401k Plan data: WELFARE BENEFIT PLAN plan

WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	WELFARE BENEFIT PLAN
Plan identification number	501

WELFARE 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 Other welfare benefit cover

401k Sponsoring company profile

PROSCI, INC. has sponsored the creation of one or more 401k plans.

Company Name: PROSCI, INC.

Employer identification number (EIN): 841307530

NAIC Classification: 541990
NAIC Description: All Other Professional, Scientific, and Technical Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2021-07-01

Plan Statistics for WELFARE BENEFIT PLAN

401k plan membership statisitcs for WELFARE BENEFIT PLAN

Measure Date Value
2021: WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-07-01 106
Total number of active participants reported on line 7a of the Form 5500 2021-07-01 135
Number of retired or separated participants receiving benefits 2021-07-01 0
Number of other retired or separated participants entitled to future benefits 2021-07-01 0
Total of all active and inactive participants 2021-07-01 135

Measure	Date	Value
2021: WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-07-01	106
Total number of active participants reported on line 7a of the Form 5500	2021-07-01	135
Number of retired or separated participants receiving benefits	2021-07-01	0
Number of other retired or separated participants entitled to future benefits	2021-07-01	0
Total of all active and inactive participants	2021-07-01	135

Form 5500 Responses for WELFARE BENEFIT PLAN

2021: WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-07-01	Type of plan entity	Single employer plan
2021-07-01	First time form 5500 has been submitted	Yes
2021-07-01	Plan funding arrangement – Insurance	Yes
2021-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-07-01	Plan benefit arrangement – Insurance	Yes
2021-07-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

0616360

Policy instance

Insurance contract or identification number	0616360
Number of Individuals Covered	104
Insurance policy start date	2021-07-01
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $10,644
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $107,246
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,815
Insurance broker organization code?	3

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

00616360

Policy instance

Insurance contract or identification number	00616360
Number of Individuals Covered	160
Insurance policy start date	2021-07-01
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $79,839
Total amount of fees paid to insurance company	USD $1,092
Welfare Benefit Premiums Paid to Carrier	USD $839,173
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $51,547
Amount paid for insurance broker fees	1092
Additional information about fees paid to insurance broker	INCENTIVE COMPENSATION
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010254131

Policy instance

Insurance contract or identification number	000010254131
Number of Individuals Covered	135
Insurance policy start date	2021-07-01
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $767
Total amount of fees paid to insurance company	USD $381
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $5,967
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $418
Insurance broker organization code?	3
Amount paid for insurance broker fees	298
Additional information about fees paid to insurance broker	OVERRIDE

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010254130

Policy instance

Insurance contract or identification number	000010254130
Number of Individuals Covered	135
Insurance policy start date	2021-07-01
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $2,713
Total amount of fees paid to insurance company	USD $1,275
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $19,636
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,461
Insurance broker organization code?	3
Amount paid for insurance broker fees	982
Additional information about fees paid to insurance broker	OVERRIDES

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010254132

Policy instance

Insurance contract or identification number	000010254132
Number of Individuals Covered	135
Insurance policy start date	2021-07-01
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $2,062
Total amount of fees paid to insurance company	USD $1,405
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $21,688
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,115
Insurance broker organization code?	3
Amount paid for insurance broker fees	1084
Additional information about fees paid to insurance broker	OVERRIDES

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

040000100026296

Policy instance

Insurance contract or identification number	040000100026296
Number of Individuals Covered	78
Insurance policy start date	2021-07-01
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $1,362
Total amount of fees paid to insurance company	USD $132
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	VOLUNTARY AD&D
Welfare Benefit Premiums Paid to Carrier	USD $9,083
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $827
Insurance broker organization code?	3
Amount paid for insurance broker fees	132
Additional information about fees paid to insurance broker	BROKER BONUS

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

759503

Policy instance

Insurance contract or identification number	759503
Number of Individuals Covered	31
Insurance policy start date	2021-07-01
Insurance policy end date	2022-06-30
Total amount of commissions paid to insurance broker	USD $4,246
Total amount of fees paid to insurance company	USD $306
Welfare Benefit Premiums Paid to Carrier	USD $6,025
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,246
Insurance broker organization code?	3
Amount paid for insurance broker fees	306
Additional information about fees paid to insurance broker	ADMINISTRATION

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Company Name:	PROSCI, INC.
Employer identification number (EIN):	841307530
NAIC Classification:	541990
NAIC Description:	All Other Professional, Scientific, and Technical Services