401k Plan data: GROB SYSTEMS, INC. plan

GROB SYSTEMS, INC. 401k Plan overview

Plan Name	GROB SYSTEMS, INC.
Plan identification number	501

GROB SYSTEMS, INC. Benefits

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

401k Sponsoring company profile

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

Company Name: GROB SYSTEMS, INC.

Employer identification number (EIN): 133059174

NAIC Classification: 333510

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROB SYSTEMS, INC.

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2021-01-01
501 2020-01-01

Plan Statistics for GROB SYSTEMS, INC.

401k plan membership statisitcs for GROB SYSTEMS, INC.

Measure Date Value
2021: GROB SYSTEMS, INC. 2021 401k membership
Total participants, beginning-of-year 2021-01-01 643
Total of all active and inactive participants 2021-01-01 0
Total participants 2021-01-01 0
Number of employers contributing to the scheme 2021-01-01 0
2020: GROB SYSTEMS, INC. 2020 401k membership
Total participants, beginning-of-year 2020-01-01 553
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 556
Number of retired or separated participants receiving benefits 2020-01-01 1
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 557
Total participants 2020-01-01 557
Number of employers contributing to the scheme 2020-01-01 0

Measure	Date	Value
2021: GROB SYSTEMS, INC. 2021 401k membership
Total participants, beginning-of-year	2021-01-01	643
Total of all active and inactive participants	2021-01-01	0
Total participants	2021-01-01	0
Number of employers contributing to the scheme	2021-01-01	0
2020: GROB SYSTEMS, INC. 2020 401k membership
Total participants, beginning-of-year	2020-01-01	553
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	556
Number of retired or separated participants receiving benefits	2020-01-01	1
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	557
Total participants	2020-01-01	557
Number of employers contributing to the scheme	2020-01-01	0

Form 5500 Responses for GROB SYSTEMS, INC.

2021: GROB SYSTEMS, INC. 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
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 benefit arrangement – Insurance	Yes
2020: GROB SYSTEMS, INC. 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	First time form 5500 has been submitted	Yes
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 – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

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

Policy contract number

SL-478132

Policy instance

Insurance contract or identification number	SL-478132
Number of Individuals Covered	556
Insurance policy start date	2020-04-01
Insurance policy end date	2021-03-31
Total amount of commissions paid to insurance broker	USD $160,857
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	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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $147,634
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	BROKERAGE

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00511305

Policy instance

Insurance contract or identification number	00511305
Number of Individuals Covered	525
Insurance policy start date	2020-04-01
Insurance policy end date	2021-03-31
Total amount of commissions paid to insurance broker	USD $8,785
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	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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,036
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	BROKERAGE

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Company Name:	GROB SYSTEMS, INC.
Employer identification number (EIN):	133059174
NAIC Classification:	333510