401k Plan data: POLYTECHNIC INSTITUTE OF NEW YORK UNIVERSITY HEALTH PLAN plan

POLYTECHNIC INSTITUTE OF NEW YORK UNIVERSITY HEALTH PLAN 401k Plan overview

Plan Name	POLYTECHNIC INSTITUTE OF NEW YORK UNIVERSITY HEALTH PLAN
Plan identification number	532

POLYTECHNIC INSTITUTE OF NEW YORK UNIVERSITY HEALTH PLAN Benefits

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

401k Sponsoring company profile

POLYTECHNIC UNIVERSITY has sponsored the creation of one or more 401k plans.

Company Name: POLYTECHNIC UNIVERSITY

Employer identification number (EIN): 111630820

NAIC Classification: 611000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan POLYTECHNIC INSTITUTE OF NEW YORK UNIVERSITY HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
532 2013-01-01 DENNIS DINTINO
532 2012-01-01 STEPHEN WEISENHOLZ STEPHEN WEISENHOLZ 2013-10-15
532 2011-01-01 DENNIS DINTINO
532 2010-01-01 SUONG IVES
532 2009-01-01 SUONG IVES

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
532	2013-01-01	DENNIS DINTINO
532	2012-01-01	STEPHEN WEISENHOLZ	STEPHEN WEISENHOLZ	2013-10-15
532	2011-01-01	DENNIS DINTINO
532	2010-01-01	SUONG IVES
532	2009-01-01	SUONG IVES

Plan Statistics for POLYTECHNIC INSTITUTE OF NEW YORK UNIVERSITY HEALTH PLAN

401k plan membership statisitcs for POLYTECHNIC INSTITUTE OF NEW YORK UNIVERSITY HEALTH PLAN

Measure Date Value
2013: POLYTECHNIC INSTITUTE OF NEW YORK UNIVERSITY HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 1,108
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 993
Total of all active and inactive participants 2013-01-01 993
Total participants 2013-01-01 993
2012: POLYTECHNIC INSTITUTE OF NEW YORK UNIVERSITY HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 1,108
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 922
Number of retired or separated participants receiving benefits 2012-01-01 184
Number of other retired or separated participants entitled to future benefits 2012-01-01 2
Total of all active and inactive participants 2012-01-01 1,108
Total participants 2012-01-01 1,108
2011: POLYTECHNIC INSTITUTE OF NEW YORK UNIVERSITY HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 1,024
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 911
Number of retired or separated participants receiving benefits 2011-01-01 197
Total of all active and inactive participants 2011-01-01 1,108
Total participants 2011-01-01 1,108
2010: POLYTECHNIC INSTITUTE OF NEW YORK UNIVERSITY HEALTH PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 968
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 839
Number of retired or separated participants receiving benefits 2010-01-01 185
Total of all active and inactive participants 2010-01-01 1,024
Total participants 2010-01-01 1,024
2009: POLYTECHNIC INSTITUTE OF NEW YORK UNIVERSITY HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 898
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 788
Number of retired or separated participants receiving benefits 2009-01-01 180
Total of all active and inactive participants 2009-01-01 968
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 968

Measure	Date	Value
2013: POLYTECHNIC INSTITUTE OF NEW YORK UNIVERSITY HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	1,108
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	993
Total of all active and inactive participants	2013-01-01	993
Total participants	2013-01-01	993
2012: POLYTECHNIC INSTITUTE OF NEW YORK UNIVERSITY HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	1,108
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	922
Number of retired or separated participants receiving benefits	2012-01-01	184
Number of other retired or separated participants entitled to future benefits	2012-01-01	2
Total of all active and inactive participants	2012-01-01	1,108
Total participants	2012-01-01	1,108
2011: POLYTECHNIC INSTITUTE OF NEW YORK UNIVERSITY HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	1,024
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	911
Number of retired or separated participants receiving benefits	2011-01-01	197
Total of all active and inactive participants	2011-01-01	1,108
Total participants	2011-01-01	1,108
2010: POLYTECHNIC INSTITUTE OF NEW YORK UNIVERSITY HEALTH PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	968
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	839
Number of retired or separated participants receiving benefits	2010-01-01	185
Total of all active and inactive participants	2010-01-01	1,024
Total participants	2010-01-01	1,024
2009: POLYTECHNIC INSTITUTE OF NEW YORK UNIVERSITY HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	898
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	788
Number of retired or separated participants receiving benefits	2009-01-01	180
Total of all active and inactive participants	2009-01-01	968
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	968

Form 5500 Responses for POLYTECHNIC INSTITUTE OF NEW YORK UNIVERSITY HEALTH PLAN

2013: POLYTECHNIC INSTITUTE OF NEW YORK UNIVERSITY HEALTH PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	First time form 5500 has been submitted	Yes
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: POLYTECHNIC INSTITUTE OF NEW YORK UNIVERSITY HEALTH PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	First time form 5500 has been submitted	Yes
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: POLYTECHNIC INSTITUTE OF NEW YORK UNIVERSITY HEALTH PLAN 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)	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: POLYTECHNIC INSTITUTE OF NEW YORK UNIVERSITY HEALTH PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	First time form 5500 has been submitted	Yes
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: POLYTECHNIC INSTITUTE OF NEW YORK UNIVERSITY HEALTH PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	First time form 5500 has been submitted	Yes
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:	POLYTECHNIC UNIVERSITY
Employer identification number (EIN):	111630820
NAIC Classification:	611000