BROWN UNIVERSITY HEALTH AND WELFARE PLAN
|
2023
|
050258809
|
2024-10-09
|
BROWN UNIVERSITY
|
4829
|
|
File |
View Page
|
Three-digit plan number (PN) |
510
|
Effective date of plan |
2011-01-01
|
Business code |
611000
|
Sponsor’s telephone number |
4018632141
|
Plan sponsor’s mailing address |
BOX 1879, PROVIDENCE, RI, 029120001
|
Plan sponsor’s
address |
BOX 1879, PROVIDENCE, RI, 029120001
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2024-10-09 |
Name of individual signing |
KIMBERLY ALMEIDA |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2024-10-09 |
Name of individual signing |
KIMBERLY ALMEIDA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROWN UNIVERSITY HEALTH AND WELFARE PLAN
|
2022
|
050258809
|
2023-10-10
|
BROWN UNIVERSITY
|
4099
|
|
File |
View Page
|
Three-digit plan number (PN) |
510
|
Effective date of plan |
2011-01-01
|
Business code |
611000
|
Sponsor’s telephone number |
4018632141
|
Plan sponsor’s mailing address |
BOX 1879, PROVIDENCE, RI, 029120001
|
Plan sponsor’s
address |
BOX 1879, PROVIDENCE, RI, 029120001
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-10-10 |
Name of individual signing |
KIMBERLY ALMEIDA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROWN UNIVERSITY HEALTH AND WELFARE PLAN
|
2021
|
050258809
|
2022-10-11
|
BROWN UNIVERSITY
|
4038
|
|
File |
View Page
|
Three-digit plan number (PN) |
510
|
Effective date of plan |
2011-01-01
|
Business code |
611000
|
Sponsor’s telephone number |
4018632141
|
Plan sponsor’s mailing address |
BOX 1879, PROVIDENCE, RI, 029120001
|
Plan sponsor’s
address |
BOX 1879, PROVIDENCE, RI, 029120001
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2022-10-11 |
Name of individual signing |
KIMBERLY ALMEIDA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROWN UNIVERSITY HEALTH AND WELFARE PLAN
|
2020
|
050258809
|
2021-10-07
|
BROWN UNIVERSITY
|
4070
|
|
File |
View Page
|
Three-digit plan number (PN) |
510
|
Effective date of plan |
2011-01-01
|
Business code |
611000
|
Sponsor’s telephone number |
4018632141
|
Plan sponsor’s mailing address |
BOX 1879, PROVIDENCE, RI, 029120001
|
Plan sponsor’s
address |
BOX 1879, PROVIDENCE, RI, 029120001
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-10-07 |
Name of individual signing |
KIMBERLY ALMEIDA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROWN UNIVERSITY DINING SERVICES AND FACILITIES MANAGEMENT EMPLOYEES PENSION PLAN
|
2019
|
050258809
|
2021-04-13
|
BROWN UNIVERSITY
|
921
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
1972-07-01
|
Business code |
611000
|
Sponsor’s telephone number |
4018632141
|
Plan sponsor’s mailing address |
BOX 1879, PROVIDENCE, RI, 029120001
|
Plan sponsor’s
address |
BOX 1879, PROVIDENCE, RI, 029120001
|
Number of participants as of the end of the plan year
Active participants |
498 |
Retired or separated participants receiving
benefits |
280 |
Other
retired or separated participants entitled to future benefits |
109 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
66 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
2 |
Signature of
Role |
Plan administrator |
Date |
2021-04-13 |
Name of individual signing |
KIMBERLY ALMEIDA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROWN UNIVERSITY HEALTH AND WELFARE PLAN
|
2019
|
050258809
|
2020-10-07
|
BROWN UNIVERSITY
|
3920
|
|
File |
View Page
|
Three-digit plan number (PN) |
510
|
Effective date of plan |
2011-01-01
|
Business code |
611000
|
Sponsor’s telephone number |
4018632141
|
Plan sponsor’s mailing address |
BOX 1879, PROVIDENCE, RI, 029120001
|
Plan sponsor’s
address |
BOX 1879, PROVIDENCE, RI, 029120001
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2020-10-07 |
Name of individual signing |
KIMBERLY ALMEIDA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROWN UNIVERSITY DINING SERVICES AND FACILITIES MANAGEMENT EMPLOYEES PENSION PLAN
|
2018
|
050258809
|
2020-04-03
|
BROWN UNIVERSITY
|
915
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
1972-07-01
|
Business code |
611000
|
Sponsor’s telephone number |
4018632141
|
Plan sponsor’s mailing address |
BOX 1879, PROVIDENCE, RI, 02912
|
Plan sponsor’s
address |
BOX 1879, PROVIDENCE, RI, 02912
|
Number of participants as of the end of the plan year
Active participants |
475 |
Retired or separated participants receiving
benefits |
270 |
Other
retired or separated participants entitled to future benefits |
114 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
63 |
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 |
2020-04-03 |
Name of individual signing |
KIMBERLY ALMEIDA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROWN UNIVERSITY HEALTH AND WELFARE PLAN
|
2018
|
050258809
|
2019-10-11
|
BROWN UNIVERSITY
|
4165
|
|
File |
View Page
|
Three-digit plan number (PN) |
510
|
Effective date of plan |
2011-01-01
|
Business code |
611000
|
Sponsor’s telephone number |
4018632141
|
Plan sponsor’s mailing address |
BOX 1879, PROVIDENCE, RI, 029120001
|
Plan sponsor’s
address |
BOX 1879, PROVIDENCE, RI, 029120001
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-10-11 |
Name of individual signing |
KIMBERLY ALMEIDA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROWN UNIVERSITY DINING SERVICES AND FACILITIES MANAGEMENT EMPLOYEES PENSION PLAN
|
2017
|
050258809
|
2019-03-20
|
BROWN UNIVERSITY
|
909
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
1972-07-01
|
Business code |
611000
|
Sponsor’s telephone number |
4018632141
|
Plan sponsor’s mailing address |
BOX 1879, PROVIDENCE, RI, 029120001
|
Plan sponsor’s
address |
BOX 1879, PROVIDENCE, RI, 029120001
|
Number of participants as of the end of the plan year
Active participants |
479 |
Retired or separated participants receiving
benefits |
262 |
Other
retired or separated participants entitled to future benefits |
113 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
61 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
5 |
Signature of
Role |
Plan administrator |
Date |
2019-03-20 |
Name of individual signing |
DREW MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROWN UNIVERSITY HEALTH AND WELFARE PLAN
|
2017
|
050258809
|
2018-09-24
|
BROWN UNIVERSITY
|
4054
|
|
File |
View Page
|
Three-digit plan number (PN) |
510
|
Effective date of plan |
2011-01-01
|
Business code |
611000
|
Sponsor’s telephone number |
4018632141
|
Plan sponsor’s mailing address |
BOX 1879, PROVIDENCE, RI, 029120001
|
Plan sponsor’s
address |
BOX 1879, PROVIDENCE, RI, 029120001
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2018-09-24 |
Name of individual signing |
DREW MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROWN UNIVERSITY HEALTH AND WELFARE PLAN
|
2016
|
050258809
|
2017-10-12
|
BROWN UNIVERSITY
|
4023
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2017/10/12/20171012125307P040198528791001.pdf |
Three-digit plan number (PN) |
510 |
Effective date of plan |
2011-01-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018632141 |
Plan
sponsor’s DBA name |
BROWN UNIVERSITY |
Plan sponsor’s mailing address |
164 ANGELL STREET, PROVIDENCE, RI, 029129002 |
Plan sponsor’s
address |
164 ANGELL STREET, PROVIDENCE, RI, 029129002 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-10-12 |
Name of individual signing |
DREW MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROWN UNIVERSITY DINING SERVICES AND FACILITIES MANAGEMENT EMPLOYEES PENSION PLAN
|
2016
|
050258809
|
2018-03-14
|
BROWN UNIVERSITY
|
912
|
|
Three-digit plan number (PN) |
003 |
Effective date of plan |
1972-07-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018632141 |
Plan sponsor’s mailing address |
BOX 1879, PROVIDENCE, RI, 029120001 |
Plan sponsor’s
address |
BOX 1879, PROVIDENCE, RI, 029120001 |
Number of participants as of the end of the plan year
Active participants |
482 |
Retired or separated participants receiving
benefits |
253 |
Other
retired or separated participants entitled to future benefits |
112 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
62 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
4 |
Signature of
Role |
Plan administrator |
Date |
2018-03-14 |
Name of individual signing |
DREW MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROWN UNIVERSITY DINING SERVICES AND FACILITIES MANAGEMENT EMPLOYEES PENSION PLAN
|
2016
|
050258809
|
2018-03-23
|
BROWN UNIVERSITY
|
912
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2018/03/23/20180323140312P030000356709001.pdf |
Three-digit plan number (PN) |
003 |
Effective date of plan |
1972-07-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018632141 |
Plan sponsor’s mailing address |
BOX 1879, PROVIDENCE, RI, 029120001 |
Plan sponsor’s
address |
BOX 1879, PROVIDENCE, RI, 029120001 |
Number of participants as of the end of the plan year
Active participants |
482 |
Retired or separated participants receiving
benefits |
253 |
Other
retired or separated participants entitled to future benefits |
112 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
62 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
4 |
Signature of
Role |
Plan administrator |
Date |
2018-03-23 |
Name of individual signing |
DREW MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROWN UNIVERSITY DINING SERVICES AND FACILITIES MANAGEMENT EMPLOYEES PENSION PLAN
|
2015
|
050258809
|
2017-03-21
|
BROWN UNIVERSITY
|
905
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2017/03/21/20170321123822P040068807041001.pdf |
Three-digit plan number (PN) |
003 |
Effective date of plan |
1972-07-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018632141 |
Plan sponsor’s mailing address |
BOX 1879, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
BOX 1879, PROVIDENCE, RI, 02912 |
Number of participants as of the end of the plan year
Active participants |
492 |
Retired or separated participants receiving
benefits |
248 |
Other
retired or separated participants entitled to future benefits |
112 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
60 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
1 |
Signature of
Role |
Plan administrator |
Date |
2017-03-21 |
Name of individual signing |
DREW MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROWN UNIVERSITY HEALTH AND WELFARE PLAN
|
2015
|
050258809
|
2016-10-07
|
BROWN UNIVERSITY
|
4012
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2016/10/07/20161007100428P040007710909001.pdf |
Three-digit plan number (PN) |
510 |
Effective date of plan |
2011-01-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018632141 |
Plan sponsor’s mailing address |
164 ANGELL ST, PROVIDENCE, RI, 029129002 |
Plan sponsor’s
address |
164 ANGELL ST, PROVIDENCE, RI, 029129002 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-10-07 |
Name of individual signing |
DREW MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROWN UNIVERSITY HEALTH AND WELFARE PLAN
|
2014
|
050258809
|
2016-08-11
|
BROWN UNIVERSITY
|
3989
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2016/08/11/20160811094936P040006003789001.pdf |
Three-digit plan number (PN) |
510 |
Effective date of plan |
2011-01-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018632141 |
Plan sponsor’s mailing address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-08-11 |
Name of individual signing |
DREW MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROWN UNIVERSITY HEALTH AND WELFARE PLAN
|
2014
|
050258809
|
2015-10-14
|
BROWN UNIVERSITY
|
3989
|
|
Three-digit plan number (PN) |
510 |
Effective date of plan |
2011-01-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018632141 |
Plan sponsor’s mailing address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-10-14 |
Name of individual signing |
DREW MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROWN UNIVERSITY DINING SERVICES AND FACILITIES MANAGEMENT EMPLOYEES PENSION PLAN
|
2014
|
050258809
|
2016-04-15
|
BROWN UNIVERSITY
|
872
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2016/04/15/20160415163347P040034973565001.pdf |
Three-digit plan number (PN) |
003 |
Effective date of plan |
1972-07-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018632141 |
Plan sponsor’s mailing address |
BOX 1879, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
BOX 1879, PROVIDENCE, RI, 02912 |
Number of participants as of the end of the plan year
Active participants |
490 |
Retired or separated participants receiving
benefits |
245 |
Other
retired or separated participants entitled to future benefits |
111 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
59 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
4 |
Signature of
Role |
Plan administrator |
Date |
2016-04-15 |
Name of individual signing |
DREW MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROWN UNIVERSITY DINING SERVICES AND FACILITIES MANAGEMENT EMPLOYEES PENSION PLAN
|
2013
|
050258809
|
2015-01-30
|
BROWN UNIVERSITY
|
882
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2015/01/30/20150130123508P030018521997001.pdf |
Three-digit plan number (PN) |
003 |
Effective date of plan |
1972-07-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018632141 |
Plan sponsor’s mailing address |
BOX 1879, 164 ANGELL STREET, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
BOX 1879, 164 ANGELL STREET, PROVIDENCE, RI, 02912 |
Number of participants as of the end of the plan year
Active participants |
464 |
Retired or separated participants receiving
benefits |
245 |
Other
retired or separated participants entitled to future benefits |
106 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
57 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
1 |
Signature of
Role |
Plan administrator |
Date |
2015-01-30 |
Name of individual signing |
DREW MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROWN UNIVERSITY HEATLH AND WELFARE PLAN
|
2013
|
050258809
|
2014-10-15
|
BROWN UNIVERSITY
|
3912
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2014/10/15/20141015123730P040020384687001.pdf |
Three-digit plan number (PN) |
510 |
Effective date of plan |
2011-01-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018632141 |
Plan sponsor’s mailing address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-10-15 |
Name of individual signing |
DREW MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROWN UNIVERSITY DINING SERVICES AND FACILITIES MANAGEMENT EMPLOYEES PENSION PLAN
|
2012
|
050258809
|
2014-04-14
|
BROWN UNIVERSITY
|
869
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2014/04/14/20140414140140P030345374385001.pdf |
Three-digit plan number (PN) |
003 |
Effective date of plan |
1972-07-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018632141 |
Plan sponsor’s mailing address |
BOX 1879, 164ANGELL STREET, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
BOX 1879, 164ANGELL STREET, PROVIDENCE, RI, 02912 |
Number of participants as of the end of the plan year
Active participants |
478 |
Retired or separated participants receiving
benefits |
248 |
Other
retired or separated participants entitled to future benefits |
107 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
57 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
1 |
Signature of
Role |
Plan administrator |
Date |
2014-04-14 |
Name of individual signing |
DREW MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROWN UNIVERSITY HEALTH AND WELFARE PLAN
|
2012
|
050258809
|
2013-10-15
|
BROWN UNIVERSITY
|
3898
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/10/15/20131015094725P040014933733001.pdf |
Three-digit plan number (PN) |
510 |
Effective date of plan |
2011-01-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018632141 |
Plan sponsor’s mailing address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-10-15 |
Name of individual signing |
DREW MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROWN UNIVERSITY DINING SERVICES AND FACILITIES MANAGEMENT EMPLOYEES PENSION PLAN
|
2011
|
050258809
|
2013-04-15
|
BROWN UNIVERSITY
|
844
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/04/15/20130415125348P040017294023001.pdf |
Three-digit plan number (PN) |
003 |
Effective date of plan |
1972-07-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018632141 |
Plan sponsor’s mailing address |
BOX 1879, 164 ANGELL STREET, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
BOX 1879, 164 ANGELL STREET, PROVIDENCE, RI, 02912 |
Plan administrator’s name and address
Administrator’s EIN |
050258809 |
Plan administrator’s name |
BROWN UNIVERSITY |
Plan administrator’s
address |
BOX 1879, 164 ANGELL STREET, PROVIDENCE, RI, 02912 |
Administrator’s telephone number |
4018632141 |
Number of participants as of the end of the plan year
Active participants |
455 |
Retired or separated participants receiving
benefits |
253 |
Other
retired or separated participants entitled to future benefits |
111 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
48 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
3 |
Signature of
Role |
Plan administrator |
Date |
2013-04-15 |
Name of individual signing |
DREW MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROWN UNIVERSITY DINING SERVICES AND FACILITIES MANAGEMENT EMPLOYEES PENSION PLAN
|
2011
|
050258809
|
2013-04-15
|
BROWN UNIVERSITY
|
844
|
|
Three-digit plan number (PN) |
003 |
Effective date of plan |
1972-07-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018632141 |
Plan sponsor’s mailing address |
BOX 1879, 164 ANGELL STREET, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
BOX 1879, 164 ANGELL STREET, PROVIDENCE, RI, 02912 |
Plan administrator’s name and address
Administrator’s EIN |
050258809 |
Plan administrator’s name |
BROWN UNIVERSITY |
Plan administrator’s
address |
BOX 1879, 164 ANGELL STREET, PROVIDENCE, RI, 02912 |
Administrator’s telephone number |
4018632141 |
Number of participants as of the end of the plan year
Active participants |
455 |
Retired or separated participants receiving
benefits |
253 |
Other
retired or separated participants entitled to future benefits |
111 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
48 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
3 |
Signature of
Role |
Plan administrator |
Date |
2013-04-15 |
Name of individual signing |
DREW MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROWN UNIVERSITY DENTAL PLAN
|
2010
|
050258809
|
2012-10-11
|
BROWN UNIVERSITY
|
3049
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/10/11/20121011132801P030001353908001.pdf |
Three-digit plan number (PN) |
503 |
Effective date of plan |
1987-11-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018632141 |
Plan sponsor’s mailing address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Plan administrator’s name and address
Administrator’s EIN |
050258809 |
Plan administrator’s name |
BROWN UNIVERSITY |
Plan administrator’s
address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Administrator’s telephone number |
4018632141 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-10-11 |
Name of individual signing |
ALEXANDER OLSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP LONG TERM DISABILITY
|
2010
|
050258809
|
2012-10-11
|
BROWN UNIVERSITY
|
3472
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/10/11/20121011132452P030001353108001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
1986-02-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018632141 |
Plan sponsor’s mailing address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Plan administrator’s name and address
Administrator’s EIN |
050258809 |
Plan administrator’s name |
BROWN UNIVERSITY |
Plan administrator’s
address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Administrator’s telephone number |
4018632141 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-10-11 |
Name of individual signing |
ALEXANDER OLSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
UNITED HEALTHCARE OF NEW ENGLAND
|
2010
|
050258809
|
2012-10-11
|
BROWN UNIVERSITY
|
775
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/10/11/20121011133623P030001356212001.pdf |
Three-digit plan number (PN) |
506 |
Effective date of plan |
1983-12-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018633458 |
Plan sponsor’s mailing address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Plan administrator’s name and address
Administrator’s EIN |
050258809 |
Plan administrator’s name |
BROWN UNIVERSITY |
Plan administrator’s
address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Administrator’s telephone number |
4018633458 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-10-11 |
Name of individual signing |
ALEXANDER OLSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP LIFE INSURANCE
|
2010
|
050258809
|
2012-10-11
|
BROWN UNIVERSITY
|
3771
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/10/11/20121011132148P030000719061001.pdf |
Three-digit plan number (PN) |
502 |
Effective date of plan |
1986-02-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018632141 |
Plan sponsor’s mailing address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Plan administrator’s name and address
Administrator’s EIN |
050258809 |
Plan administrator’s name |
BROWN UNIVERSITY |
Plan administrator’s
address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Administrator’s telephone number |
4018632141 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-10-11 |
Name of individual signing |
ALEXANDER OLSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FLEXIBLE BENEFITS PLAN
|
2010
|
050258809
|
2012-10-11
|
BROWN UNIVERSITY
|
3890
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/10/11/20121011133416P030001355540001.pdf |
Three-digit plan number (PN) |
507 |
Effective date of plan |
1983-01-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018633458 |
Plan sponsor’s mailing address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Plan administrator’s name and address
Administrator’s EIN |
050258809 |
Plan administrator’s name |
BROWN UNIVERSITY |
Plan administrator’s
address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Administrator’s telephone number |
4018633458 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-10-11 |
Name of individual signing |
ALEXANDER OLSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLUE CROSS BLUE SHIELD OF RI
|
2010
|
050258809
|
2012-10-11
|
BROWN UNIVERSITY
|
2699
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/10/11/20121011133242P030001355156001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
1939-11-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018632141 |
Plan sponsor’s mailing address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Plan administrator’s name and address
Administrator’s EIN |
050258809 |
Plan administrator’s name |
BROWN UNIVERSITY |
Plan administrator’s
address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Administrator’s telephone number |
4018632141 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-10-11 |
Name of individual signing |
ALEXANDER OLSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROWN UNIVERSITY BUSINESS TRAVEL ACCIDENT PLAN
|
2010
|
050258809
|
2012-10-11
|
BROWN UNIVERSITY
|
6304
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/10/11/20121011133023P030001354580001.pdf |
Three-digit plan number (PN) |
520 |
Effective date of plan |
1970-07-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018632141 |
Plan sponsor’s mailing address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Plan administrator’s name and address
Administrator’s EIN |
050258809 |
Plan administrator’s name |
BROWN UNIVERSITY |
Plan administrator’s
address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Administrator’s telephone number |
4018632141 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-10-11 |
Name of individual signing |
ALEXANDER OLSEN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROWN UNIVERSITY DINING SERVICES AND FACILITIES MANAGEMENT EMPLOYEES PENSION PLAN
|
2010
|
050258809
|
2012-04-16
|
BROWN UNIVERSITY
|
854
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/04/16/20120416094941P040069182033001.pdf |
Three-digit plan number (PN) |
003 |
Effective date of plan |
1972-07-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018632141 |
Plan sponsor’s mailing address |
BOX 1879, 164 ANGELL STREET, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
BOX 1879, 164 ANGELL STREET, PROVIDENCE, RI, 02912 |
Plan administrator’s name and address
Administrator’s EIN |
050258809 |
Plan administrator’s name |
BROWN UNIVERSITY |
Plan administrator’s
address |
BOX 1879, 164 ANGELL STREET, PROVIDENCE, RI, 02912 |
Administrator’s telephone number |
4018632141 |
Number of participants as of the end of the plan year
Active participants |
437 |
Retired or separated participants receiving
benefits |
249 |
Other
retired or separated participants entitled to future benefits |
112 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
46 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
1 |
Signature of
Role |
Plan administrator |
Date |
2012-04-16 |
Name of individual signing |
DREW MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FLEXIBLE BENEFITS PLAN
|
2010
|
050258809
|
2011-10-14
|
BROWN UNIVERSITY
|
3890
|
|
Three-digit plan number (PN) |
507 |
Effective date of plan |
1983-01-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018633458 |
Plan sponsor’s mailing address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Plan administrator’s name and address
Administrator’s EIN |
050258809 |
Plan administrator’s name |
BROWN UNIVERSITY |
Plan administrator’s
address |
164 ANGELL STREET, BOX 1879, PROVIDENCE, RI, 02912 |
Administrator’s telephone number |
4018633458 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2011-10-14 |
Name of individual signing |
DREW MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
UNITED HEALTHCARE OF NEW ENGLAND
|
2010
|
050258809
|
2011-10-14
|
BROWN UNIVERSITY
|
775
|
|
Three-digit plan number (PN) |
506 |
Effective date of plan |
1983-12-01 |
Sponsor’s telephone number |
4018633458 |
Plan sponsor’s mailing address |
BOX 1879, 164 ANGELL STREET, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
BOX 1879, 164 ANGELL STREET, PROVIDENCE, RI, 02912 |
Plan administrator’s name and address
Administrator’s EIN |
050258809 |
Plan administrator’s name |
BROWN UNIVERSITY |
Plan administrator’s
address |
BOX 1879, 164 ANGELL STREET, PROVIDENCE, RI, 02912 |
Administrator’s telephone number |
4018633458 |
Number of participants as of the end of the plan year
Active participants |
767 |
Retired or separated participants receiving
benefits |
8 |
Signature of
Role |
Plan administrator |
Date |
2011-10-14 |
Name of individual signing |
DREW MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLUE CROSS BLUE SHIELD OF RI
|
2010
|
050258809
|
2011-10-14
|
BROWN UNIVERSITY
|
2699
|
|
Three-digit plan number (PN) |
504 |
Effective date of plan |
1939-11-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018632141 |
Plan sponsor’s mailing address |
BENEFITS OFFICE, BOX 1879, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
BENEFITS OFFICE, BOX 1879, PROVIDENCE, RI, 02912 |
Plan administrator’s name and address
Administrator’s EIN |
050258809 |
Plan administrator’s name |
BROWN UNIVERSITY |
Plan administrator’s
address |
BENEFITS OFFICE, BOX 1879, PROVIDENCE, RI, 02912 |
Administrator’s telephone number |
4018632141 |
Number of participants as of the end of the plan year
Active participants |
2520 |
Retired or separated participants receiving
benefits |
145 |
Signature of
Role |
Plan administrator |
Date |
2011-10-14 |
Name of individual signing |
DREW MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
UNITED HEALTHCARE OF NEW ENGLAND
|
2010
|
050258809
|
2011-10-14
|
BROWN UNIVERSITY
|
775
|
|
Three-digit plan number (PN) |
506 |
Effective date of plan |
1983-12-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018633458 |
Plan sponsor’s mailing address |
BOX 1879, 164 ANGELL STREET, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
BOX 1879, 164 ANGELL STREET, PROVIDENCE, RI, 02912 |
Plan administrator’s name and address
Administrator’s EIN |
050258809 |
Plan administrator’s name |
BROWN UNIVERSITY |
Plan administrator’s
address |
BOX 1879, 164 ANGELL STREET, PROVIDENCE, RI, 02912 |
Administrator’s telephone number |
4018633458 |
Number of participants as of the end of the plan year
Active participants |
767 |
Retired or separated participants receiving
benefits |
8 |
Signature of
Role |
Plan administrator |
Date |
2011-10-14 |
Name of individual signing |
DREW MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP LONG TERM DISABILITY
|
2010
|
050258809
|
2011-08-01
|
BROWN UNIVERSITY
|
3472
|
|
Three-digit plan number (PN) |
501 |
Effective date of plan |
1986-02-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018632141 |
Plan sponsor’s mailing address |
BENEFITS OFFICE, BOX 1879, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
BENEFITS OFFICE, BOX 1879, PROVIDENCE, RI, 02912 |
Plan administrator’s name and address
Administrator’s EIN |
050258809 |
Plan administrator’s name |
BROWN UNIVERSITY |
Plan administrator’s
address |
BENEFITS OFFICE, BOX 1879, PROVIDENCE, RI, 02912 |
Administrator’s telephone number |
4018632141 |
Number of participants as of the end of the plan year
Active participants |
3190 |
Retired or separated participants receiving
benefits |
37 |
Signature of
Role |
Plan administrator |
Date |
2011-08-01 |
Name of individual signing |
DREW MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP LIFE INSURANCE
|
2010
|
050258809
|
2011-08-01
|
BROWN UNIVERSITY
|
3771
|
|
Three-digit plan number (PN) |
502 |
Effective date of plan |
1986-02-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018632141 |
Plan sponsor’s mailing address |
BENEFITS OFFICE, BOX 1879, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
BENEFITS OFFICE, BOX 1879, PROVIDENCE, RI, 02912 |
Plan administrator’s name and address
Administrator’s EIN |
050258809 |
Plan administrator’s name |
BROWN UNIVERSITY |
Plan administrator’s
address |
BENEFITS OFFICE, BOX 1879, PROVIDENCE, RI, 02912 |
Administrator’s telephone number |
4018632141 |
Number of participants as of the end of the plan year
Active participants |
3660 |
Retired or separated participants receiving
benefits |
37 |
Signature of
Role |
Plan administrator |
Date |
2011-08-01 |
Name of individual signing |
DREW MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROWN UNIVERSITY BUSINESS TRAVEL ACCIDENT PLAN
|
2010
|
050258809
|
2011-08-01
|
BROWN UNIVERSITY
|
6304
|
|
Three-digit plan number (PN) |
520 |
Effective date of plan |
1970-07-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018632141 |
Plan sponsor’s mailing address |
BENEFITS OFFICE, BOX 1879, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
BENEFITS OFFICE, BOX 1879, PROVIDENCE, RI, 02912 |
Plan administrator’s name and address
Administrator’s EIN |
050258809 |
Plan administrator’s name |
BROWN UNIVERSITY |
Plan administrator’s
address |
BENEFITS OFFICE, BOX 1879, PROVIDENCE, RI, 02912 |
Administrator’s telephone number |
4018632141 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2011-08-01 |
Name of individual signing |
DREW MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
UNITED HEALTHCARE OF NEW ENGLAND
|
2009
|
050258809
|
2010-10-12
|
BROWN UNIVERSITY
|
705
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/10/12/20101012081639P040008317266001.pdf |
Three-digit plan number (PN) |
506 |
Effective date of plan |
1983-12-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018632141 |
Plan sponsor’s mailing address |
BOX 1879, 164 ANGELL STREET, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
BOX 1879, 164 ANGELL STREET, PROVIDENCE, RI, 02912 |
Plan administrator’s name and address
Administrator’s EIN |
050258809 |
Plan administrator’s name |
BROWN UNIVERSITY |
Plan administrator’s
address |
BOX 1879, 164 ANGELL STREET, PROVIDENCE, RI, 02912 |
Administrator’s telephone number |
4018632141 |
Number of participants as of the end of the plan year
Active participants |
767 |
Retired or separated participants receiving
benefits |
8 |
Signature of
Role |
Plan administrator |
Date |
2010-10-12 |
Name of individual signing |
DREW MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FLEXIBLE BENEFITS PLAN
|
2009
|
050258809
|
2010-10-12
|
BROWN UNIVERSITY
|
3954
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/10/12/20101012081701P030005874760001.pdf |
Three-digit plan number (PN) |
507 |
Effective date of plan |
1983-01-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018632141 |
Plan sponsor’s mailing address |
BOX 1879, 164 ANGELL STREET, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
BOX 1879, 164 ANGELL STREET, PROVIDENCE, RI, 02912 |
Plan administrator’s name and address
Administrator’s EIN |
050258809 |
Plan administrator’s name |
BROWN UNIVERSITY |
Plan administrator’s
address |
BOX 1879, 164 ANGELL STREET, PROVIDENCE, RI, 02912 |
Administrator’s telephone number |
4018632141 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2010-10-12 |
Name of individual signing |
DREW MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROWN UNIVERSITY DINING SERVICES AND FACILITIES MANAGEMENT EMPLOYEES PENSION PLAN
|
2009
|
050258809
|
2011-04-13
|
BROWN UNIVERSITY
|
862
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/04/13/20110413104151P040193658176001.pdf |
Three-digit plan number (PN) |
003 |
Effective date of plan |
1972-07-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018632141 |
Plan sponsor’s mailing address |
BOX 1879, 164 ANGELL STREET, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
BOX 1879, 164 ANGELL STREET, PROVIDENCE, RI, 02912 |
Plan administrator’s name and address
Administrator’s EIN |
050258809 |
Plan administrator’s name |
BROWN UNIVERSITY |
Plan administrator’s
address |
BOX 1879, 164 ANGELL STREET, PROVIDENCE, RI, 02912 |
Administrator’s telephone number |
4018632141 |
Number of participants as of the end of the plan year
Active participants |
445 |
Retired or separated participants receiving
benefits |
250 |
Other
retired or separated participants entitled to future benefits |
115 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
44 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
4 |
Signature of
Role |
Plan administrator |
Date |
2011-04-13 |
Name of individual signing |
DREW MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLUE CROSS BLUE SHIELD OF RI
|
2009
|
050258809
|
2010-10-12
|
BROWN UNIVERSITY
|
2751
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/10/12/20101012081650P030003007591001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
1939-11-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018632141 |
Plan sponsor’s mailing address |
BOX 1879, 164 ANGELL STREET, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
BOX 1879, 164 ANGELL STREET, PROVIDENCE, RI, 02912 |
Plan administrator’s name and address
Administrator’s EIN |
050258809 |
Plan administrator’s name |
BROWN UNIVERSITY |
Plan administrator’s
address |
BOX 1879, 164 ANGELL STREET, PROVIDENCE, RI, 02912 |
Administrator’s telephone number |
4018632141 |
Number of participants as of the end of the plan year
Active participants |
2550 |
Retired or separated participants receiving
benefits |
149 |
Signature of
Role |
Plan administrator |
Date |
2010-10-12 |
Name of individual signing |
DREW MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROWN UNIVERSITY TRAVEL ACCIDENT PLAN
|
2009
|
050258809
|
2010-10-12
|
BROWN UNIVERSITY
|
4058
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/10/12/20101012081554P040008316946001.pdf |
Three-digit plan number (PN) |
520 |
Effective date of plan |
1970-07-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018632141 |
Plan sponsor’s mailing address |
BENEFITS OFFICE, 164 ANGELL STREET BOX 1879, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
BENEFITS OFFICE, 164 ANGELL STREET BOX 1879, PROVIDENCE, RI, 02912 |
Plan administrator’s name and address
Administrator’s EIN |
050258809 |
Plan administrator’s name |
BROWN UNIVERSITY |
Plan administrator’s
address |
BENEFITS OFFICE, BOX 1879 164 ANGELL STREET, PROVIDENCE, RI, 02912 |
Administrator’s telephone number |
4018632141 |
Number of participants as of the end of the plan year
Active participants |
4058 |
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 |
Signature of
Role |
Plan administrator |
Date |
2010-10-12 |
Name of individual signing |
DREW MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP LIFE INSURANCE
|
2009
|
050258809
|
2010-07-30
|
BROWN UNIVERSITY
|
5032
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/30/20100730123704P070026961378001.pdf |
Three-digit plan number (PN) |
502 |
Effective date of plan |
1986-02-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018632141 |
Plan sponsor’s mailing address |
BENEFITS OFFICE, BOX 1879, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
BENEFITS OFFICE, BOX 1879, PROVIDENCE, RI, 02912 |
Plan administrator’s name and address
Administrator’s EIN |
050258809 |
Plan administrator’s name |
BROWN UNIVERSITY |
Plan administrator’s
address |
BENEFITS OFFICE, BOX 1879, PROVIDENCE, RI, 02912 |
Administrator’s telephone number |
4018632141 |
Number of participants as of the end of the plan year
Active participants |
3732 |
Retired or separated participants receiving
benefits |
39 |
Signature of
Role |
Plan administrator |
Date |
2010-07-26 |
Name of individual signing |
DREW MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP LONG TERM DISABILITY
|
2009
|
050258809
|
2010-07-26
|
BROWN UNIVERSITY
|
3354
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/26/20100726104045P070008181363001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
1986-02-01 |
Business code |
611000 |
Sponsor’s telephone number |
4018632141 |
Plan sponsor’s mailing address |
BENEFITS OFFICE, BOX 1879, PROVIDENCE, RI, 02912 |
Plan sponsor’s
address |
BENEFITS OFFICE, BOX 1879, PROVIDENCE, RI, 02912 |
Plan administrator’s name and address
Administrator’s EIN |
050258809 |
Plan administrator’s name |
BROWN UNIVERSITY |
Plan administrator’s
address |
BENEFITS OFFICE, BOX 1879, PROVIDENCE, RI, 02912 |
Administrator’s telephone number |
4018632141 |
Number of participants as of the end of the plan year
Active participants |
3433 |
Retired or separated participants receiving
benefits |
39 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2010-07-26 |
Name of individual signing |
DREW MURPHY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|