401k Plan data: PRESCOTT COLLEGE MEDICAL BENEFIT PLAN plan

PRESCOTT COLLEGE MEDICAL BENEFIT PLAN 401k Plan overview

Plan Name	PRESCOTT COLLEGE MEDICAL BENEFIT PLAN
Plan identification number	501

PRESCOTT COLLEGE MEDICAL BENEFIT PLAN Benefits

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

401k Sponsoring company profile

PRESCOTT COLLEGE, INC. has sponsored the creation of one or more 401k plans.

Company Name: PRESCOTT COLLEGE, INC.

Employer identification number (EIN): 860294012

NAIC Classification: 611000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PRESCOTT COLLEGE MEDICAL BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2016-01-01 JAMES C MINER
501 2015-01-01 LAVINIA NOWOSIELSKI
501 2014-01-01 CHRISTINE L LOFFIN
501 2013-01-01 CHRISTINE L LOFTIN
501 2012-01-01 CHRISTINE L LOFFIN
501 2011-01-01 CHRISTINE L LOFFIN
501 2010-01-01 CHRISTINE L LOFTIN
501 2009-01-01 CHRISTINE L LOFTIN

Plan id#	Filing Submission Date	Name of Administrator
501	2016-01-01	JAMES C MINER
501	2015-01-01	LAVINIA NOWOSIELSKI
501	2014-01-01	CHRISTINE L LOFFIN
501	2013-01-01	CHRISTINE L LOFTIN
501	2012-01-01	CHRISTINE L LOFFIN
501	2011-01-01	CHRISTINE L LOFFIN
501	2010-01-01	CHRISTINE L LOFTIN
501	2009-01-01	CHRISTINE L LOFTIN

Plan Statistics for PRESCOTT COLLEGE MEDICAL BENEFIT PLAN

401k plan membership statisitcs for PRESCOTT COLLEGE MEDICAL BENEFIT PLAN

Measure Date Value
2016: PRESCOTT COLLEGE MEDICAL BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 124
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 124
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 2016-01-01 124
2015: PRESCOTT COLLEGE MEDICAL BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 129
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 124
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 124
2014: PRESCOTT COLLEGE MEDICAL BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 140
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 124
Number of retired or separated participants receiving benefits 2014-01-01 5
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 129
2013: PRESCOTT COLLEGE MEDICAL BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 160
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 142
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 2013-01-01 142
2012: PRESCOTT COLLEGE MEDICAL BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 166
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 160
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 2012-01-01 160
2011: PRESCOTT COLLEGE MEDICAL BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 184
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 170
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 2011-01-01 170
2010: PRESCOTT COLLEGE MEDICAL BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 167
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 178
Number of retired or separated participants receiving benefits 2010-01-01 6
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 184
2009: PRESCOTT COLLEGE MEDICAL BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 294
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 164
Number of retired or separated participants receiving benefits 2009-01-01 3
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 167

Measure	Date	Value
2016: PRESCOTT COLLEGE MEDICAL BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	124
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	124
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	124
2015: PRESCOTT COLLEGE MEDICAL BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	129
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	124
Number of retired or separated participants receiving benefits	2015-01-01	0
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	124
2014: PRESCOTT COLLEGE MEDICAL BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	140
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	124
Number of retired or separated participants receiving benefits	2014-01-01	5
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	129
2013: PRESCOTT COLLEGE MEDICAL BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	160
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	142
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	142
2012: PRESCOTT COLLEGE MEDICAL BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	166
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	160
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	160
2011: PRESCOTT COLLEGE MEDICAL BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	184
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	170
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	170
2010: PRESCOTT COLLEGE MEDICAL BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	167
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	178
Number of retired or separated participants receiving benefits	2010-01-01	6
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	184
2009: PRESCOTT COLLEGE MEDICAL BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	294
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	164
Number of retired or separated participants receiving benefits	2009-01-01	3
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	167

Form 5500 Responses for PRESCOTT COLLEGE MEDICAL BENEFIT PLAN

2016: PRESCOTT COLLEGE MEDICAL BENEFIT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
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 – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: PRESCOTT COLLEGE MEDICAL BENEFIT PLAN 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 – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: PRESCOTT COLLEGE MEDICAL BENEFIT PLAN 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 – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: PRESCOTT COLLEGE MEDICAL BENEFIT PLAN 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 – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: PRESCOTT COLLEGE MEDICAL BENEFIT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	Yes
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 – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: PRESCOTT COLLEGE MEDICAL BENEFIT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	Yes
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 – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: PRESCOTT COLLEGE MEDICAL BENEFIT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	Yes
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 funding arrangement – General assets of the sponsor	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: PRESCOTT COLLEGE MEDICAL BENEFIT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
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 – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )

Policy contract number

26426

Policy instance

Insurance contract or identification number	26426
Number of Individuals Covered	178
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
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 $118,570
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 )

Policy contract number

26426

Policy instance

Insurance contract or identification number	26426
Number of Individuals Covered	167
Insurance policy start date	2009-01-01
Insurance policy end date	2009-12-31
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 $79,313
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	PRESCOTT COLLEGE, INC.
Employer identification number (EIN):	860294012
NAIC Classification:	611000