401k Plan data: FDR SERVICES CORP. WRAP AROUND PLAN DOCUMENT

FDR SERVICES CORP. WRAP AROUND PLAN DOCUMENT - UNION 401k Plan overview

Plan Name	FDR SERVICES CORP. WRAP AROUND PLAN DOCUMENT - UNION
Plan identification number	502

FDR SERVICES CORP. WRAP AROUND PLAN DOCUMENT - UNION Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Dental Vision Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

FDR SERVICE CORP has sponsored the creation of one or more 401k plans.

Company Name: FDR SERVICE CORP

Employer identification number (EIN): 202651495

NAIC Classification: 812330
NAIC Description: Linen and Uniform Supply

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FDR SERVICES CORP. WRAP AROUND PLAN DOCUMENT - UNION

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2019-12-01 DONNA HOURIGAN 2021-06-14
502 2018-12-01 DONNA HOURIGAN 2020-09-02

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
502	2019-12-01	DONNA HOURIGAN	2021-06-14
502	2018-12-01	DONNA HOURIGAN	2020-09-02

Plan Statistics for FDR SERVICES CORP. WRAP AROUND PLAN DOCUMENT - UNION

401k plan membership statisitcs for FDR SERVICES CORP. WRAP AROUND PLAN DOCUMENT - UNION

Measure Date Value
2019: FDR SERVICES CORP. WRAP AROUND PLAN DOCUMENT - UNION 2019 401k membership
Total participants, beginning-of-year 2019-12-01 101
Total number of active participants reported on line 7a of the Form 5500 2019-12-01 26
Number of retired or separated participants receiving benefits 2019-12-01 0
Number of other retired or separated participants entitled to future benefits 2019-12-01 0
Total of all active and inactive participants 2019-12-01 26
Number of employers contributing to the scheme 2019-12-01 0
2018: FDR SERVICES CORP. WRAP AROUND PLAN DOCUMENT - UNION 2018 401k membership
Total participants, beginning-of-year 2018-12-01 100
Total number of active participants reported on line 7a of the Form 5500 2018-12-01 101
Number of retired or separated participants receiving benefits 2018-12-01 0
Number of other retired or separated participants entitled to future benefits 2018-12-01 0
Total of all active and inactive participants 2018-12-01 101
Number of employers contributing to the scheme 2018-12-01 0

Measure	Date	Value
2019: FDR SERVICES CORP. WRAP AROUND PLAN DOCUMENT - UNION 2019 401k membership
Total participants, beginning-of-year	2019-12-01	101
Total number of active participants reported on line 7a of the Form 5500	2019-12-01	26
Number of retired or separated participants receiving benefits	2019-12-01	0
Number of other retired or separated participants entitled to future benefits	2019-12-01	0
Total of all active and inactive participants	2019-12-01	26
Number of employers contributing to the scheme	2019-12-01	0
2018: FDR SERVICES CORP. WRAP AROUND PLAN DOCUMENT - UNION 2018 401k membership
Total participants, beginning-of-year	2018-12-01	100
Total number of active participants reported on line 7a of the Form 5500	2018-12-01	101
Number of retired or separated participants receiving benefits	2018-12-01	0
Number of other retired or separated participants entitled to future benefits	2018-12-01	0
Total of all active and inactive participants	2018-12-01	101
Number of employers contributing to the scheme	2018-12-01	0

Form 5500 Responses for FDR SERVICES CORP. WRAP AROUND PLAN DOCUMENT - UNION

2019: FDR SERVICES CORP. WRAP AROUND PLAN DOCUMENT - UNION 2019 form 5500 responses
2019-12-01	Type of plan entity	Single employer plan
2019-12-01	Plan funding arrangement – Insurance	Yes
2019-12-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-12-01	Plan benefit arrangement – Insurance	Yes
2019-12-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: FDR SERVICES CORP. WRAP AROUND PLAN DOCUMENT - UNION 2018 form 5500 responses
2018-12-01	Type of plan entity	Single employer plan
2018-12-01	First time form 5500 has been submitted	Yes
2018-12-01	Plan funding arrangement – Insurance	Yes
2018-12-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-12-01	Plan benefit arrangement – Insurance	Yes
2018-12-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

916505

Policy instance

Insurance contract or identification number	916505
Number of Individuals Covered	34
Insurance policy start date	2019-12-01
Insurance policy end date	2020-11-30
Total amount of commissions paid to insurance broker	USD $1,815
Total amount of fees paid to insurance company	USD $624
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $20,071
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,815
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	BONUS

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

BCM004251

Policy instance

Insurance contract or identification number	BCM004251
Number of Individuals Covered	96
Insurance policy start date	2018-04-01
Insurance policy end date	2019-03-31
Total amount of commissions paid to insurance broker	USD $8,993
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $71,048
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,993
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

916505

Policy instance

Insurance contract or identification number	916505
Number of Individuals Covered	38
Insurance policy start date	2018-12-01
Insurance policy end date	2019-11-30
Total amount of commissions paid to insurance broker	USD $1,305
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $13,551
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,305
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

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Company Name:	FDR SERVICE CORP
Employer identification number (EIN):	202651495
NAIC Classification:	812330
NAIC Description:	Linen and Uniform Supply