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BOOMI, LP HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameBOOMI, LP HEALTH AND WELFARE PLAN
Plan identification number 501

BOOMI, LP HEALTH AND WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Prepaid legal
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

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

Company Name:DELL INC.
Employer identification number (EIN):233016018
NAIC Classification:541511
NAIC Description:Custom Computer Programming Services

Additional information about DELL INC.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 1987-10-27
Company Identification Number: 0007444706
Legal Registered Office Address: ONE DELL WAY RR1-35 TAX DEPT

AUSTIN
United States of America (USA)
78714

More information about DELL INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BOOMI, LP HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-04-01MEGAN BARBIER2023-07-05

Plan Statistics for BOOMI, LP HEALTH AND WELFARE PLAN

401k plan membership statisitcs for BOOMI, LP HEALTH AND WELFARE PLAN

Measure Date Value
2022: BOOMI, LP HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-04-01896
Total number of active participants reported on line 7a of the Form 55002022-04-01958
Number of retired or separated participants receiving benefits2022-04-0153
Number of other retired or separated participants entitled to future benefits2022-04-011
Total of all active and inactive participants2022-04-011,012
Number of employers contributing to the scheme2022-04-010

Form 5500 Responses for BOOMI, LP HEALTH AND WELFARE PLAN

2022: BOOMI, LP HEALTH AND WELFARE PLAN 2022 form 5500 responses
2022-04-01Type of plan entitySingle employer plan
2022-04-01First time form 5500 has been submittedYes
2022-04-01This return/report is a short plan year return/report (less than 12 months)Yes
2022-04-01Plan funding arrangement – InsuranceYes
2022-04-01Plan funding arrangement – General assets of the sponsorYes
2022-04-01Plan benefit arrangement – InsuranceYes
2022-04-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

HARTFORD LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 19682 )
Policy contract numberGTA101805
Policy instance 1
Insurance contract or identification numberGTA101805
Number of Individuals Covered958
Insurance policy start date2021-10-02
Insurance policy end date2022-10-01
Total amount of commissions paid to insurance brokerUSD $1,008
Total amount of fees paid to insurance companyUSD $1,479
Other welfare benefits providedBUSINESS TRAVEL ACCIDENT
Welfare Benefit Premiums Paid to CarrierUSD $6,721
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees1479
Additional information about fees paid to insurance brokerFEES, BONUS
Insurance broker organization code?3
HYATT LEGAL PLANS (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number9905752
Policy instance 9
Insurance contract or identification number9905752
Number of Individuals Covered213
Insurance policy start date2022-04-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedLEGAL
Welfare Benefit Premiums Paid to CarrierUSD $33,818
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number9240A
Policy instance 8
Insurance contract or identification number9240A
Number of Individuals Covered1
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $601
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,006
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $601
Amount paid for insurance broker fees0
Insurance broker organization code?3
AETNA EMPLOYEE ASSISTANCE PLAN (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract numberEAP
Policy instance 7
Insurance contract or identification numberEAP
Number of Individuals Covered1116
Insurance policy start date2022-04-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedEMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $20,000
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30110207
Policy instance 6
Insurance contract or identification number30110207
Number of Individuals Covered871
Insurance policy start date2022-04-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $12,349
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $123,428
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,349
Amount paid for insurance broker fees0
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number240685
Policy instance 5
Insurance contract or identification number240685
Number of Individuals Covered1344
Insurance policy start date2022-04-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $26,459
Total amount of fees paid to insurance companyUSD $3,410
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $482,249
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,459
Amount paid for insurance broker fees3410
Additional information about fees paid to insurance brokerNON-MONETARY /SUPPLEMENTAL COMPENSATION, MARKETING FEES
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract numberGF2890LF084001
Policy instance 4
Insurance contract or identification numberGF2890LF084001
Number of Individuals Covered794
Insurance policy start date2022-04-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $12,439
Total amount of fees paid to insurance companyUSD $0
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $124,390
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,439
Amount paid for insurance broker fees0
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number235676
Policy instance 3
Insurance contract or identification number235676
Number of Individuals Covered17
Insurance policy start date2022-04-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $3,872
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $57,505
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,872
Amount paid for insurance broker fees0
Insurance broker organization code?3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract number607330
Policy instance 2
Insurance contract or identification number607330
Number of Individuals Covered38
Insurance policy start date2022-04-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberAI962176
Policy instance 10
Insurance contract or identification numberAI962176
Number of Individuals Covered958
Insurance policy start date2022-04-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
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
Other welfare benefits providedACCIDENT,CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $102,998
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes

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