401k Plan data: OXFORD UNIVERSITY PRESS USA MEDICAL PLAN plan

OXFORD UNIVERSITY PRESS USA MEDICAL PLAN 401k Plan overview

Plan Name	OXFORD UNIVERSITY PRESS USA MEDICAL PLAN
Plan identification number	511

OXFORD UNIVERSITY PRESS USA MEDICAL PLAN Benefits

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

401k Sponsoring company profile

THE CHANCELLOR, MASTERS AND SCHOLARS OF THE UNIVERSITY OF OXFORD has sponsored the creation of one or more 401k plans.

Company Name: THE CHANCELLOR, MASTERS AND SCHOLARS OF THE UNIVERSITY OF OXFORD

Employer identification number (EIN): 986001062

NAIC Classification: 511130
NAIC Description: Book Publishers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan OXFORD UNIVERSITY PRESS USA MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
511 2015-04-01 ROSANN ASHE
511 2014-04-01
511 2013-04-01
511 2012-04-01 MARILYN OKRENT

Plan Statistics for OXFORD UNIVERSITY PRESS USA MEDICAL PLAN

401k plan membership statisitcs for OXFORD UNIVERSITY PRESS USA MEDICAL PLAN

Measure Date Value
2015: OXFORD UNIVERSITY PRESS USA MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year 2015-04-01 599
Total number of active participants reported on line 7a of the Form 5500 2015-04-01 0
Number of retired or separated participants receiving benefits 2015-04-01 0
Number of other retired or separated participants entitled to future benefits 2015-04-01 0
Total of all active and inactive participants 2015-04-01 0
2014: OXFORD UNIVERSITY PRESS USA MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year 2014-04-01 582
Total number of active participants reported on line 7a of the Form 5500 2014-04-01 599
Total of all active and inactive participants 2014-04-01 599
2013: OXFORD UNIVERSITY PRESS USA MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year 2013-04-01 622
Total number of active participants reported on line 7a of the Form 5500 2013-04-01 582
Total of all active and inactive participants 2013-04-01 582
2012: OXFORD UNIVERSITY PRESS USA MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year 2012-04-01 617
Total number of active participants reported on line 7a of the Form 5500 2012-04-01 622
Total of all active and inactive participants 2012-04-01 622

Measure	Date	Value
2015: OXFORD UNIVERSITY PRESS USA MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year	2015-04-01	599
Total number of active participants reported on line 7a of the Form 5500	2015-04-01	0
Number of retired or separated participants receiving benefits	2015-04-01	0
Number of other retired or separated participants entitled to future benefits	2015-04-01	0
Total of all active and inactive participants	2015-04-01	0
2014: OXFORD UNIVERSITY PRESS USA MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year	2014-04-01	582
Total number of active participants reported on line 7a of the Form 5500	2014-04-01	599
Total of all active and inactive participants	2014-04-01	599
2013: OXFORD UNIVERSITY PRESS USA MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year	2013-04-01	622
Total number of active participants reported on line 7a of the Form 5500	2013-04-01	582
Total of all active and inactive participants	2013-04-01	582
2012: OXFORD UNIVERSITY PRESS USA MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year	2012-04-01	617
Total number of active participants reported on line 7a of the Form 5500	2012-04-01	622
Total of all active and inactive participants	2012-04-01	622

Form 5500 Responses for OXFORD UNIVERSITY PRESS USA MEDICAL PLAN

2015: OXFORD UNIVERSITY PRESS USA MEDICAL PLAN 2015 form 5500 responses
2015-04-01	Type of plan entity	Single employer plan
2015-04-01	Submission has been amended	No
2015-04-01	This submission is the final filing	Yes
2015-04-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2015-04-01	Plan is a collectively bargained plan	No
2015-04-01	Plan funding arrangement – Insurance	Yes
2015-04-01	Plan benefit arrangement – Insurance	Yes
2014: OXFORD UNIVERSITY PRESS USA MEDICAL PLAN 2014 form 5500 responses
2014-04-01	Type of plan entity	Single employer plan
2014-04-01	Plan funding arrangement – Insurance	Yes
2014-04-01	Plan benefit arrangement – Insurance	Yes
2013: OXFORD UNIVERSITY PRESS USA MEDICAL PLAN 2013 form 5500 responses
2013-04-01	Type of plan entity	Single employer plan
2013-04-01	Plan funding arrangement – Insurance	Yes
2013-04-01	Plan benefit arrangement – Insurance	Yes
2012: OXFORD UNIVERSITY PRESS USA MEDICAL PLAN 2012 form 5500 responses
2012-04-01	Type of plan entity	Single employer plan
2012-04-01	Plan funding arrangement – Insurance	Yes
2012-04-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

0903507

Policy instance

Insurance contract or identification number	0903507
Number of Individuals Covered	1175
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $186,256
Total amount of fees paid to insurance company	USD $10,000
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	Yes
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 $5,748,747
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $186,256
Insurance broker organization code?	3
Amount paid for insurance broker fees	10000
Additional information about fees paid to insurance broker	BONUS
Insurance broker name	MERCER

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

Policy contract number

AE 431432

Policy instance

Insurance contract or identification number	AE 431432
Number of Individuals Covered	1
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $75
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	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 $4,425
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $75
Insurance broker organization code?	3
Insurance broker name	MERCER

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

Policy contract number

AE 430921

Policy instance

Insurance contract or identification number	AE 430921
Number of Individuals Covered	1
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $75
Total amount of fees paid to insurance company	USD $92
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 $4,025
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $75
Amount paid for insurance broker fees	92
Additional information about fees paid to insurance broker	2014-2015 PPP ENGAGEMENT CREDIT
Insurance broker organization code?	3
Insurance broker name	MERCER

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

Policy contract number

AE431432

Policy instance

Insurance contract or identification number	AE431432
Number of Individuals Covered	2
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $150
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Welfare Benefit Premiums Paid to Carrier	USD $7,553
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $150
Insurance broker organization code?	3
Insurance broker name	MERCER HEALTH & BENEFITS, LLC

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

Policy contract number

AE430921

Policy instance

Insurance contract or identification number	AE430921
Number of Individuals Covered	1
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $150
Total amount of fees paid to insurance company	USD $192
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Welfare Benefit Premiums Paid to Carrier	USD $7,060
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $150
Amount paid for insurance broker fees	192
Additional information about fees paid to insurance broker	2013/2014 MM P3 BONUS
Insurance broker organization code?	3
Insurance broker name	MERCER HEALTH & BENEFITS, LLC

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3333172

Policy instance

Insurance contract or identification number	3333172
Number of Individuals Covered	596
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $175,488
Total amount of fees paid to insurance company	USD $997
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $5,890,912
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $175,488
Amount paid for insurance broker fees	997
Additional information about fees paid to insurance broker	GENERAL AGENT PAYMENTS
Insurance broker organization code?	3
Insurance broker name	MERCER HEALTH & BENEFITS, LLC

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

Policy contract number

AE431432

Policy instance

Insurance contract or identification number	AE431432
Number of Individuals Covered	2
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Welfare Benefit Premiums Paid to Carrier	USD $8,878
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

AE430921

Policy instance

Insurance contract or identification number	AE430921
Number of Individuals Covered	2
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Welfare Benefit Premiums Paid to Carrier	USD $7,643
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3333172

Policy instance

Insurance contract or identification number	3333172
Number of Individuals Covered	578
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $187,777
Total amount of fees paid to insurance company	USD $771
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $6,298,098
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $187,777
Amount paid for insurance broker fees	771
Insurance broker organization code?	3
Insurance broker name	MERCER HEALTH & BENEFITS, LLC

AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95234 )

Policy contract number

AE431432

Policy instance

Insurance contract or identification number	AE431432
Number of Individuals Covered	4
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $675
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Welfare Benefit Premiums Paid to Carrier	USD $16,705
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $675
Insurance broker name	MERCER HEALTH & BENEFITS, LLC

AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95234 )

Policy contract number

AE430921

Policy instance

Insurance contract or identification number	AE430921
Number of Individuals Covered	1
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $150
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Welfare Benefit Premiums Paid to Carrier	USD $4,532
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $150
Insurance broker name	MERCER HEALTH & BENEFITS, LLC

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3333172

Policy instance

Insurance contract or identification number	3333172
Number of Individuals Covered	617
Insurance policy start date	2012-04-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $142,756
Total amount of fees paid to insurance company	USD $777
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,789,700
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $142,756
Amount paid for insurance broker fees	777
Insurance broker organization code?	3
Insurance broker name	MERCER HEALTH & BENEFITS, LLC

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Company Name:	THE CHANCELLOR, MASTERS AND SCHOLARS OF THE UNIVERSITY OF OXFORD
Employer identification number (EIN):	986001062
NAIC Classification:	511130
NAIC Description:	Book Publishers

Plan id#	Filing Submission Date	Name of Administrator
511	2015-04-01	ROSANN ASHE
511	2014-04-01
511	2013-04-01
511	2012-04-01	MARILYN OKRENT