401k Plan data: LLR MANAGEMENT, LP HEALTH AND WELFARE PLAN plan

LLR MANAGEMENT, LP HEALTH AND WELFARE PLAN 401k Plan overview

Plan Name	LLR MANAGEMENT, LP HEALTH AND WELFARE PLAN
Plan identification number	501

LLR MANAGEMENT, LP HEALTH AND WELFARE 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

LLR MANAGEMENT, LP has sponsored the creation of one or more 401k plans.

Company Name: LLR MANAGEMENT, LP

Employer identification number (EIN): 233016072

NAIC Classification: 523900

Form 5500 Filing Information

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

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-03-01 SARAH KORNHABER 2024-06-27

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2023-03-01	SARAH KORNHABER	2024-06-27

Form 5500 Responses for LLR MANAGEMENT, LP HEALTH AND WELFARE PLAN

2023: LLR MANAGEMENT, LP HEALTH AND WELFARE PLAN 2023 form 5500 responses
2023-03-01	Type of plan entity	Single employer plan
2023-03-01	First time form 5500 has been submitted	Yes
2023-03-01	Plan funding arrangement – Insurance	Yes
2023-03-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

INDEPENDENCE BLUE CROSS (National Association of Insurance Commissioners NAIC id number: 93688 )

Policy contract number

1819695

Policy instance

Insurance contract or identification number	1819695
Number of Individuals Covered	171
Insurance policy start date	2023-03-01
Insurance policy end date	2024-02-29
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $842,508
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 )

Policy contract number

A23909-000

Policy instance

Insurance contract or identification number	A23909-000
Number of Individuals Covered	200
Insurance policy start date	2023-03-01
Insurance policy end date	2024-02-29
Total amount of commissions paid to insurance broker	USD $11,186
Total amount of fees paid to insurance company	USD $331
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $78,208
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

1027601001

Policy instance

Insurance contract or identification number	1027601001
Number of Individuals Covered	131
Insurance policy start date	2023-03-01
Insurance policy end date	2024-02-29
Total amount of commissions paid to insurance broker	USD $721
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $7,839
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLUG0C7BG

Policy instance

Insurance contract or identification number	GLUG0C7BG
Number of Individuals Covered	119
Insurance policy start date	2022-11-01
Insurance policy end date	2023-10-31
Total amount of commissions paid to insurance broker	USD $9,914
Total amount of fees paid to insurance company	USD $5,748
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	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $99,138
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	LLR MANAGEMENT, LP
Employer identification number (EIN):	233016072
NAIC Classification:	523900