401k Plan data: DELTA INFORMATION SYSTEMS BENEFIT PLAN plan

DELTA INFORMATION SYSTEMS BENEFIT PLAN 401k Plan overview

Plan Name	DELTA INFORMATION SYSTEMS BENEFIT PLAN
Plan identification number	501

DELTA INFORMATION SYSTEMS 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 Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

DELTA INFORMATION SYSTEMS has sponsored the creation of one or more 401k plans.

Company Name: DELTA INFORMATION SYSTEMS

Employer identification number (EIN): 232044632

NAIC Classification: 335900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DELTA INFORMATION SYSTEMS BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-01-01 CINDY SCHELLER 2024-06-28

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2023-01-01	CINDY SCHELLER	2024-06-28

Form 5500 Responses for DELTA INFORMATION SYSTEMS BENEFIT PLAN

2023: DELTA INFORMATION SYSTEMS BENEFIT PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Multi-employer plan
2023-01-01	First time form 5500 has been submitted	Yes
2023-01-01	Plan is a collectively bargained plan	Yes
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement – Insurance	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

638368

Policy instance

Insurance contract or identification number	638368
Number of Individuals Covered	176
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $145,518
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $562,920
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

539958

Policy instance

Insurance contract or identification number	539958
Number of Individuals Covered	539
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $24,116
Total amount of fees paid to insurance company	USD $3,089
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $249,673
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	DELTA INFORMATION SYSTEMS
Employer identification number (EIN):	232044632
NAIC Classification:	335900