Summary Annual ReportsVanderbilt University is required to file annual reports with the Internal Revenue Service on each of its insured benefits programs. In addition, a summary of each annual report must be provided to employees and beneficiaries. Following is an insured benefit report. The format, style, and content for this report were designed by the Internal Revenue Service (IRS). The IRS requires employers to strictly follow this format. Employees who would like clarification or additional information should contact the Human Resource Services, 322-8330.
SUMMARY ANNUAL REPORT FOR VANDERBILT UNIVERSITY GROUP HEALTH CARE PROTECTION PLAN This is a summary of the annual report of the Group Health Care Protection Plan for Vanderbilt University Employer Identification Number 62-0476822, Plan Number 504, for July 1, 1999 and ending June 30, 2000. The annual report has been filed with the Internal Revenue Service, as required under the Employee Retirement Income Security Act of 1974 (ERISA).
Insurance Information The Plan has contracts with Blue Cross and Blue Shield of Tennessee, Prudential HealthCare Company and Health 1-2-3 to pay all eligible claims incurred under the terms of the plan. The total premiums paid for the plan year ending June 30, 2000 were $44,507,949. Because the Blue Cross contract is a so-called "experience-rated" contract, the premium costs are affected by, among other things, the number and size of claims. Of the total insurance premiums paid for the plan year ending June 30, 2000, the premiums paid under such "experience-rated" contract were $13,576,139 and the total of all benefit claims paid under such experience-rated contract during the plan year were $12,652,997. The Prudential contract provides Health Maintenance Organization services for eligible claims on an insured basis. Total premiums paid for the plan year ending June 30, 2000 were $3,230,015. The Health 1-2-3 contract also provides Health Maintenance Organization services for eligible claims on an insured basis. Total premiums paid for the plan year June 30, 2000 were $20,775,119. The Blue Cross HMO Blue plan also provides Health Maintenance Organization services for eligible claims on an insured basis. Total premiums paid for the plan year June 30, 2000 were $6,926,676.
SUMMARY ANNUAL REPORT FOR VANDERBILT GROUP ACCIDENTAL DEATH & DISMEMBERMENT PLAN This is a summary of the annual report of the Vanderbilt University Group Accidental Death & Dismemberment Plan, Employer Identification Number 62-0476822, Plan Number 503, for the period July 1, 1999 through June 30, 2000. The annual report has been filed with Internal Revenue Service, as required under the Employee Retirement Income Security Act of 1974 (ERISA).
Insurance Information The plan had a contract with Continental Casualty Co. and Metropolitan Life to pay claims incurred under the terms of the plan. The total premiums paid for plan year ending June 30, 2000 were $308,414.
SUMMARY ANNUAL REPORT FOR VANDERBILT UNIVERSITY GROUP TRAVEL ACCIDENT INSURANCE PLAN This is a summary of the annual report of the Vanderbilt University Group Travel Accident Insurance Plan, Employer Identification Number 62-0476822, Plan Number 505, for the period July 1, 1999 through June 30, 2000. The annual report has been filed with Internal Revenue Service, as required under the Employee Retirement Income Security Act of 1974 (ERISA).
Insurance Information The plan has a contract with Continental Casualty Co. to pay claims incurred under the terms of the plan. The total premiums paid for plan year ending June 30, 2000 were $5,473.
SUMMARY ANNUAL REPORT FOR VANDERBILT UNIVERSITY MEDICAL CENTER HOUSESTAFF HIV INSURANCE PROTECTION PLAN This summary of the annual report of the Vanderbilt University, Medical Center Housestaff HIV Insurance Protection Plan, Employer Identification Number 62-0476822, Plan No 511, for the period August 1, 1999 through July 31, 2000. The annual report has been filed with the Internal Revenue Service, as required under the Employee Retirement Income Act of 1974 (ERISA).
Insurance Information The plan has a contract with Allianz Life Insurance Co. of North America to pay claims incurred under the terms of the plan. The total premiums paid for the plan year ending July 31, 2000 were $34,568.
YOUR RIGHTS TO ADDITIONAL INFORMATION You have the right to receive a copy of the full annual report, or any part thereof, on request. One of the items included in that report is insurance information including sales commissions paid by insurance carriers, if any. To obtain a copy of the full annual report, or any part thereof, write or call the office of the Plan Administrator, Vanderbilt University, Box 7700, Station B, 213 Peabody Administration Building, Nashville, Tennessee 37235; Telephone Number (615) 322-8330. The charge to cover copying costs will be $.25 per page. You also have the right to receive from the Plan Administrator, on request and at no charge, a statement of the assets and liabilities of the plan and accompanying notes, or both. If you request a copy of the full annual report from the Plan Administrator, these two statements and accompanying notes will be included as part of that report. The charge to cover copying costs given above does not include a charge for the copying of these portions of the report because these portions are furnished without a charge. You also have the legally protected right to examine the annual report at the main office of the Plan Administrator and at the U.S. Department of Labor in Washington, D.C. or to obtain a copy from the U.S. Department of Labor upon payment of copying costs. Requests to the Department should be addressed to Public Disclosure, Room N4677, Pension and Welfare Benefit Programs, U.S. Department of Labor, 200 Constitution Avenue, N. W., Washington, D.C. 20216.
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