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| Plan Name | UPPER IOWA UNIVERSITY GROUP HEALTH PLAN |
| Plan identification number | 508 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | UPPER IOWA UNIVERSITY |
| Employer identification number (EIN): | 420680372 |
| NAIC Classification: | 611000 |
Additional information about UPPER IOWA UNIVERSITY
| Jurisdiction of Incorporation: | Iowa Secretary of State Business Entities |
| Incorporation Date: | 1911-08-11 |
| Company Identification Number: | 064249 |
| Legal Registered Office Address: |
605 WASHINGTON ST PO BOX 1857 FAYETTE United States of America (USA) 52142 |
More information about UPPER IOWA UNIVERSITY
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 508 | 2022-07-01 | TIM GUYER | 2023-12-13 |
| Measure | Date | Value |
|---|---|---|
| 2022: UPPER IOWA UNIVERSITY GROUP HEALTH PLAN 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-07-01 | 302 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-07-01 | 257 |
| Number of retired or separated participants receiving benefits | 2022-07-01 | 10 |
| Number of other retired or separated participants entitled to future benefits | 2022-07-01 | 0 |
| Total of all active and inactive participants | 2022-07-01 | 267 |
| Number of employers contributing to the scheme | 2022-07-01 | 0 |
| 2022: UPPER IOWA UNIVERSITY GROUP HEALTH PLAN 2022 form 5500 responses | ||
|---|---|---|
| 2022-07-01 | Type of plan entity | Single employer plan |
| 2022-07-01 | First time form 5500 has been submitted | Yes |
| 2022-07-01 | Plan funding arrangement – Insurance | Yes |
| 2022-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |||||||||||||||||||||||||||||||
| Policy contract number | 309177 | ||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||
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| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) | |||||||||||||||||||||||||||||||
| Policy contract number | 57854 | ||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||
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| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) | |||||||||||||||||||||||||||||||
| Policy contract number | 60790-2306 | ||||||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||||||
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