BUSINESS TRAVEL ACCIDENT INSURANCE FOR THE UNIVERSITY OF BRIDGEPORT
|
2019
|
060646936
|
2021-01-26
|
UNIVERSITY OF BRIDGEPORT
|
300
|
|
File |
View Page
|
Three-digit plan number (PN) |
507
|
Effective date of plan |
2005-09-24
|
Business code |
611000
|
Sponsor’s telephone number |
2035764588
|
Plan sponsor’s mailing address |
7TH FLOOR HUMAN RESOURCES, 126 PARK AVE, BRIDGEPORT, CT, 066047620
|
Plan sponsor’s
address |
7TH FLOOR HUMAN RESOURCES, 126 PARK AVE, BRIDGEPORT, CT, 066047620
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-01-26 |
Name of individual signing |
MELITHA PRZYGODA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL INSURANCE PLAN FOR FULL TIME EMPLOYEES OF THE UNIVERSITY OF BRIDGEPORT
|
2018
|
060646936
|
2020-01-31
|
UNIVERSITY OF BRIDGEPORT
|
392
|
|
File |
View Page
|
Three-digit plan number (PN) |
506
|
Effective date of plan |
1983-04-01
|
Business code |
611000
|
Sponsor’s telephone number |
2035764588
|
Plan sponsor’s mailing address |
126 PARK AVE 7TH FL, BRIDGEPORT, CT, 066047620
|
Plan sponsor’s
address |
126 PARK AVE 7TH FL, BRIDGEPORT, CT, 066047620
|
Number of participants as of the end of the plan year
Active participants |
361 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2020-01-31 |
Name of individual signing |
MELITHA PRZYGODA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VARIOUS MEDICAL BENEFIT PLANS FOR FULL TIME EMPLOYEES OF THE UNIVERSITY OF BRIDGEPORT
|
2018
|
060646936
|
2020-01-31
|
UNIVERSITY OF BRIDGEPORT
|
421
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
1947-01-01
|
Business code |
611000
|
Sponsor’s telephone number |
2035764588
|
Plan sponsor’s mailing address |
126 PARK AVE 7TH FL, BRIDGEPORT, CT, 066047620
|
Plan sponsor’s
address |
126 PARK AVE 7TH FL, BRIDGEPORT, CT, 066047620
|
Number of participants as of the end of the plan year
Active participants |
350 |
Retired or separated participants receiving
benefits |
41 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2020-01-31 |
Name of individual signing |
MELITHA PRZYGODA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP LIFE INSURANCE PLAN FOR FULL TIME EMPLOYEES OF THE UNIVERSITY OF BRIDGEPORT
|
2018
|
060646936
|
2020-01-31
|
UNIVERSITY OF BRIDGEPORT
|
461
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2016-12-01
|
Business code |
611000
|
Sponsor’s telephone number |
2035764588
|
Plan sponsor’s mailing address |
126 PARK AVE, BRIDGEPORT, CT, 066047620
|
Plan sponsor’s
address |
126 PARK AVE, BRIDGEPORT, CT, 066047620
|
Number of participants as of the end of the plan year
Active participants |
440 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2020-01-31 |
Name of individual signing |
MELITHA PRZYGODA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
TOTAL DISABILITY INSURANCE PLAN FOR FULL TIME EMPLOYEES OF THE UNIVERSITY OF BRIDGEPORT
|
2018
|
060646936
|
2020-01-31
|
UNIVERSITY OF BRIDGEPORT
|
410
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2016-12-01
|
Business code |
611000
|
Sponsor’s telephone number |
2035764588
|
Plan sponsor’s mailing address |
126 PARK AVE, BRIDGEPORT, CT, 066047620
|
Plan sponsor’s
address |
126 PARK AVE, BRIDGEPORT, CT, 066047620
|
Number of participants as of the end of the plan year
Active participants |
376 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2020-01-31 |
Name of individual signing |
MELITHA PRZYGODA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BUSINESS TRAVEL ACCIDENT INSURANCE FOR THE UNIVERSITY OF BRIDGEPORT
|
2018
|
060646936
|
2020-01-31
|
UNIVERSITY OF BRIDGEPORT
|
300
|
|
File |
View Page
|
Three-digit plan number (PN) |
507
|
Effective date of plan |
2005-09-24
|
Business code |
611000
|
Sponsor’s telephone number |
2035764588
|
Plan sponsor’s mailing address |
7TH FLOOR - HUMAN RESOURCES, 126 PARK AVE, BRIDGEPORT, CT, 066047620
|
Plan sponsor’s
address |
7TH FLOOR - HUMAN RESOURCES, 126 PARK AVE, BRIDGEPORT, CT, 066047620
|
Number of participants as of the end of the plan year
Active participants |
300 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2020-01-31 |
Name of individual signing |
MELITHA PRZYGODA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VARIOUS MEDICAL BENEFIT PLANS FOR FULL TIME EMPLOYEES OF THE UNIVERSITY OF BRIDGEPORT
|
2017
|
060646936
|
2019-01-31
|
UNIVERSITY OF BRIDGEPORT
|
429
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
1947-01-01
|
Business code |
611000
|
Sponsor’s telephone number |
2035764588
|
Plan sponsor’s mailing address |
126 PARK AVE 7TH FL, BRIDGEPORT, CT, 066047620
|
Plan sponsor’s
address |
126 PARK AVE 7TH FL, BRIDGEPORT, CT, 066047620
|
Number of participants as of the end of the plan year
Active participants |
376 |
Retired or separated participants receiving
benefits |
45 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2019-01-30 |
Name of individual signing |
MELITHA PRZYGODA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP LIFE INSURANCE PLAN FOR FULL TIME EMPLOYEES OF THE UNIVERSITY OF BRIDGEPORT
|
2017
|
060646936
|
2019-01-31
|
UNIVERSITY OF BRIDGEPORT
|
527
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2016-12-01
|
Business code |
611000
|
Sponsor’s telephone number |
2035764588
|
Plan sponsor’s mailing address |
126 PARK AVE, BRIDGEPORT, CT, 066047620
|
Plan sponsor’s
address |
126 PARK AVE, BRIDGEPORT, CT, 066047620
|
Number of participants as of the end of the plan year
Active participants |
461 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2019-01-30 |
Name of individual signing |
MELITHA PRZYGODA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BUSINESS TRAVEL ACCIDENT INSURANCE FOR THE UNIVERSITY OF BRIDGEPORT
|
2017
|
060646936
|
2019-01-31
|
UNIVERSITY OF BRIDGEPORT
|
300
|
|
File |
View Page
|
Three-digit plan number (PN) |
507
|
Effective date of plan |
2005-09-24
|
Business code |
611000
|
Sponsor’s telephone number |
2035764588
|
Plan sponsor’s mailing address |
7TH FLOOR - HUMAN RESOURCES, 126 PARK AVE, BRIDGEPORT, CT, 066047620
|
Plan sponsor’s
address |
7TH FLOOR - HUMAN RESOURCES, 126 PARK AVE, BRIDGEPORT, CT, 066047620
|
Number of participants as of the end of the plan year
Active participants |
300 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2019-01-30 |
Name of individual signing |
MELITHA PRZYGODA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
TOTAL DISABILITY INSURANCE PLAN FOR FULL TIME EMPLOYEES OF THE UNIVERSITY OF BRIDGEPORT
|
2017
|
060646936
|
2019-01-31
|
UNIVERSITY OF BRIDGEPORT
|
414
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2016-12-01
|
Business code |
611000
|
Sponsor’s telephone number |
2035764588
|
Plan sponsor’s mailing address |
126 PARK AVE, BRIDGEPORT, CT, 066047620
|
Plan sponsor’s
address |
126 PARK AVE, BRIDGEPORT, CT, 066047620
|
Number of participants as of the end of the plan year
Active participants |
410 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2019-01-30 |
Name of individual signing |
MELITHA PRZYGODA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|