401k Plan data: COSENTIAL, INC. HEALTH AND WELFARE PLAN plan

COSENTIAL, INC. HEALTH AND WELFARE PLAN 401k Plan overview

Plan Name	COSENTIAL, INC. HEALTH AND WELFARE PLAN
Plan identification number	501

COSENTIAL, INC. HEALTH AND WELFARE 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

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

Company Name: COSENTIAL, INC.

Employer identification number (EIN): 061567298

NAIC Classification: 541519
NAIC Description: Other Computer Related Services

Additional information about COSENTIAL, INC.

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 2010-03-29

Company Identification Number: 0801250532

Legal Registered Office Address: 3100 ALVIN DEVANE BLVD STE A100

AUSTIN
United States of America (USA)
78741

More information about COSENTIAL, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COSENTIAL, INC. HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2020-12-01 STACY CRITZER 2021-06-17

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2020-12-01	STACY CRITZER	2021-06-17

Plan Statistics for COSENTIAL, INC. HEALTH AND WELFARE PLAN

401k plan membership statisitcs for COSENTIAL, INC. HEALTH AND WELFARE PLAN

Measure Date Value
2020: COSENTIAL, INC. HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year 2020-12-01 106
Total number of active participants reported on line 7a of the Form 5500 2020-12-01 0
Number of retired or separated participants receiving benefits 2020-12-01 0
Number of other retired or separated participants entitled to future benefits 2020-12-01 0
Total of all active and inactive participants 2020-12-01 0
Number of employers contributing to the scheme 2020-12-01 0

Measure	Date	Value
2020: COSENTIAL, INC. HEALTH AND WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year	2020-12-01	106
Total number of active participants reported on line 7a of the Form 5500	2020-12-01	0
Number of retired or separated participants receiving benefits	2020-12-01	0
Number of other retired or separated participants entitled to future benefits	2020-12-01	0
Total of all active and inactive participants	2020-12-01	0
Number of employers contributing to the scheme	2020-12-01	0

Form 5500 Responses for COSENTIAL, INC. HEALTH AND WELFARE PLAN

2020: COSENTIAL, INC. HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-12-01	Type of plan entity	Single employer plan
2020-12-01	First time form 5500 has been submitted	Yes
2020-12-01	This submission is the final filing	Yes
2020-12-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2020-12-01	Plan funding arrangement – Insurance	Yes
2020-12-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-12-01	Plan benefit arrangement – Insurance	Yes
2020-12-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

222530

Policy instance

Insurance contract or identification number	222530
Number of Individuals Covered	202
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $58,490
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,006,312
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $58,490
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

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

Policy contract number

5956828

Policy instance

Insurance contract or identification number	5956828
Number of Individuals Covered	329
Insurance policy start date	2020-12-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $1,113
Total amount of fees paid to insurance company	USD $46
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $8,338
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $916
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

699787

Policy instance

Insurance contract or identification number	699787
Number of Individuals Covered	34
Insurance policy start date	2020-12-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $1,006
Total amount of fees paid to insurance company	USD $43
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	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $791
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $722
Amount paid for insurance broker fees	43
Additional information about fees paid to insurance broker	ADDITIONAL COMPENSATION
Insurance broker organization code?	3

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Company Name:	COSENTIAL, INC.
Employer identification number (EIN):	061567298
NAIC Classification:	541519
NAIC Description:	Other Computer Related Services

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	2010-03-29
Company Identification Number:	0801250532
Legal Registered Office Address:	3100 ALVIN DEVANE BLVD STE A100 AUSTIN United States of America (USA) 78741