401k Plan data: FIRST COAST SECURITY SOLUTIONS HEALTH AND WELLNESS PLAN plan

FIRST COAST SECURITY SOLUTIONS HEALTH AND WELLNESS PLAN 401k Plan overview

Plan Name	FIRST COAST SECURITY SOLUTIONS HEALTH AND WELLNESS PLAN
Plan identification number	503

FIRST COAST SECURITY SOLUTIONS HEALTH AND WELLNESS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision)

401k Sponsoring company profile

FIRST COAST SECURITY SOLUTIONS, INC. has sponsored the creation of one or more 401k plans.

Company Name: FIRST COAST SECURITY SOLUTIONS, INC.

Employer identification number (EIN): 200593362

NAIC Classification: 561600

Additional information about FIRST COAST SECURITY SOLUTIONS, INC.

Jurisdiction of Incorporation: Florida Department of State Division of Corporations

Incorporation Date: 2003-12-31

Company Identification Number: P04000000650

Legal Registered Office Address: ONE INDEPENDENT DRIVE

JACKSONVILLE

32202

More information about FIRST COAST SECURITY SOLUTIONS, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FIRST COAST SECURITY SOLUTIONS HEALTH AND WELLNESS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2022-01-01
503 2022-01-01
503 2021-01-01
503 2020-01-01
503 2020-01-01
503 2019-01-01
503 2018-01-01 SOFIA ROLLINS SOFIA ROLLINS 2019-07-16
503 2017-01-01 SOFIA ROLLINS 2019-07-16 SOFIA ROLLINS 2019-07-16

Plan Statistics for FIRST COAST SECURITY SOLUTIONS HEALTH AND WELLNESS PLAN

401k plan membership statisitcs for FIRST COAST SECURITY SOLUTIONS HEALTH AND WELLNESS PLAN

Measure Date Value
2022: FIRST COAST SECURITY SOLUTIONS HEALTH AND WELLNESS PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 179
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 122
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 122
2021: FIRST COAST SECURITY SOLUTIONS HEALTH AND WELLNESS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 215
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 179
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 0
Total of all active and inactive participants 2021-01-01 179
2020: FIRST COAST SECURITY SOLUTIONS HEALTH AND WELLNESS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 139
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 115
Total of all active and inactive participants 2020-01-01 115
2019: FIRST COAST SECURITY SOLUTIONS HEALTH AND WELLNESS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 151
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 139
Total of all active and inactive participants 2019-01-01 139
2018: FIRST COAST SECURITY SOLUTIONS HEALTH AND WELLNESS PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 184
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 151
Total of all active and inactive participants 2018-01-01 151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0

Measure	Date	Value
2022: FIRST COAST SECURITY SOLUTIONS HEALTH AND WELLNESS PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	179
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	122
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	122
2021: FIRST COAST SECURITY SOLUTIONS HEALTH AND WELLNESS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	215
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	179
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	179
2020: FIRST COAST SECURITY SOLUTIONS HEALTH AND WELLNESS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	139
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	115
Total of all active and inactive participants	2020-01-01	115
2019: FIRST COAST SECURITY SOLUTIONS HEALTH AND WELLNESS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	151
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	139
Total of all active and inactive participants	2019-01-01	139
2018: FIRST COAST SECURITY SOLUTIONS HEALTH AND WELLNESS PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	184
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	151
Total of all active and inactive participants	2018-01-01	151
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0

Financial Data on FIRST COAST SECURITY SOLUTIONS HEALTH AND WELLNESS PLAN

Measure	Date	Value
2022 : FIRST COAST SECURITY SOLUTIONS HEALTH AND WELLNESS PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total income from all sources (including contributions)	2022-12-31	$0
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$14,596
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$5,552
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$0
Value of total assets at end of year	2022-12-31	$60,714
Value of total assets at beginning of year	2022-12-31	$75,310
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$9,044
Total interest from all sources	2022-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Administrative expenses professional fees incurred	2022-12-31	$9,044
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$6,071
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-14,596
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$60,714
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$75,310
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Assets. Value of investments in 103.12 investment entities at end of year	2022-12-31	$60,714
Assets. Value of investments in 103.12 investment entities at beginning of year	2022-12-31	$75,310
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$5,552
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	ARMANINO LLP
Accountancy firm EIN	2022-12-31	946214841
2021 : FIRST COAST SECURITY SOLUTIONS HEALTH AND WELLNESS PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$0
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$14,884
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$3,410
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$0
Value of total assets at end of year	2021-12-31	$75,310
Value of total assets at beginning of year	2021-12-31	$90,194
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$11,474
Total interest from all sources	2021-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Administrative expenses professional fees incurred	2021-12-31	$11,474
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$8,000
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$-14,884
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$75,310
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$90,194
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Assets. Value of investments in 103.12 investment entities at end of year	2021-12-31	$75,310
Assets. Value of investments in 103.12 investment entities at beginning of year	2021-12-31	$90,194
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$3,410
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
2020 : FIRST COAST SECURITY SOLUTIONS HEALTH AND WELLNESS PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$0
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$19,529
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$5,814
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$0
Value of total assets at end of year	2020-12-31	$90,194
Value of total assets at beginning of year	2020-12-31	$109,723
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$13,715
Total interest from all sources	2020-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Administrative expenses professional fees incurred	2020-12-31	$13,715
Was this plan covered by a fidelity bond	2020-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$-19,529
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$90,194
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$109,723
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Assets. Value of investments in 103.12 investment entities at end of year	2020-12-31	$90,194
Assets. Value of investments in 103.12 investment entities at beginning of year	2020-12-31	$109,723
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$5,814
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
2019 : FIRST COAST SECURITY SOLUTIONS HEALTH AND WELLNESS PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets	2019-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$0
Total income from all sources (including contributions)	2019-12-31	$11,702
Total loss/gain on sale of assets	2019-12-31	$0
Total of all expenses incurred	2019-12-31	$17,767
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$1,997
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$11,702
Value of total assets at end of year	2019-12-31	$109,723
Value of total assets at beginning of year	2019-12-31	$115,788
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$15,770
Total interest from all sources	2019-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2019-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Administrative expenses professional fees incurred	2019-12-31	$15,770
Was this plan covered by a fidelity bond	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$-6,065
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$109,723
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$115,788
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Assets. Value of investments in 103.12 investment entities at end of year	2019-12-31	$109,723
Assets. Value of investments in 103.12 investment entities at beginning of year	2019-12-31	$115,788
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$11,702
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$1,997
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
2018 : FIRST COAST SECURITY SOLUTIONS HEALTH AND WELLNESS PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$982
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$27,866
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$9,781
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$982
Value of total assets at end of year	2018-12-31	$115,788
Value of total assets at beginning of year	2018-12-31	$142,672
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$18,085
Total interest from all sources	2018-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Administrative expenses professional fees incurred	2018-12-31	$18,085
Was this plan covered by a fidelity bond	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-26,884
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$115,788
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$142,672
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Assets. Value of investments in 103.12 investment entities at end of year	2018-12-31	$115,788
Assets. Value of investments in 103.12 investment entities at beginning of year	2018-12-31	$142,672
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$982
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$9,781
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No

Form 5500 Responses for FIRST COAST SECURITY SOLUTIONS HEALTH AND WELLNESS PLAN

2022: FIRST COAST SECURITY SOLUTIONS HEALTH AND WELLNESS PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: FIRST COAST SECURITY SOLUTIONS HEALTH AND WELLNESS PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	Yes
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: FIRST COAST SECURITY SOLUTIONS HEALTH AND WELLNESS PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: FIRST COAST SECURITY SOLUTIONS HEALTH AND WELLNESS PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: FIRST COAST SECURITY SOLUTIONS HEALTH AND WELLNESS PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

0214939

Policy instance

Insurance contract or identification number	0214939
Number of Individuals Covered	34
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $103
Are there contracts with allocated funds for individual policies?	0
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	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 $3,638
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	103
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

0214939

Policy instance

Insurance contract or identification number	0214939
Number of Individuals Covered	34
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $103
Are there contracts with allocated funds for individual policies?	0
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	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 $3,638
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	103
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3

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Company Name:	FIRST COAST SECURITY SOLUTIONS, INC.
Employer identification number (EIN):	200593362
NAIC Classification:	561600

Jurisdiction of Incorporation:	Florida Department of State Division of Corporations
Incorporation Date:	2003-12-31
Company Identification Number:	P04000000650
Legal Registered Office Address:	ONE INDEPENDENT DRIVE JACKSONVILLE 32202