401k Plan data: AMERICAN WATER RESOURCES, LLC DBA HOMEOWNER SERVICES BENEFIT PLAN plan

AMERICAN WATER RESOURCES, LLC DBA HOMEOWNER SERVICES BENEFIT PLAN 401k Plan overview

Plan Name	AMERICAN WATER RESOURCES, LLC DBA HOMEOWNER SERVICES BENEFIT PLAN
Plan identification number	501

AMERICAN WATER RESOURCES, LLC DBA HOMEOWNER SERVICES BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

AMERICAN WATER RESOURCES, LLC has sponsored the creation of one or more 401k plans.

Company Name: AMERICAN WATER RESOURCES, LLC

Employer identification number (EIN): 540912221

NAIC Classification: 221300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AMERICAN WATER RESOURCES, LLC DBA HOMEOWNER SERVICES BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-04-01

Plan Statistics for AMERICAN WATER RESOURCES, LLC DBA HOMEOWNER SERVICES BENEFIT PLAN

401k plan membership statisitcs for AMERICAN WATER RESOURCES, LLC DBA HOMEOWNER SERVICES BENEFIT PLAN

Measure Date Value
2022: AMERICAN WATER RESOURCES, LLC DBA HOMEOWNER SERVICES BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-04-01 501
Total number of active participants reported on line 7a of the Form 5500 2022-04-01 501
Number of retired or separated participants receiving benefits 2022-04-01 5
Number of other retired or separated participants entitled to future benefits 2022-04-01 6
Total of all active and inactive participants 2022-04-01 512

Measure	Date	Value
2022: AMERICAN WATER RESOURCES, LLC DBA HOMEOWNER SERVICES BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-04-01	501
Total number of active participants reported on line 7a of the Form 5500	2022-04-01	501
Number of retired or separated participants receiving benefits	2022-04-01	5
Number of other retired or separated participants entitled to future benefits	2022-04-01	6
Total of all active and inactive participants	2022-04-01	512

Form 5500 Responses for AMERICAN WATER RESOURCES, LLC DBA HOMEOWNER SERVICES BENEFIT PLAN

2022: AMERICAN WATER RESOURCES, LLC DBA HOMEOWNER SERVICES BENEFIT PLAN 2022 form 5500 responses
2022-04-01	Type of plan entity	Single employer plan
2022-04-01	First time form 5500 has been submitted	Yes
2022-04-01	Submission has been amended	No
2022-04-01	This submission is the final filing	No
2022-04-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2022-04-01	Plan is a collectively bargained plan	No
2022-04-01	Plan funding arrangement – Insurance	Yes
2022-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-04-01	Plan benefit arrangement – Insurance	Yes
2022-04-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

0182107

Policy instance

Insurance contract or identification number	0182107
Number of Individuals Covered	987
Insurance policy start date	2022-04-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $38,755
Total amount of fees paid to insurance company	USD $9,000
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	No
Dental Insurance Welfare Benefit	Yes
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 $422,540
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $31,970
Amount paid for insurance broker fees	9000
Additional information about fees paid to insurance broker	FEES PAID
Insurance broker organization code?	3

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

10374351

Policy instance

Insurance contract or identification number	10374351
Number of Individuals Covered	929
Insurance policy start date	2022-04-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $8,741
Total amount of fees paid to insurance company	USD $0
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	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
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 $77,527
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,741
Insurance broker organization code?	3

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

896816G

Policy instance

Insurance contract or identification number	896816G
Number of Individuals Covered	501
Insurance policy start date	2022-04-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $32,856
Total amount of fees paid to insurance company	USD $23,633
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	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	VOLUNTARY LIFE, ACCIDENT, CRITICAL ILLNESS, HOSPITAL INDEMNITY, AD&D, VOL AD&D
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 $302,115
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $32,856
Amount paid for insurance broker fees	23633
Additional information about fees paid to insurance broker	FEES PAID
Insurance broker organization code?	3

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Company Name:	AMERICAN WATER RESOURCES, LLC
Employer identification number (EIN):	540912221
NAIC Classification:	221300