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FSU FOUNDATION ERISA PLAN 401k Plan overview

Plan NameFSU FOUNDATION ERISA PLAN
Plan identification number 502

FSU FOUNDATION ERISA PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

FLORIDA STATE UNIVERSITY FOUNDATION INC. has sponsored the creation of one or more 401k plans.

Company Name:FLORIDA STATE UNIVERSITY FOUNDATION INC.
Employer identification number (EIN):596152180
NAIC Classification:813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FSU FOUNDATION ERISA PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022017-04-01
5022016-04-01
5022015-04-01DAVID BOWMAN
5022014-04-01DAVID BOWMAN

Plan Statistics for FSU FOUNDATION ERISA PLAN

401k plan membership statisitcs for FSU FOUNDATION ERISA PLAN

Measure Date Value
2017: FSU FOUNDATION ERISA PLAN 2017 401k membership
Total participants, beginning-of-year2017-04-01116
Total number of active participants reported on line 7a of the Form 55002017-04-01109
Number of retired or separated participants receiving benefits2017-04-010
Number of other retired or separated participants entitled to future benefits2017-04-010
Total of all active and inactive participants2017-04-01109
2016: FSU FOUNDATION ERISA PLAN 2016 401k membership
Total participants, beginning-of-year2016-04-01116
Total number of active participants reported on line 7a of the Form 55002016-04-01116
Number of retired or separated participants receiving benefits2016-04-010
Number of other retired or separated participants entitled to future benefits2016-04-010
Total of all active and inactive participants2016-04-01116
2015: FSU FOUNDATION ERISA PLAN 2015 401k membership
Total participants, beginning-of-year2015-04-01114
Total number of active participants reported on line 7a of the Form 55002015-04-01117
Number of retired or separated participants receiving benefits2015-04-010
Number of other retired or separated participants entitled to future benefits2015-04-010
Total of all active and inactive participants2015-04-01117
2014: FSU FOUNDATION ERISA PLAN 2014 401k membership
Total participants, beginning-of-year2014-04-01100
Total number of active participants reported on line 7a of the Form 55002014-04-01114
Number of retired or separated participants receiving benefits2014-04-010
Number of other retired or separated participants entitled to future benefits2014-04-010
Total of all active and inactive participants2014-04-01114

Form 5500 Responses for FSU FOUNDATION ERISA PLAN

2017: FSU FOUNDATION ERISA PLAN 2017 form 5500 responses
2017-04-01Type of plan entitySingle employer plan
2017-04-01Plan funding arrangement – InsuranceYes
2017-04-01Plan funding arrangement – General assets of the sponsorYes
2017-04-01Plan benefit arrangement – InsuranceYes
2017-04-01Plan benefit arrangement – General assets of the sponsorYes
2016: FSU FOUNDATION ERISA PLAN 2016 form 5500 responses
2016-04-01Type of plan entitySingle employer plan
2016-04-01Submission has been amendedNo
2016-04-01This submission is the final filingNo
2016-04-01This return/report is a short plan year return/report (less than 12 months)No
2016-04-01Plan is a collectively bargained planNo
2016-04-01Plan funding arrangement – InsuranceYes
2016-04-01Plan funding arrangement – General assets of the sponsorYes
2016-04-01Plan benefit arrangement – InsuranceYes
2016-04-01Plan benefit arrangement – General assets of the sponsorYes
2015: FSU FOUNDATION ERISA PLAN 2015 form 5500 responses
2015-04-01Type of plan entitySingle employer plan
2015-04-01Submission has been amendedNo
2015-04-01This submission is the final filingNo
2015-04-01This return/report is a short plan year return/report (less than 12 months)No
2015-04-01Plan is a collectively bargained planNo
2015-04-01Plan funding arrangement – InsuranceYes
2015-04-01Plan benefit arrangement – InsuranceYes
2014: FSU FOUNDATION ERISA PLAN 2014 form 5500 responses
2014-04-01Type of plan entitySingle employer plan
2014-04-01First time form 5500 has been submittedYes
2014-04-01Submission has been amendedNo
2014-04-01This submission is the final filingNo
2014-04-01This return/report is a short plan year return/report (less than 12 months)No
2014-04-01Plan is a collectively bargained planNo
2014-04-01Plan funding arrangement – InsuranceYes
2014-04-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 32395 )
Policy contract number12259200
Policy instance 1
Insurance contract or identification number12259200
Number of Individuals Covered64
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $709
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,980
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $709
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameBROWN AND BROWN OF FLORIDA, INC.
BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )
Policy contract numberB1917
Policy instance 2
Insurance contract or identification numberB1917
Number of Individuals Covered10
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $10,372
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,372
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameBROWN AND BROWN OF FLORIDA, INC.
CAPITAL HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95112 )
Policy contract number00411
Policy instance 3
Insurance contract or identification number00411
Number of Individuals Covered147
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $30,974
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $954,304
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $30,974
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameJUILIE FREIDUS
HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 )
Policy contract number742613
Policy instance 4
Insurance contract or identification number742613
Number of Individuals Covered85
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $2,550
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,720
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,550
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameBROWN AND BROWN OF FLORIDA, INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10090116
Policy instance 5
Insurance contract or identification number10090116
Number of Individuals Covered109
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $7,471
Total amount of fees paid to insurance companyUSD $583
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $49,806
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,471
Amount paid for insurance broker fees583
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameBROWN AND BROWN OF FLORIDA, INC.

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