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VIDEORAY LLC EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan NameVIDEORAY LLC EMPLOYEE BENEFIT PLAN
Plan identification number 501

VIDEORAY LLC EMPLOYEE BENEFIT PLAN Benefits

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

401k Sponsoring company profile

VIDEORAY LLC has sponsored the creation of one or more 401k plans.

Company Name:VIDEORAY LLC
Employer identification number (EIN):233063180
NAIC Classification:336990

Form 5500 Filing Information

Submission information for form 5500 for 401k plan VIDEORAY LLC EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-11-01
5012021-11-01
5012020-11-01

Plan Statistics for VIDEORAY LLC EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for VIDEORAY LLC EMPLOYEE BENEFIT PLAN

Measure Date Value
2022: VIDEORAY LLC EMPLOYEE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-11-0131
Total number of active participants reported on line 7a of the Form 55002022-11-0135
Number of retired or separated participants receiving benefits2022-11-010
Number of other retired or separated participants entitled to future benefits2022-11-010
Total of all active and inactive participants2022-11-0135
2021: VIDEORAY LLC EMPLOYEE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-11-0132
Total number of active participants reported on line 7a of the Form 55002021-11-0130
Number of retired or separated participants receiving benefits2021-11-011
Number of other retired or separated participants entitled to future benefits2021-11-010
Total of all active and inactive participants2021-11-0131
2020: VIDEORAY LLC EMPLOYEE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-11-0130
Total number of active participants reported on line 7a of the Form 55002020-11-0131
Number of retired or separated participants receiving benefits2020-11-011
Number of other retired or separated participants entitled to future benefits2020-11-010
Total of all active and inactive participants2020-11-0132

Financial Data on VIDEORAY LLC EMPLOYEE BENEFIT PLAN

Measure Date Value
2022 : VIDEORAY LLC EMPLOYEE BENEFIT PLAN 2022 401k financial data
Total plan liabilities at end of year2022-12-31$22,714
Total plan liabilities at beginning of year2022-12-31$38,225
Total income from all sources2022-12-31$306,866
Expenses. Total of all expenses incurred2022-12-31$261,532
Benefits paid (including direct rollovers)2022-12-31$148,423
Total plan assets at end of year2022-12-31$48,877
Total plan assets at beginning of year2022-12-31$19,054
Value of fidelity bond covering the plan2022-12-31$100,000
Total contributions received or receivable from participants2022-12-31$57,684
Expenses. Other expenses not covered elsewhere2022-12-31$107,733
Contributions received from other sources (not participants or employers)2022-12-31$599
Other income received2022-12-31$0
Noncash contributions received2022-12-31$0
Net income (gross income less expenses)2022-12-31$45,334
Net plan assets at end of year (total assets less liabilities)2022-12-31$26,163
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$-19,171
Total contributions received or receivable from employer(s)2022-12-31$248,583
Value of certain deemed distributions of participant loans2022-12-31$0
Value of corrective distributions2022-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$5,376
2021 : VIDEORAY LLC EMPLOYEE BENEFIT PLAN 2021 401k financial data
Total plan liabilities at end of year2021-12-31$38,225
Total plan liabilities at beginning of year2021-12-31$35,438
Total income from all sources2021-12-31$41,406
Expenses. Total of all expenses incurred2021-12-31$45,613
Benefits paid (including direct rollovers)2021-12-31$27,688
Total plan assets at end of year2021-12-31$19,054
Total plan assets at beginning of year2021-12-31$20,474
Value of fidelity bond covering the plan2021-12-31$100,000
Total contributions received or receivable from participants2021-12-31$7,935
Expenses. Other expenses not covered elsewhere2021-12-31$17,175
Contributions received from other sources (not participants or employers)2021-12-31$965
Net income (gross income less expenses)2021-12-31$-4,207
Net plan assets at end of year (total assets less liabilities)2021-12-31$-19,171
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$-14,964
Total contributions received or receivable from employer(s)2021-12-31$32,506
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$750
Total plan liabilities at end of year2021-10-31$35,438
Total income from all sources2021-10-31$240,157
Expenses. Total of all expenses incurred2021-10-31$255,121
Benefits paid (including direct rollovers)2021-10-31$151,384
Total plan assets at end of year2021-10-31$20,474
Value of fidelity bond covering the plan2021-10-31$100,000
Total contributions received or receivable from participants2021-10-31$51,379
Expenses. Other expenses not covered elsewhere2021-10-31$99,417
Contributions received from other sources (not participants or employers)2021-10-31$5,787
Net income (gross income less expenses)2021-10-31$-14,964
Net plan assets at end of year (total assets less liabilities)2021-10-31$-14,964
Net plan assets at beginning of year (total assets less liabilities)2021-10-31$0
Total contributions received or receivable from employer(s)2021-10-31$182,991
Expenses. Administrative service providers (salaries,fees and commissions)2021-10-31$4,320

Form 5500 Responses for VIDEORAY LLC EMPLOYEE BENEFIT PLAN

2022: VIDEORAY LLC EMPLOYEE BENEFIT PLAN 2022 form 5500 responses
2022-11-01Type of plan entitySingle employer plan
2022-11-01Submission has been amendedNo
2022-11-01This submission is the final filingNo
2022-11-01This return/report is a short plan year return/report (less than 12 months)Yes
2022-11-01Plan is a collectively bargained planNo
2022-11-01Plan funding arrangement – InsuranceYes
2022-11-01Plan funding arrangement – TrustYes
2022-11-01Plan benefit arrangement – InsuranceYes
2022-11-01Plan benefit arrangement - TrustYes
2021: VIDEORAY LLC EMPLOYEE BENEFIT PLAN 2021 form 5500 responses
2021-11-01Type of plan entitySingle employer plan
2021-11-01Submission has been amendedNo
2021-11-01This submission is the final filingNo
2021-11-01This return/report is a short plan year return/report (less than 12 months)Yes
2021-11-01Plan is a collectively bargained planNo
2021-11-01Plan funding arrangement – InsuranceYes
2021-11-01Plan funding arrangement – TrustYes
2021-11-01Plan benefit arrangement – InsuranceYes
2021-11-01Plan benefit arrangement - TrustYes
2020: VIDEORAY LLC EMPLOYEE BENEFIT PLAN 2020 form 5500 responses
2020-11-01Type of plan entitySingle employer plan
2020-11-01First time form 5500 has been submittedYes
2020-11-01Submission has been amendedNo
2020-11-01This submission is the final filingNo
2020-11-01This return/report is a short plan year return/report (less than 12 months)No
2020-11-01Plan is a collectively bargained planNo
2020-11-01Plan funding arrangement – InsuranceYes
2020-11-01Plan funding arrangement – TrustYes
2020-11-01Plan benefit arrangement – InsuranceYes
2020-11-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

EVEREST REINSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number30500639
Policy instance 1
Insurance contract or identification number30500639
Number of Individuals Covered35
Insurance policy start date2022-11-01
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 $86,287
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 number30500639
Policy instance 1
Insurance contract or identification number30500639
Number of Individuals Covered31
Insurance policy start date2021-11-01
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 $13,798
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 number30500639
Policy instance 1
Insurance contract or identification number30500639
Number of Individuals Covered31
Insurance policy start date2020-11-01
Insurance policy end date2021-10-31
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 $80,156
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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