401k Plan data: ABBOTT LABORATORIES PUERTO RICO DISABILITY LIFE INSURANCE PLAN plan

ABBOTT LABORATORIES PUERTO RICO DISABILITY LIFE INSURANCE PLAN 401k Plan overview

Plan Name	ABBOTT LABORATORIES PUERTO RICO DISABILITY LIFE INSURANCE PLAN
Plan identification number	537

ABBOTT LABORATORIES PUERTO RICO DISABILITY LIFE INSURANCE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Death benefits (include travel accident but not life insurance) 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.

401k Sponsoring company profile

ABBOTT HEALTHCARE (PUERTO RICO) LTD. C/O ABBOTT LABORATORIES has sponsored the creation of one or more 401k plans.

Company Name: ABBOTT HEALTHCARE (PUERTO RICO) LTD. C/O ABBOTT LABORATORIES

Employer identification number (EIN): 981051267

NAIC Classification: 325410

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ABBOTT LABORATORIES PUERTO RICO DISABILITY LIFE INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
537 2016-01-01 MARY MORELAND MARY MORELAND 2017-09-17
537 2015-01-01 MARY MORELAND MARY MORELAND 2016-09-28
537 2014-01-01 MARY MORELAND MARY MORELAND 2015-10-13
537 2013-01-01 MARY MORELAND MARY MORELAND 2014-09-17

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
537	2016-01-01	MARY MORELAND	MARY MORELAND	2017-09-17
537	2015-01-01	MARY MORELAND	MARY MORELAND	2016-09-28
537	2014-01-01	MARY MORELAND	MARY MORELAND	2015-10-13
537	2013-01-01	MARY MORELAND	MARY MORELAND	2014-09-17

Plan Statistics for ABBOTT LABORATORIES PUERTO RICO DISABILITY LIFE INSURANCE PLAN

401k plan membership statisitcs for ABBOTT LABORATORIES PUERTO RICO DISABILITY LIFE INSURANCE PLAN

Measure Date Value
2016: ABBOTT LABORATORIES PUERTO RICO DISABILITY LIFE INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 111
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
Number of retired or separated participants receiving benefits 2016-01-01 0
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 0
2015: ABBOTT LABORATORIES PUERTO RICO DISABILITY LIFE INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 150
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 0
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 110
Total of all active and inactive participants 2015-01-01 110
2014: ABBOTT LABORATORIES PUERTO RICO DISABILITY LIFE INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 176
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 0
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 150
Total of all active and inactive participants 2014-01-01 150
2013: ABBOTT LABORATORIES PUERTO RICO DISABILITY LIFE INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 195
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 0
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 178
Total of all active and inactive participants 2013-01-01 178

Measure	Date	Value
2016: ABBOTT LABORATORIES PUERTO RICO DISABILITY LIFE INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	111
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
Number of retired or separated participants receiving benefits	2016-01-01	0
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	0
2015: ABBOTT LABORATORIES PUERTO RICO DISABILITY LIFE INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	150
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	0
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	110
Total of all active and inactive participants	2015-01-01	110
2014: ABBOTT LABORATORIES PUERTO RICO DISABILITY LIFE INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	176
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	0
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	150
Total of all active and inactive participants	2014-01-01	150
2013: ABBOTT LABORATORIES PUERTO RICO DISABILITY LIFE INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	195
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	0
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	178
Total of all active and inactive participants	2013-01-01	178

Form 5500 Responses for ABBOTT LABORATORIES PUERTO RICO DISABILITY LIFE INSURANCE PLAN

2016: ABBOTT LABORATORIES PUERTO RICO DISABILITY LIFE INSURANCE PLAN 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: ABBOTT LABORATORIES PUERTO RICO DISABILITY LIFE INSURANCE PLAN 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: ABBOTT LABORATORIES PUERTO RICO DISABILITY LIFE INSURANCE PLAN 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: ABBOTT LABORATORIES PUERTO RICO DISABILITY LIFE INSURANCE PLAN 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

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

33041

Policy instance

Insurance contract or identification number	33041
Number of Individuals Covered	110
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
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	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
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 $91,645
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

33041

Policy instance

Insurance contract or identification number	33041
Number of Individuals Covered	150
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
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	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
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 $122,933
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MINNESOTA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66168 )

Policy contract number

33041

Policy instance

Insurance contract or identification number	33041
Number of Individuals Covered	178
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $3,887
Total amount of fees paid to insurance company	USD $0
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	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
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 $129,584
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,604
Insurance broker organization code?	3
Insurance broker name	WILLIAM F SHEAN JR.

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Company Name:	ABBOTT HEALTHCARE (PUERTO RICO) LTD. C/O ABBOTT LABORATORIES
Employer identification number (EIN):	981051267
NAIC Classification:	325410