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| Plan Name | GEORGE JUNIOR REPUBLIC IN PENNSYLVANIA FBP |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | GEORGE JUNIOR REPUBLIC IN PENNSYLVANIA |
| Employer identification number (EIN): | 250723320 |
| NAIC Classification: | 624100 |
| NAIC Description: | Individual and Family Services |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2010-01-01 | MICHELLE GERWICK, CFO | MICHELLE GERWICK, CFO | 2015-02-15 |
| Measure | Date | Value |
|---|---|---|
| 2010: GEORGE JUNIOR REPUBLIC IN PENNSYLVANIA FBP 2010 401k membership | ||
| Total participants, beginning-of-year | 2010-01-01 | 1,221 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 1,242 |
| Total of all active and inactive participants | 2010-01-01 | 1,242 |
| 2010: GEORGE JUNIOR REPUBLIC IN PENNSYLVANIA FBP 2010 form 5500 responses | ||
|---|---|---|
| 2010-01-01 | Type of plan entity | Mulitple employer plan |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) | |
| Policy contract number | 49934 |
| Policy instance | 6 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) | |
| Policy contract number | 139913 |
| Policy instance | 14 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) | |
| Policy contract number | 49934 |
| Policy instance | 13 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) | |
| Policy contract number | 49934 |
| Policy instance | 11 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) | |
| Policy contract number | 49934 |
| Policy instance | 10 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) | |
| Policy contract number | 49934 |
| Policy instance | 9 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) | |
| Policy contract number | 49934 |
| Policy instance | 12 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) | |
| Policy contract number | 49934 |
| Policy instance | 8 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) | |
| Policy contract number | 49934 |
| Policy instance | 7 |
| KEYSTONE HEALTH PLAN WEST, INC (National Association of Insurance Commissioners NAIC id number: 95048 ) | |
| Policy contract number | 024350 |
| Policy instance | 5 |
| KEYSTONE HEALTH PLAN SOUTHWESTERN (National Association of Insurance Commissioners NAIC id number: 10131 ) | |
| Policy contract number | 024350 |
| Policy instance | 4 |
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) | |
| Policy contract number | 024350 |
| Policy instance | 3 |
| HIGHMARK HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 54771 ) | |
| Policy contract number | 024350 |
| Policy instance | 2 |
| DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 ) | |
| Policy contract number | 09364 |
| Policy instance | 1 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) | |
| Policy contract number | 139913 |
| Policy instance | 15 |
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