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| Plan Name | EASTER SEALS NEW YORK HEALTH AND WELFARE PLAN |
| Plan identification number | 503 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | EASTER SEALS NEW YORK |
| Employer identification number (EIN): | 135596808 |
| NAIC Classification: | 624200 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 503 | 2017-07-01 | DONNA M. QUINN | 2019-06-18 | ||
| 503 | 2016-07-01 | ||||
| 503 | 2015-09-01 | BRUCE R LASKO |
| Measure | Date | Value |
|---|---|---|
| 2017: EASTER SEALS NEW YORK HEALTH AND WELFARE PLAN 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-07-01 | 419 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-07-01 | 0 |
| Number of retired or separated participants receiving benefits | 2017-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-07-01 | 0 |
| Total of all active and inactive participants | 2017-07-01 | 0 |
| Number of employers contributing to the scheme | 2017-07-01 | 0 |
| 2016: EASTER SEALS NEW YORK HEALTH AND WELFARE PLAN 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-07-01 | 324 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-07-01 | 419 |
| Number of retired or separated participants receiving benefits | 2016-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-07-01 | 0 |
| Total of all active and inactive participants | 2016-07-01 | 419 |
| 2015: EASTER SEALS NEW YORK HEALTH AND WELFARE PLAN 2015 401k membership | ||
| Total participants, beginning-of-year | 2015-09-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-09-01 | 324 |
| Number of retired or separated participants receiving benefits | 2015-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-09-01 | 0 |
| Total of all active and inactive participants | 2015-09-01 | 324 |
| 2017: EASTER SEALS NEW YORK HEALTH AND WELFARE PLAN 2017 form 5500 responses | ||
|---|---|---|
| 2017-07-01 | Type of plan entity | Single employer plan |
| 2017-07-01 | This submission is the final filing | Yes |
| 2017-07-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2017-07-01 | Plan funding arrangement – Insurance | Yes |
| 2017-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: EASTER SEALS NEW YORK HEALTH AND WELFARE PLAN 2016 form 5500 responses | ||
| 2016-07-01 | Type of plan entity | Single employer plan |
| 2016-07-01 | Submission has been amended | No |
| 2016-07-01 | This submission is the final filing | No |
| 2016-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-07-01 | Plan is a collectively bargained plan | No |
| 2016-07-01 | Plan funding arrangement – Insurance | Yes |
| 2016-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: EASTER SEALS NEW YORK HEALTH AND WELFARE PLAN 2015 form 5500 responses | ||
| 2015-09-01 | Type of plan entity | Single employer plan |
| 2015-09-01 | First time form 5500 has been submitted | Yes |
| 2015-09-01 | Submission has been amended | No |
| 2015-09-01 | This submission is the final filing | No |
| 2015-09-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2015-09-01 | Plan is a collectively bargained plan | No |
| 2015-09-01 | Plan funding arrangement – Insurance | Yes |
| 2015-09-01 | Plan benefit arrangement – Insurance | Yes |
| UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | AL00005893 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| ANTHEM LIFE & DISABILITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 13573 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | AL00005893 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | AL00003868 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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