered	5
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
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
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 $2,858
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

820363-363-38

Policy instance

Insurance contract or identification number	820363-363-38
Number of Individuals Covered	6
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
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	Yes
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
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 $28,765
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

AE351468

Policy instance

Insurance contract or identification number	AE351468
Number of Individuals Covered	5
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
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
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 $2,128
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

820363-363-38

Policy instance

Insurance contract or identification number	820363-363-38
Number of Individuals Covered	6
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $11,711
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

AE351468

Policy instance

Insurance contract or identification number	AE351468
Number of Individuals Covered	4
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Welfare Benefit Premiums Paid to Carrier	USD $901
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

82036336338

Policy instance

Insurance contract or identification number	82036336338
Number of Individuals Covered	3
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
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $6,171

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

AE351468

Policy instance

Insurance contract or identification number	AE351468
Number of Individuals Covered	3
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
Welfare Benefit Premiums Paid to Carrier	USD $739

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Company Name:	HARVEY MUDD COLLEGE
Employer identification number (EIN):	951911219
NAIC Classification:	611000

Jurisdiction of Incorporation:	California Department of State
Incorporation Date:
Company Identification Number:	C0313129