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GRAPHCOM, INC. GROUP MEDICAL PLAN 401k Plan overview

Plan NameGRAPHCOM, INC. GROUP MEDICAL PLAN
Plan identification number 503

GRAPHCOM, INC. GROUP MEDICAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

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

Company Name:GRAPHCOM, INC.
Employer identification number (EIN):232248117
NAIC Classification:323100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GRAPHCOM, INC. GROUP MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032022-01-01
5032021-12-01
5032020-12-01

Plan Statistics for GRAPHCOM, INC. GROUP MEDICAL PLAN

401k plan membership statisitcs for GRAPHCOM, INC. GROUP MEDICAL PLAN

Measure Date Value
2022: GRAPHCOM, INC. GROUP MEDICAL PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0188
Total number of active participants reported on line 7a of the Form 55002022-01-0188
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-0188
2021: GRAPHCOM, INC. GROUP MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-12-0185
Total number of active participants reported on line 7a of the Form 55002021-12-0188
Number of retired or separated participants receiving benefits2021-12-010
Number of other retired or separated participants entitled to future benefits2021-12-010
Total of all active and inactive participants2021-12-0188
2020: GRAPHCOM, INC. GROUP MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-12-0179
Total number of active participants reported on line 7a of the Form 55002020-12-0185
Number of retired or separated participants receiving benefits2020-12-010
Number of other retired or separated participants entitled to future benefits2020-12-010
Total of all active and inactive participants2020-12-0185

Financial Data on GRAPHCOM, INC. GROUP MEDICAL PLAN

Measure Date Value
2022 : GRAPHCOM, INC. GROUP MEDICAL PLAN 2022 401k financial data
Total plan liabilities at end of year2022-12-31$411,424
Total plan liabilities at beginning of year2022-12-31$128,560
Total income from all sources2022-12-31$796,342
Expenses. Total of all expenses incurred2022-12-31$1,097,490
Benefits paid (including direct rollovers)2022-12-31$776,297
Total plan assets at end of year2022-12-31$47,311
Total plan assets at beginning of year2022-12-31$65,595
Value of fidelity bond covering the plan2022-12-31$500,000
Total contributions received or receivable from participants2022-12-31$240,382
Expenses. Other expenses not covered elsewhere2022-12-31$313,259
Contributions received from other sources (not participants or employers)2022-12-31$3,356
Other income received2022-12-31$279
Net income (gross income less expenses)2022-12-31$-301,148
Net plan assets at end of year (total assets less liabilities)2022-12-31$-364,113
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$-62,965
Total contributions received or receivable from employer(s)2022-12-31$552,325
Value of corrective distributions2022-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$7,934
2021 : GRAPHCOM, INC. GROUP MEDICAL PLAN 2021 401k financial data
Total plan liabilities at end of year2021-12-31$128,560
Total plan liabilities at beginning of year2021-12-31$152,328
Total income from all sources2021-12-31$65,976
Expenses. Total of all expenses incurred2021-12-31$-11,915
Benefits paid (including direct rollovers)2021-12-31$-41,679
Total plan assets at end of year2021-12-31$65,595
Total plan assets at beginning of year2021-12-31$11,472
Value of fidelity bond covering the plan2021-12-31$500,000
Total contributions received or receivable from participants2021-12-31$18,480
Expenses. Other expenses not covered elsewhere2021-12-31$23,420
Other income received2021-12-31$9
Net income (gross income less expenses)2021-12-31$77,891
Net plan assets at end of year (total assets less liabilities)2021-12-31$-62,965
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$-140,856
Total contributions received or receivable from employer(s)2021-12-31$47,487
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$6,344
Total plan liabilities at end of year2021-11-30$152,328
Total income from all sources2021-11-30$743,476
Expenses. Total of all expenses incurred2021-11-30$884,332
Benefits paid (including direct rollovers)2021-11-30$536,800
Total plan assets at end of year2021-11-30$11,472
Value of fidelity bond covering the plan2021-11-30$500,000
Total contributions received or receivable from participants2021-11-30$209,997
Expenses. Other expenses not covered elsewhere2021-11-30$277,524
Other income received2021-11-30$139
Net income (gross income less expenses)2021-11-30$-140,856
Net plan assets at end of year (total assets less liabilities)2021-11-30$-140,856
Net plan assets at beginning of year (total assets less liabilities)2021-11-30$0
Total contributions received or receivable from employer(s)2021-11-30$533,340
Expenses. Administrative service providers (salaries,fees and commissions)2021-11-30$70,008

Form 5500 Responses for GRAPHCOM, INC. GROUP MEDICAL PLAN

2022: GRAPHCOM, INC. GROUP MEDICAL PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: GRAPHCOM, INC. GROUP MEDICAL PLAN 2021 form 5500 responses
2021-12-01Type of plan entitySingle employer plan
2021-12-01Submission has been amendedNo
2021-12-01This submission is the final filingNo
2021-12-01This return/report is a short plan year return/report (less than 12 months)Yes
2021-12-01Plan is a collectively bargained planNo
2021-12-01Plan funding arrangement – InsuranceYes
2021-12-01Plan funding arrangement – TrustYes
2021-12-01Plan funding arrangement – General assets of the sponsorYes
2021-12-01Plan benefit arrangement – InsuranceYes
2021-12-01Plan benefit arrangement - TrustYes
2021-12-01Plan benefit arrangement – General assets of the sponsorYes
2020: GRAPHCOM, INC. GROUP MEDICAL PLAN 2020 form 5500 responses
2020-12-01Type of plan entitySingle employer plan
2020-12-01First time form 5500 has been submittedYes
2020-12-01Submission has been amendedNo
2020-12-01This submission is the final filingNo
2020-12-01This return/report is a short plan year return/report (less than 12 months)No
2020-12-01Plan is a collectively bargained planNo
2020-12-01Plan funding arrangement – InsuranceYes
2020-12-01Plan funding arrangement – TrustYes
2020-12-01Plan funding arrangement – General assets of the sponsorYes
2020-12-01Plan benefit arrangement – InsuranceYes
2020-12-01Plan benefit arrangement - TrustYes
2020-12-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number30500652
Policy instance 1
Insurance contract or identification number30500652
Number of Individuals Covered88
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $249,221
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number30500652
Policy instance 1
Insurance contract or identification number30500652
Number of Individuals Covered88
Insurance policy start date2021-12-01
Insurance policy end date2021-12-31
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $17,994
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number30500652
Policy instance 1
Insurance contract or identification number30500652
Number of Individuals Covered85
Insurance policy start date2020-12-01
Insurance policy end date2021-11-30
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $205,391
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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