401k Plan data: GROUP STD AND LTD plan

GROUP STD AND LTD 401k Plan overview

Plan Name	GROUP STD AND LTD
Plan identification number	503

GROUP STD AND LTD Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Temporary disability (accident and sickness) Long-term disability cover Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20. Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

ANTIOCH COLLEGE CORPORATION has sponsored the creation of one or more 401k plans.

Company Name: ANTIOCH COLLEGE CORPORATION

Employer identification number (EIN): 261672457

NAIC Classification: 611000

Additional information about ANTIOCH COLLEGE CORPORATION

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division

Incorporation Date: 2007-12-07

Company Identification Number: 1744795

Legal Registered Office Address: 41 S HIGH STREET
SUITE 2600
COLUMBUS
United States of America (USA)
43215

More information about ANTIOCH COLLEGE CORPORATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP STD AND LTD

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2014-10-01 JOANNE LAKOMSKI
503 2012-10-01 THOMAS BROOKEY

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
503	2014-10-01	JOANNE LAKOMSKI
503	2012-10-01	THOMAS BROOKEY

Plan Statistics for GROUP STD AND LTD

401k plan membership statisitcs for GROUP STD AND LTD

Measure Date Value
2014: GROUP STD AND LTD 2014 401k membership
Total participants, beginning-of-year 2014-10-01 116
Total number of active participants reported on line 7a of the Form 5500 2014-10-01 0
Number of retired or separated participants receiving benefits 2014-10-01 0
Number of other retired or separated participants entitled to future benefits 2014-10-01 0
Total of all active and inactive participants 2014-10-01 0
2012: GROUP STD AND LTD 2012 401k membership
Total participants, beginning-of-year 2012-10-01 100
Total number of active participants reported on line 7a of the Form 5500 2012-10-01 96
Number of retired or separated participants receiving benefits 2012-10-01 0
Number of other retired or separated participants entitled to future benefits 2012-10-01 0
Total of all active and inactive participants 2012-10-01 96

Measure	Date	Value
2014: GROUP STD AND LTD 2014 401k membership
Total participants, beginning-of-year	2014-10-01	116
Total number of active participants reported on line 7a of the Form 5500	2014-10-01	0
Number of retired or separated participants receiving benefits	2014-10-01	0
Number of other retired or separated participants entitled to future benefits	2014-10-01	0
Total of all active and inactive participants	2014-10-01	0
2012: GROUP STD AND LTD 2012 401k membership
Total participants, beginning-of-year	2012-10-01	100
Total number of active participants reported on line 7a of the Form 5500	2012-10-01	96
Number of retired or separated participants receiving benefits	2012-10-01	0
Number of other retired or separated participants entitled to future benefits	2012-10-01	0
Total of all active and inactive participants	2012-10-01	96

Form 5500 Responses for GROUP STD AND LTD

2014: GROUP STD AND LTD 2014 form 5500 responses
2014-10-01	Type of plan entity	Single employer plan
2014-10-01	Submission has been amended	No
2014-10-01	This submission is the final filing	Yes
2014-10-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2014-10-01	Plan is a collectively bargained plan	No
2014-10-01	Plan funding arrangement – Insurance	Yes
2014-10-01	Plan benefit arrangement – Insurance	Yes
2012: GROUP STD AND LTD 2012 form 5500 responses
2012-10-01	Type of plan entity	Single employer plan
2012-10-01	First time form 5500 has been submitted	Yes
2012-10-01	Submission has been amended	No
2012-10-01	This submission is the final filing	No
2012-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-10-01	Plan is a collectively bargained plan	No
2012-10-01	Plan funding arrangement – Insurance	Yes
2012-10-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

21573

Policy instance

Insurance contract or identification number	21573
Number of Individuals Covered	0
Insurance policy start date	2014-10-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $1,460
Total amount of fees paid to insurance company	USD $15
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	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
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 $23,487
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,460
Insurance broker organization code?	3
Amount paid for insurance broker fees	15
Additional information about fees paid to insurance broker	FEES
Insurance broker name	AXA ASSISTANCE, USA

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

21573

Policy instance

Insurance contract or identification number	21573
Number of Individuals Covered	96
Insurance policy start date	2012-10-01
Insurance policy end date	2013-09-30
Total amount of commissions paid to insurance broker	USD $1,934
Total amount of fees paid to insurance company	USD $11
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	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
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 $18,941
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,934
Insurance broker organization code?	3
Amount paid for insurance broker fees	11
Additional information about fees paid to insurance broker	THIRD PARTY ADMINISTRATION FEES
Insurance broker name	AXA ASSISTANCE, USA

Potentially related plans

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Company Name:	ANTIOCH COLLEGE CORPORATION
Employer identification number (EIN):	261672457
NAIC Classification:	611000

Jurisdiction of Incorporation:	Ohio Secretary of State Business Services Division
Incorporation Date:	2007-12-07
Company Identification Number:	1744795
Legal Registered Office Address:	41 S HIGH STREET SUITE 2600 COLUMBUS United States of America (USA) 43215