401k Plan data: THERADEX SYSTEMS, INC. WRAP WELFARE BENEFITS PLAN plan

THERADEX SYSTEMS, INC. WRAP WELFARE BENEFITS PLAN 401k Plan overview

Plan Name	THERADEX SYSTEMS, INC. WRAP WELFARE BENEFITS PLAN
Plan identification number	501

THERADEX SYSTEMS, INC. WRAP WELFARE BENEFITS 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) Other welfare benefit cover

401k Sponsoring company profile

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

Company Name: THERADEX SYSTEMS, INC.

Employer identification number (EIN): 222418075

NAIC Classification: 541700

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THERADEX SYSTEMS, INC. WRAP WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-07-01 MARGARET VALNOSKI 2024-01-11

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2022-07-01	MARGARET VALNOSKI	2024-01-11

Plan Statistics for THERADEX SYSTEMS, INC. WRAP WELFARE BENEFITS PLAN

401k plan membership statisitcs for THERADEX SYSTEMS, INC. WRAP WELFARE BENEFITS PLAN

Measure Date Value
2022: THERADEX SYSTEMS, INC. WRAP WELFARE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year 2022-07-01 108
Total number of active participants reported on line 7a of the Form 5500 2022-07-01 105
Number of retired or separated participants receiving benefits 2022-07-01 0
Number of other retired or separated participants entitled to future benefits 2022-07-01 0
Total of all active and inactive participants 2022-07-01 105
Number of employers contributing to the scheme 2022-07-01 0

Measure	Date	Value
2022: THERADEX SYSTEMS, INC. WRAP WELFARE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year	2022-07-01	108
Total number of active participants reported on line 7a of the Form 5500	2022-07-01	105
Number of retired or separated participants receiving benefits	2022-07-01	0
Number of other retired or separated participants entitled to future benefits	2022-07-01	0
Total of all active and inactive participants	2022-07-01	105
Number of employers contributing to the scheme	2022-07-01	0

Form 5500 Responses for THERADEX SYSTEMS, INC. WRAP WELFARE BENEFITS PLAN

2022: THERADEX SYSTEMS, INC. WRAP WELFARE BENEFITS PLAN 2022 form 5500 responses
2022-07-01	Type of plan entity	Single employer plan
2022-07-01	First time form 5500 has been submitted	Yes
2022-07-01	Plan funding arrangement – Insurance	Yes
2022-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-07-01	Plan benefit arrangement – Insurance	Yes
2022-07-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 )

Policy contract number

82428

Policy instance

Insurance contract or identification number	82428
Number of Individuals Covered	70
Insurance policy start date	2022-07-01
Insurance policy end date	2023-06-30
Total amount of commissions paid to insurance broker	USD $78,559
Total amount of fees paid to insurance company	USD $17,074
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,707,394
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $78,559
Amount paid for insurance broker fees	17074
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3

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

Policy contract number

85434460/500240

Policy instance

Insurance contract or identification number	85434460/500240
Number of Individuals Covered	180
Insurance policy start date	2022-07-01
Insurance policy end date	2023-06-30
Total amount of commissions paid to insurance broker	USD $3,282
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $57,649
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $3,282
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

40149063

Policy instance

Insurance contract or identification number	40149063
Number of Individuals Covered	44
Insurance policy start date	2022-07-01
Insurance policy end date	2023-06-30
Total amount of commissions paid to insurance broker	USD $730
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $9,595
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $730
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGM0602520

Policy instance

Insurance contract or identification number	SGM0602520
Number of Individuals Covered	108
Insurance policy start date	2022-07-01
Insurance policy end date	2023-06-30
Total amount of commissions paid to insurance broker	USD $9,512
Total amount of fees paid to insurance company	USD $0
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	EMPLOYEE ASSISTANCE PROGRAM,ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $106,520
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $9,512
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

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Company Name:	THERADEX SYSTEMS, INC.
Employer identification number (EIN):	222418075
NAIC Classification:	541700