401k Plan data: EMPLOYEE MEDICAL BENEFIT PLAN OF INTERNATIONAL SCHOOL OF THE PENINSULA plan

EMPLOYEE MEDICAL BENEFIT PLAN OF INTERNATIONAL SCHOOL OF THE PENINSULA 401k Plan overview

Plan Name	EMPLOYEE MEDICAL BENEFIT PLAN OF INTERNATIONAL SCHOOL OF THE PENINSULA
Plan identification number	504

EMPLOYEE MEDICAL BENEFIT PLAN OF INTERNATIONAL SCHOOL OF THE PENINSULA Benefits

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

401k Sponsoring company profile

SILICON VALLEY INTERNATIONAL SCHOOL has sponsored the creation of one or more 401k plans.

Company Name: SILICON VALLEY INTERNATIONAL SCHOOL

Employer identification number (EIN): 942599581

NAIC Classification: 611000

Additional information about SILICON VALLEY INTERNATIONAL SCHOOL

Jurisdiction of Incorporation: California Department of State

Incorporation Date:

Company Identification Number: C0923752

More information about SILICON VALLEY INTERNATIONAL SCHOOL

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE MEDICAL BENEFIT PLAN OF INTERNATIONAL SCHOOL OF THE PENINSULA

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
504 2018-09-01
504 2017-09-01 DIANE MORRIS 2019-03-28 DIANE MORRIS 2019-03-28
504 2017-01-01 DIANE MORRIS 2019-03-28 DIANE MORRIS 2019-03-28
504 2016-01-01 JORDAN SHIELDS
504 2015-01-01 JORDAN SHIELDS
504 2014-01-01 JORDAN SHIELDS
504 2013-01-01 JORDAN SHIELDS

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
504	2018-09-01
504	2017-09-01	DIANE MORRIS	2019-03-28	DIANE MORRIS	2019-03-28
504	2017-01-01	DIANE MORRIS	2019-03-28	DIANE MORRIS	2019-03-28
504	2016-01-01	JORDAN SHIELDS
504	2015-01-01	JORDAN SHIELDS
504	2014-01-01	JORDAN SHIELDS
504	2013-01-01	JORDAN SHIELDS

Plan Statistics for EMPLOYEE MEDICAL BENEFIT PLAN OF INTERNATIONAL SCHOOL OF THE PENINSULA

401k plan membership statisitcs for EMPLOYEE MEDICAL BENEFIT PLAN OF INTERNATIONAL SCHOOL OF THE PENINSULA

Measure Date Value
2018: EMPLOYEE MEDICAL BENEFIT PLAN OF INTERNATIONAL SCHOOL OF THE PENINSULA 2018 401k membership
Total participants, beginning-of-year 2018-09-01 95
Total number of active participants reported on line 7a of the Form 5500 2018-09-01 0
Number of retired or separated participants receiving benefits 2018-09-01 0
Number of other retired or separated participants entitled to future benefits 2018-09-01 0
Total of all active and inactive participants 2018-09-01 0
2017: EMPLOYEE MEDICAL BENEFIT PLAN OF INTERNATIONAL SCHOOL OF THE PENINSULA 2017 401k membership
Total participants, beginning-of-year 2017-09-01 140
Total number of active participants reported on line 7a of the Form 5500 2017-09-01 119
Number of retired or separated participants receiving benefits 2017-09-01 2
Total of all active and inactive participants 2017-09-01 121
Total participants 2017-09-01 121
Total participants, beginning-of-year 2017-01-01 106
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 140
Number of retired or separated participants receiving benefits 2017-01-01 2
Total of all active and inactive participants 2017-01-01 142
Total participants 2017-01-01 142
2016: EMPLOYEE MEDICAL BENEFIT PLAN OF INTERNATIONAL SCHOOL OF THE PENINSULA 2016 401k membership
Total participants, beginning-of-year 2016-01-01 112
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 106
Number of retired or separated participants receiving benefits 2016-01-01 6
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 112
2015: EMPLOYEE MEDICAL BENEFIT PLAN OF INTERNATIONAL SCHOOL OF THE PENINSULA 2015 401k membership
Total participants, beginning-of-year 2015-01-01 103
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 107
Number of retired or separated participants receiving benefits 2015-01-01 5
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 112
2014: EMPLOYEE MEDICAL BENEFIT PLAN OF INTERNATIONAL SCHOOL OF THE PENINSULA 2014 401k membership
Total participants, beginning-of-year 2014-01-01 103
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 102
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 102
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 102
2013: EMPLOYEE MEDICAL BENEFIT PLAN OF INTERNATIONAL SCHOOL OF THE PENINSULA 2013 401k membership
Total participants, beginning-of-year 2013-01-01 98
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 103
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 103
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 103
Number of participants with account balances 2013-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0

Measure	Date	Value
2018: EMPLOYEE MEDICAL BENEFIT PLAN OF INTERNATIONAL SCHOOL OF THE PENINSULA 2018 401k membership
Total participants, beginning-of-year	2018-09-01	95
Total number of active participants reported on line 7a of the Form 5500	2018-09-01	0
Number of retired or separated participants receiving benefits	2018-09-01	0
Number of other retired or separated participants entitled to future benefits	2018-09-01	0
Total of all active and inactive participants	2018-09-01	0
2017: EMPLOYEE MEDICAL BENEFIT PLAN OF INTERNATIONAL SCHOOL OF THE PENINSULA 2017 401k membership
Total participants, beginning-of-year	2017-09-01	140
Total number of active participants reported on line 7a of the Form 5500	2017-09-01	119
Number of retired or separated participants receiving benefits	2017-09-01	2
Total of all active and inactive participants	2017-09-01	121
Total participants	2017-09-01	121
Total participants, beginning-of-year	2017-01-01	106
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	140
Number of retired or separated participants receiving benefits	2017-01-01	2
Total of all active and inactive participants	2017-01-01	142
Total participants	2017-01-01	142
2016: EMPLOYEE MEDICAL BENEFIT PLAN OF INTERNATIONAL SCHOOL OF THE PENINSULA 2016 401k membership
Total participants, beginning-of-year	2016-01-01	112
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	106
Number of retired or separated participants receiving benefits	2016-01-01	6
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	112
2015: EMPLOYEE MEDICAL BENEFIT PLAN OF INTERNATIONAL SCHOOL OF THE PENINSULA 2015 401k membership
Total participants, beginning-of-year	2015-01-01	103
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	107
Number of retired or separated participants receiving benefits	2015-01-01	5
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	112
2014: EMPLOYEE MEDICAL BENEFIT PLAN OF INTERNATIONAL SCHOOL OF THE PENINSULA 2014 401k membership
Total participants, beginning-of-year	2014-01-01	103
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	102
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	102
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	102
2013: EMPLOYEE MEDICAL BENEFIT PLAN OF INTERNATIONAL SCHOOL OF THE PENINSULA 2013 401k membership
Total participants, beginning-of-year	2013-01-01	98
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	103
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	103
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	103
Number of participants with account balances	2013-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0

Form 5500 Responses for EMPLOYEE MEDICAL BENEFIT PLAN OF INTERNATIONAL SCHOOL OF THE PENINSULA

2018: EMPLOYEE MEDICAL BENEFIT PLAN OF INTERNATIONAL SCHOOL OF THE PENINSULA 2018 form 5500 responses
2018-09-01	Type of plan entity	Single employer plan
2018-09-01	Submission has been amended	No
2018-09-01	This submission is the final filing	Yes
2018-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-09-01	Plan is a collectively bargained plan	No
2018-09-01	Plan funding arrangement – Insurance	Yes
2018-09-01	Plan benefit arrangement – Insurance	Yes
2017: EMPLOYEE MEDICAL BENEFIT PLAN OF INTERNATIONAL SCHOOL OF THE PENINSULA 2017 form 5500 responses
2017-09-01	Type of plan entity	Single employer plan
2017-09-01	Submission has been amended	No
2017-09-01	This submission is the final filing	No
2017-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-09-01	Plan is a collectively bargained plan	No
2017-09-01	Plan funding arrangement – Insurance	Yes
2017-09-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: EMPLOYEE MEDICAL BENEFIT PLAN OF INTERNATIONAL SCHOOL OF THE PENINSULA 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: EMPLOYEE MEDICAL BENEFIT PLAN OF INTERNATIONAL SCHOOL OF THE PENINSULA 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: EMPLOYEE MEDICAL BENEFIT PLAN OF INTERNATIONAL SCHOOL OF THE PENINSULA 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: EMPLOYEE MEDICAL BENEFIT PLAN OF INTERNATIONAL SCHOOL OF THE PENINSULA 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

Insurance Providers Used on plan

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	22116
Policy instance	1
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	22116
Policy instance	1
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	22116
Policy instance	1
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	22116
Policy instance	1
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	22116
Policy instance	1
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	22116
Policy instance	1

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Company Name:	SILICON VALLEY INTERNATIONAL SCHOOL
Employer identification number (EIN):	942599581
NAIC Classification:	611000

Jurisdiction of Incorporation:	California Department of State
Incorporation Date:
Company Identification Number:	C0923752