401k Plan data: GROUP LONG TERM DISABILITY plan

GROUP LONG TERM DISABILITY 401k Plan overview

Plan Name	GROUP LONG TERM DISABILITY
Plan identification number	503

GROUP LONG TERM DISABILITY Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Long-term disability cover

401k Sponsoring company profile

BLUE CROSS AND BLUE SHIELD OF NEBRASKA has sponsored the creation of one or more 401k plans.

Company Name: BLUE CROSS AND BLUE SHIELD OF NEBRASKA

Employer identification number (EIN): 470095156

NAIC Classification: 524140

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP LONG TERM DISABILITY

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2016-01-01 CATHY FILIPIAK
503 2016-01-01
503 2015-01-01 BRAD SCHROEDER
503 2014-01-01 CATHY FILIPIAK
503 2013-01-01 CATHY FILIPIAK
503 2012-01-01 TOM WHALEN LEWIS E TROWBRIDGE 2013-06-25
503 2011-01-01 TOMMY WHALEN
503 2010-01-01 TOMMY WHALEN LEWIS TROWBRIDGE 2011-07-21
503 2009-01-01 TOMMY WHALEN LEWIS TROWBRIDGE 2010-07-19

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
503	2016-01-01	CATHY FILIPIAK
503	2016-01-01
503	2015-01-01	BRAD SCHROEDER
503	2014-01-01	CATHY FILIPIAK
503	2013-01-01	CATHY FILIPIAK
503	2012-01-01	TOM WHALEN	LEWIS E TROWBRIDGE	2013-06-25
503	2011-01-01	TOMMY WHALEN
503	2010-01-01	TOMMY WHALEN	LEWIS TROWBRIDGE	2011-07-21
503	2009-01-01	TOMMY WHALEN	LEWIS TROWBRIDGE	2010-07-19

Plan Statistics for GROUP LONG TERM DISABILITY

401k plan membership statisitcs for GROUP LONG TERM DISABILITY

Measure Date Value
2016: GROUP LONG TERM DISABILITY 2016 401k membership
Total participants, beginning-of-year 2016-01-01 1,118
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 0
2015: GROUP LONG TERM DISABILITY 2015 401k membership
Total participants, beginning-of-year 2015-01-01 1,094
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 1,116
Number of retired or separated participants receiving benefits 2015-01-01 2
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 1,118
2014: GROUP LONG TERM DISABILITY 2014 401k membership
Total participants, beginning-of-year 2014-01-01 1,085
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 1,090
Number of retired or separated participants receiving benefits 2014-01-01 4
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 1,094
2013: GROUP LONG TERM DISABILITY 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1,178
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 1,085
Number of retired or separated participants receiving benefits 2013-01-01 0
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 1,085
2012: GROUP LONG TERM DISABILITY 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1,320
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 1,178
Number of retired or separated participants receiving benefits 2012-01-01 0
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 1,178
2011: GROUP LONG TERM DISABILITY 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,404
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 1,320
Number of retired or separated participants receiving benefits 2011-01-01 0
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 1,320
2010: GROUP LONG TERM DISABILITY 2010 401k membership
Total participants, beginning-of-year 2010-01-01 1,382
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 1,404
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 1,404
2009: GROUP LONG TERM DISABILITY 2009 401k membership
Total participants, beginning-of-year 2009-01-01 1,191
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 1,376
Number of retired or separated participants receiving benefits 2009-01-01 6
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 1,382
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 1,382

Measure	Date	Value
2016: GROUP LONG TERM DISABILITY 2016 401k membership
Total participants, beginning-of-year	2016-01-01	1,118
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	0
2015: GROUP LONG TERM DISABILITY 2015 401k membership
Total participants, beginning-of-year	2015-01-01	1,094
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	1,116
Number of retired or separated participants receiving benefits	2015-01-01	2
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	1,118
2014: GROUP LONG TERM DISABILITY 2014 401k membership
Total participants, beginning-of-year	2014-01-01	1,085
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	1,090
Number of retired or separated participants receiving benefits	2014-01-01	4
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	1,094
2013: GROUP LONG TERM DISABILITY 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,178
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	1,085
Number of retired or separated participants receiving benefits	2013-01-01	0
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	1,085
2012: GROUP LONG TERM DISABILITY 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,320
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	1,178
Number of retired or separated participants receiving benefits	2012-01-01	0
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	1,178
2011: GROUP LONG TERM DISABILITY 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,404
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	1,320
Number of retired or separated participants receiving benefits	2011-01-01	0
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	1,320
2010: GROUP LONG TERM DISABILITY 2010 401k membership
Total participants, beginning-of-year	2010-01-01	1,382
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	1,404
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	1,404
2009: GROUP LONG TERM DISABILITY 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,191
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	1,376
Number of retired or separated participants receiving benefits	2009-01-01	6
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	1,382
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	1,382

Form 5500 Responses for GROUP LONG TERM DISABILITY

2016: GROUP LONG TERM DISABILITY 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	This submission is the final filing	Yes
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: GROUP LONG TERM DISABILITY 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 benefit arrangement – Insurance	Yes
2014: GROUP LONG TERM DISABILITY 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 benefit arrangement – Insurance	Yes
2013: GROUP LONG TERM DISABILITY 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 benefit arrangement – Insurance	Yes
2012: GROUP LONG TERM DISABILITY 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 benefit arrangement – Insurance	Yes
2011: GROUP LONG TERM DISABILITY 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
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)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: GROUP LONG TERM DISABILITY 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: GROUP LONG TERM DISABILITY 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 benefit arrangement – Insurance	Yes

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Company Name:	BLUE CROSS AND BLUE SHIELD OF NEBRASKA
Employer identification number (EIN):	470095156
NAIC Classification:	524140