GROUP MEDICAL INSURANCE PLAN FOR EMPLOYEES OF BEREA COLLEGE
|
2014
|
610444650
|
2016-01-27
|
BEREA COLLEGE
|
1005
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1949-07-01
|
Business code |
611000
|
Sponsor’s telephone number |
8599853088
|
Plan sponsor’s mailing address |
CPO 2214, BEREA, KY, 40404
|
Plan sponsor’s
address |
SUITE 220, LINCOLN HALL, BEREA, KY, 40404
|
Signature of
Role |
Plan administrator |
Date |
2016-01-27 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-01-27 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BEREA COLLEGE DENTAL BENEFIT PLAN
|
2014
|
610444650
|
2016-01-27
|
BEREA COLLEGE
|
988
|
|
File |
View Page
|
Three-digit plan number (PN) |
550
|
Effective date of plan |
2012-07-01
|
Business code |
611000
|
Sponsor’s telephone number |
8599853088
|
Plan sponsor’s mailing address |
CPO 2214, BEREA, KY, 40404
|
Plan sponsor’s
address |
SUITE 220, LINCOLN HALL, BEREA, KY, 40404
|
Signature of
Role |
Plan administrator |
Date |
2016-01-27 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-01-27 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP DISABILITY INSURANCE PLAN FOR EMPLOYEES OF BEREA COLLEGE
|
2014
|
610444650
|
2016-01-27
|
BEREA COLLEGE
|
548
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
1968-10-01
|
Business code |
611000
|
Sponsor’s telephone number |
8599853088
|
Plan sponsor’s mailing address |
CPO 2214, BEREA, KY, 40404
|
Plan sponsor’s
address |
SUITE 220, LINCOLN HALL, BEREA, KY, 40404
|
Signature of
Role |
Plan administrator |
Date |
2016-01-27 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-01-27 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP LIFE INSURANCE PLAN FOR EMPLOYEES OF BEREA COLLEGE
|
2014
|
610444650
|
2016-01-27
|
BEREA COLLEGE
|
670
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1947-09-30
|
Business code |
611000
|
Sponsor’s telephone number |
8599853088
|
Plan sponsor’s mailing address |
CPO BOX 2214, BEREA, KY, 40404
|
Plan sponsor’s
address |
SUITE 220, LINCOLN HALL, BEREA, KY, 40404
|
Signature of
Role |
Plan administrator |
Date |
2016-01-27 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-01-27 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VOLUNTARY LIFE INSURANCE PLAN FOR EMPLOYEES OF BEREA COLLEGE
|
2014
|
610444650
|
2015-10-28
|
BEREA COLLEGE
|
95
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2008-07-01
|
Business code |
611000
|
Sponsor’s telephone number |
8599853088
|
Plan sponsor’s mailing address |
CPO BOX 2214, BEREA, KY, 40404
|
Plan sponsor’s
address |
SUITE 220, LINCOLN HALL, BEREA, KY, 40404
|
Number of participants as of the end of the plan year
Retired or separated participants receiving
benefits |
151 |
Signature of
Role |
Plan administrator |
Date |
2015-10-28 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-10-28 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP LIFE INSURANCE PLAN FOR EMPLOYEES OF BEREA COLLEGE
|
2013
|
610444650
|
2015-01-16
|
BEREA COLLEGE
|
579
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1947-09-30
|
Business code |
611000
|
Sponsor’s telephone number |
8599853088
|
Plan sponsor’s mailing address |
CPO BOX 2214, BEREA, KY, 40404
|
Plan sponsor’s
address |
SUITE 220, LINCOLN HALL, BEREA, KY, 40404
|
Number of participants as of the end of the plan year
Active participants |
509 |
Retired or separated participants receiving
benefits |
161 |
Signature of
Role |
Plan administrator |
Date |
2015-01-16 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-01-16 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP DISABILITY INSURANCE PLAN FOR EMPLOYEES OF BEREA COLLEGE
|
2013
|
610444650
|
2015-01-16
|
BEREA COLLEGE
|
523
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
1968-10-01
|
Business code |
611000
|
Sponsor’s telephone number |
8599853088
|
Plan sponsor’s mailing address |
CPO 2214, BEREA, KY, 40404
|
Plan sponsor’s
address |
SUITE 220, LINCOLN HALL, BEREA, KY, 40404
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-01-16 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-01-16 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BEREA COLLEGE DENTAL BENEFIT PLAN
|
2013
|
610444650
|
2015-01-16
|
BEREA COLLEGE
|
1031
|
|
File |
View Page
|
Three-digit plan number (PN) |
550
|
Effective date of plan |
2012-07-01
|
Business code |
611000
|
Sponsor’s telephone number |
8599853088
|
Plan sponsor’s mailing address |
CPO 2214, BEREA, KY, 40404
|
Plan sponsor’s
address |
SUITE 220, LINCOLN HALL, BEREA, KY, 40404
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-01-16 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-01-16 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP MEDICAL INSURANCE PLAN FOR EMPLOYEES OF BEREA COLLEGE
|
2013
|
610444650
|
2015-01-16
|
BEREA COLLEGE
|
965
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1949-07-01
|
Business code |
611000
|
Sponsor’s telephone number |
8599853088
|
Plan sponsor’s mailing address |
CPO 2214, BEREA, KY, 40404
|
Plan sponsor’s
address |
SUITE 220, LINCOLN HALL, BEREA, KY, 40404
|
Number of participants as of the end of the plan year
Active participants |
992 |
Retired or separated participants receiving
benefits |
13 |
Signature of
Role |
Plan administrator |
Date |
2015-01-16 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-01-16 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VOLUNTARY LIFE INSURANCE PLAN FOR EMPLOYEES OF BEREA COLLEGE
|
2013
|
610444650
|
2014-09-30
|
BEREA COLLEGE
|
99
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2008-07-01
|
Business code |
611000
|
Sponsor’s telephone number |
8599853088
|
Plan sponsor’s mailing address |
CPO BOX 2214, BEREA, KY, 40404
|
Plan sponsor’s
address |
SUITE 220, LINCOLN HALL, BEREA, KY, 40404
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-09-30 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-09-30 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP DISABILITY INSURANCE PLAN FOR EMPLOYEES OF BEREA COLLEGE
|
2012
|
610444650
|
2013-12-19
|
BEREA COLLEGE
|
440
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/12/19/20131219151802P030132302691001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
1968-10-01 |
Business code |
611000 |
Sponsor’s telephone number |
8599853088 |
Plan sponsor’s mailing address |
CPO 2214, BEREA, KY, 40404 |
Plan sponsor’s
address |
SUITE 220, LINCOLN HALL, BEREA, KY, 40404 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-12-19 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-12-19 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP LIFE INSURANCE PLAN FOR EMPLOYEES OF BEREA COLLEGE
|
2012
|
610444650
|
2013-12-19
|
BEREA COLLEGE
|
579
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/12/19/20131219151734P030132301875001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
1947-09-30 |
Business code |
611000 |
Sponsor’s telephone number |
8599853088 |
Plan sponsor’s mailing address |
CPO BOX 2214, BEREA, KY, 40404 |
Plan sponsor’s
address |
SUITE 220, LINCOLN HALL, BEREA, KY, 40404 |
Number of participants as of the end of the plan year
Active participants |
451 |
Retired or separated participants receiving
benefits |
169 |
Signature of
Role |
Plan administrator |
Date |
2013-12-19 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-12-19 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BEREA COLLEGE DENTAL BENEFIT PLAN
|
2012
|
610444650
|
2013-12-20
|
BEREA COLLEGE
|
0
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/12/20/20131220155531P040133794883001.pdf |
Three-digit plan number (PN) |
550 |
Effective date of plan |
2012-07-01 |
Business code |
611000 |
Sponsor’s telephone number |
8599853088 |
Plan sponsor’s mailing address |
CPO 2214, BEREA, KY, 40404 |
Plan sponsor’s
address |
SUITE 220, LINCOLN HALL, BEREA, KY, 40404 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-12-20 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-12-20 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP MEDICAL INSURANCE PLAN FOR EMPLOYEES OF BEREA COLLEGE
|
2012
|
610444650
|
2013-12-20
|
BEREA COLLEGE
|
893
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/12/20/20131220155420P040133793459001.pdf |
Three-digit plan number (PN) |
502 |
Effective date of plan |
1949-07-01 |
Business code |
611000 |
Sponsor’s telephone number |
8599853088 |
Plan sponsor’s mailing address |
CPO 2214, BEREA, KY, 40404 |
Plan sponsor’s
address |
SUITE 220, LINCOLN HALL, BEREA, KY, 40404 |
Number of participants as of the end of the plan year
Active participants |
948 |
Retired or separated participants receiving
benefits |
17 |
Signature of
Role |
Plan administrator |
Date |
2013-12-20 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-12-20 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VOLUNTARY LIFE INSURANCE PLAN FOR EMPLOYEES OF BEREA COLLEGE
|
2012
|
610444650
|
2013-10-31
|
BEREA COLLEGE
|
100
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/10/31/20131031144541P040063412275001.pdf |
Three-digit plan number (PN) |
503 |
Effective date of plan |
2008-07-01 |
Business code |
611000 |
Sponsor’s telephone number |
8599853088 |
Plan sponsor’s mailing address |
CPO BOX 2214, BEREA, KY, 40404 |
Plan sponsor’s
address |
SUITE 220, LINCOLN HALL, BEREA, KY, 40404 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-10-31 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-10-31 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP LIFE INSURANCE PLAN FOR EMPLOYEES OF BEREA COLLEGE
|
2011
|
610444650
|
2012-12-21
|
BEREA COLLEGE
|
553
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/12/21/20121221074846P040018134355001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
1947-09-30 |
Business code |
611000 |
Sponsor’s telephone number |
8599853088 |
Plan sponsor’s mailing address |
CPO BOX 2214, BEREA, KY, 40404 |
Plan sponsor’s
address |
SUITE 220, LINCOLN HALL, BEREA, KY, 40404 |
Plan administrator’s name and address
Administrator’s EIN |
610444650 |
Plan administrator’s name |
BEREA COLLEGE |
Plan administrator’s
address |
CPO BOX 2214, BEREA, KY, 40404 |
Administrator’s telephone number |
8599853088 |
Number of participants as of the end of the plan year
Active participants |
405 |
Retired or separated participants receiving
benefits |
174 |
Signature of
Role |
Plan administrator |
Date |
2012-12-21 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-12-21 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP DISABILITY INSURANCE PLAN FOR EMPLOYEES OF BEREA COLLEGE
|
2011
|
610444650
|
2012-12-21
|
BEREA COLLEGE
|
423
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/12/21/20121221074841P040018134035001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
1968-10-01 |
Business code |
611000 |
Sponsor’s telephone number |
8599853088 |
Plan sponsor’s mailing address |
CPO 2214, BEREA, KY, 40404 |
Plan sponsor’s
address |
SUITE 220, LINCOLN HALL, BEREA, KY, 40404 |
Plan administrator’s name and address
Administrator’s EIN |
610444650 |
Plan administrator’s name |
BEREA COLLEGE |
Plan administrator’s
address |
CPO 2214, BEREA, KY, 40404 |
Administrator’s telephone number |
8599853088 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-12-21 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-12-21 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP MEDICAL INSURANCE PLAN FOR EMPLOYEES OF BEREA COLLEGE
|
2011
|
610444650
|
2012-12-21
|
BEREA COLLEGE
|
789
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/12/21/20121221074835P040018133955001.pdf |
Three-digit plan number (PN) |
502 |
Effective date of plan |
1949-07-01 |
Business code |
611000 |
Sponsor’s telephone number |
8599853088 |
Plan sponsor’s mailing address |
CPO 2214, BEREA, KY, 40404 |
Plan sponsor’s
address |
SUITE 220, LINCOLN HALL, BEREA, KY, 40404 |
Plan administrator’s name and address
Administrator’s EIN |
610444650 |
Plan administrator’s name |
BEREA COLLEGE |
Plan administrator’s
address |
CPO 2214, BEREA, KY, 40404 |
Administrator’s telephone number |
8599853088 |
Number of participants as of the end of the plan year
Active participants |
851 |
Retired or separated participants receiving
benefits |
42 |
Signature of
Role |
Plan administrator |
Date |
2012-12-21 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-12-21 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VOLUNTARY LIFE INSURANCE PLAN FOR EMPLOYEES OF BEREA COLLEGE
|
2011
|
610444650
|
2012-09-04
|
BEREA COLLEGE
|
101
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/09/04/20120904074021P030045378178001.pdf |
Three-digit plan number (PN) |
503 |
Effective date of plan |
2008-07-01 |
Business code |
611000 |
Sponsor’s telephone number |
8599853088 |
Plan sponsor’s mailing address |
CPO BOX 2214, BEREA, KY, 40404 |
Plan sponsor’s
address |
SUITE 220, LINCOLN HALL, BEREA, KY, 40404 |
Plan administrator’s name and address
Administrator’s EIN |
610444650 |
Plan administrator’s name |
BEREA COLLEGE |
Plan administrator’s
address |
CPO BOX 2214, BEREA, KY, 40404 |
Administrator’s telephone number |
8599853088 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-09-04 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-09-04 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VOLUNTARY LIFE INSURANCE PLAN FOR EMPLOYEES OF BEREA COLLEGE
|
2010
|
610444650
|
2012-01-27
|
BEREA COLLEGE
|
99
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/01/27/20120127142639P030025450369001.pdf |
Three-digit plan number (PN) |
503 |
Effective date of plan |
2008-07-01 |
Business code |
611000 |
Sponsor’s telephone number |
8599853088 |
Plan sponsor’s mailing address |
CPO BOX 2214, BEREA, KY, 40404 |
Plan sponsor’s
address |
SUITE 220. LINCOLN HALL, BEREA, KY, 40404 |
Plan administrator’s name and address
Administrator’s EIN |
610444650 |
Plan administrator’s name |
BEREA COLLEGE |
Plan administrator’s
address |
CPO BOX 2214, BEREA, KY, 40404 |
Administrator’s telephone number |
8599853088 |
Number of participants as of the end of the plan year
Active participants |
101 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2012-01-27 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-01-27 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP LIFE INSURANCE PLAN FOR EMPLOYEES OF BEREA COLLEGE
|
2010
|
610444650
|
2012-01-27
|
BEREA COLLEGE
|
536
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/01/27/20120127142634P030001913541001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
1947-09-30 |
Business code |
611000 |
Sponsor’s telephone number |
8599853088 |
Plan sponsor’s mailing address |
CPO BOX 2214, BEREA, KY, 40404 |
Plan sponsor’s
address |
SUITE 220, LINCOLN HALL, BEREA, KY, 40404 |
Plan administrator’s name and address
Administrator’s EIN |
610444650 |
Plan administrator’s name |
BEREA COLLEGE |
Plan administrator’s
address |
CPO BOX 2214, BEREA, KY, 40404 |
Administrator’s telephone number |
8599853088 |
Number of participants as of the end of the plan year
Active participants |
385 |
Retired or separated participants receiving
benefits |
168 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2012-01-27 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-01-27 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP MEDICAL INSURANCE PLAN FOR EMPLOYEES OF BEREA COLLEGE
|
2010
|
610444650
|
2012-01-27
|
BEREA COLLEGE
|
795
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/01/27/20120127142629P030025450305001.pdf |
Three-digit plan number (PN) |
502 |
Effective date of plan |
1949-07-01 |
Business code |
611000 |
Sponsor’s telephone number |
8599853088 |
Plan sponsor’s mailing address |
CPO 2214, BEREA, KY, 40404 |
Plan sponsor’s
address |
SUITE 220, LINCOLN HALL, BEREA, KY, 40404 |
Plan administrator’s name and address
Administrator’s EIN |
610444650 |
Plan administrator’s name |
BEREA COLLEGE |
Plan administrator’s
address |
CPO 2214, BEREA, KY, 40404 |
Administrator’s telephone number |
8599853088 |
Number of participants as of the end of the plan year
Active participants |
779 |
Retired or separated participants receiving
benefits |
10 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2012-01-27 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-01-27 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP DISABILITY INSURANCE PLAN FOR EMPLOYEES OF BEREA COLLEGE
|
2010
|
610444650
|
2012-01-27
|
BEREA COLLEGE
|
441
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/01/27/20120127142622P030007508855001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
1968-10-01 |
Business code |
611000 |
Sponsor’s telephone number |
8599853088 |
Plan sponsor’s mailing address |
CPO 2214, BEREA, KY, 40404 |
Plan sponsor’s
address |
SUITE 220, LINCOLN HALL, BEREA, KY, 40404 |
Plan administrator’s name and address
Administrator’s EIN |
610444650 |
Plan administrator’s name |
BEREA COLLEGE |
Plan administrator’s
address |
CPO 2214, BEREA, KY, 40404 |
Administrator’s telephone number |
8599853088 |
Number of participants as of the end of the plan year
Active participants |
423 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2012-01-27 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-01-27 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP LIFE INSURANCE PLAN FOR EMPLOYEES OF BEREA COLLEGE
|
2009
|
610444650
|
2011-01-22
|
BEREA COLLEGE
|
576
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/01/22/20110122095454P030084313856001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
1947-09-30 |
Business code |
611000 |
Sponsor’s telephone number |
8599853088 |
Plan sponsor’s mailing address |
CPO BOX 2214, BEREA, KY, 40404 |
Plan sponsor’s
address |
SUITE 220, LINCOLN HALL, BEREA, KY, 40404 |
Plan administrator’s name and address
Administrator’s EIN |
610444650 |
Plan administrator’s name |
BEREA COLLEGE |
Plan administrator’s
address |
CPO BOX 2214, BEREA, KY, 40404 |
Administrator’s telephone number |
8599853088 |
Number of participants as of the end of the plan year
Active participants |
380 |
Retired or separated participants receiving
benefits |
156 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2011-01-22 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-01-22 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP MEDICAL INSURANCE PLAN FOR EMPLOYEES OF BEREA COLLEGE
|
2009
|
610444650
|
2011-01-24
|
BEREA COLLEGE
|
853
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/01/24/20110124091939P040000604163001.pdf |
Three-digit plan number (PN) |
502 |
Effective date of plan |
1949-07-01 |
Business code |
611000 |
Sponsor’s telephone number |
8599853088 |
Plan sponsor’s mailing address |
CPO 2214, BEREA, KY, 40404 |
Plan sponsor’s
address |
SUITE 220, LINCOLN HALL, BEREA, KY, 40404 |
Plan administrator’s name and address
Administrator’s EIN |
610444650 |
Plan administrator’s name |
BEREA COLLEGE |
Plan administrator’s
address |
CPO 2214, BEREA, KY, 40404 |
Administrator’s telephone number |
8599853088 |
Number of participants as of the end of the plan year
Active participants |
775 |
Retired or separated participants receiving
benefits |
20 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2011-01-24 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-01-24 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP DISABILITY INSURANCE PLAN FOR EMPLOYEES OF BEREA COLLEGE
|
2009
|
610444650
|
2011-01-21
|
BEREA COLLEGE
|
460
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/01/21/20110121165407P030018003201001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
1968-10-01 |
Business code |
611000 |
Sponsor’s telephone number |
8599853088 |
Plan sponsor’s mailing address |
CPO 2214, BEREA, KY, 40404 |
Plan sponsor’s
address |
SUITE 220, LINCOLN HALL, BEREA, KY, 40404 |
Plan administrator’s name and address
Administrator’s EIN |
610444650 |
Plan administrator’s name |
BEREA COLLEGE |
Plan administrator’s
address |
CPO 2214, BEREA, KY, 40404 |
Administrator’s telephone number |
8599853088 |
Number of participants as of the end of the plan year
Active participants |
441 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2011-01-21 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-01-21 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP DISABILITY INSURANCE PLAN FOR EMPLOYEES OF BEREA COLLEGE
|
2009
|
610444650
|
2011-01-21
|
BEREA COLLEGE
|
460
|
|
Three-digit plan number (PN) |
504 |
Effective date of plan |
1968-10-01 |
Business code |
611000 |
Sponsor’s telephone number |
8599853088 |
Plan sponsor’s mailing address |
CPO 2214, BEREA, KY, 40404 |
Plan sponsor’s
address |
SUITE 220, LINCOLN HALL, BEREA, KY, 40404 |
Plan administrator’s name and address
Administrator’s EIN |
610444650 |
Plan administrator’s name |
BEREA COLLEGE |
Plan administrator’s
address |
CPO 2214, BEREA, KY, 40404 |
Administrator’s telephone number |
8599853088 |
Number of participants as of the end of the plan year
Active participants |
441 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2011-01-21 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-01-21 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VOLUNTARY LIFE INSURANCE PLAN FOR EMPLOYEES OF BEREA COLLEGE
|
2009
|
610444650
|
2011-01-22
|
BEREA COLLEGE
|
93
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/01/22/20110122095635P030018341105001.pdf |
Three-digit plan number (PN) |
503 |
Effective date of plan |
2008-07-01 |
Business code |
611000 |
Sponsor’s telephone number |
8599853088 |
Plan sponsor’s mailing address |
CPO BOX 2214, BEREA, KY, 40404 |
Plan sponsor’s
address |
SUITE 220. LINCOLN HALL, BEREA, KY, 40404 |
Plan administrator’s name and address
Administrator’s EIN |
610444650 |
Plan administrator’s name |
BEREA COLLEGE |
Plan administrator’s
address |
CPO BOX 2214, BEREA, KY, 40404 |
Administrator’s telephone number |
8599853088 |
Number of participants as of the end of the plan year
Active participants |
99 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2011-01-22 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-01-22 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP DISABILITY INSURANCE PLAN FOR EMPLOYEES OF BEREA COLLEGE
|
2009
|
610444650
|
2011-01-21
|
BEREA COLLEGE
|
460
|
|
Three-digit plan number (PN) |
504 |
Effective date of plan |
1968-10-01 |
Business code |
611000 |
Sponsor’s telephone number |
8599853088 |
Plan sponsor’s mailing address |
CPO 2214, BEREA, KY, 40404 |
Plan sponsor’s
address |
SUITE 220, LINCOLN HALL, BEREA, KY, 40404 |
Plan administrator’s name and address
Administrator’s EIN |
610444650 |
Plan administrator’s name |
BEREA COLLEGE |
Plan administrator’s
address |
CPO 2214, BEREA, KY, 40404 |
Administrator’s telephone number |
8599853088 |
Number of participants as of the end of the plan year
Active participants |
441 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2011-01-21 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-01-21 |
Name of individual signing |
JEFF AMBURGEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|