401k Plan data: SINGER EQUITIES HEALTH & WELFARE PLAN plan

SINGER EQUITIES HEALTH & WELFARE PLAN 401k Plan overview

Plan Name	SINGER EQUITIES HEALTH & WELFARE PLAN
Plan identification number	501

SINGER EQUITIES HEALTH & 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

SINGER EQUITIES has sponsored the creation of one or more 401k plans.

Company Name: SINGER EQUITIES

Employer identification number (EIN): 262672368

NAIC Classification: 326200

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SINGER EQUITIES HEALTH & WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2021-11-01 JOHN HERR 2023-04-26

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2021-11-01	JOHN HERR	2023-04-26

Plan Statistics for SINGER EQUITIES HEALTH & WELFARE PLAN

401k plan membership statisitcs for SINGER EQUITIES HEALTH & WELFARE PLAN

Measure Date Value
2021: SINGER EQUITIES HEALTH & WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year 2021-11-01 239
Total number of active participants reported on line 7a of the Form 5500 2021-11-01 369
Number of retired or separated participants receiving benefits 2021-11-01 0
Number of other retired or separated participants entitled to future benefits 2021-11-01 0
Total of all active and inactive participants 2021-11-01 369
Number of employers contributing to the scheme 2021-11-01 0

Measure	Date	Value
2021: SINGER EQUITIES HEALTH & WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year	2021-11-01	239
Total number of active participants reported on line 7a of the Form 5500	2021-11-01	369
Number of retired or separated participants receiving benefits	2021-11-01	0
Number of other retired or separated participants entitled to future benefits	2021-11-01	0
Total of all active and inactive participants	2021-11-01	369
Number of employers contributing to the scheme	2021-11-01	0

Form 5500 Responses for SINGER EQUITIES HEALTH & WELFARE PLAN

2021: SINGER EQUITIES HEALTH & WELFARE PLAN 2021 form 5500 responses
2021-11-01	Type of plan entity	Single employer plan
2021-11-01	First time form 5500 has been submitted	Yes
2021-11-01	Plan funding arrangement – Insurance	Yes
2021-11-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-11-01	Plan benefit arrangement – Insurance	Yes
2021-11-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30105316

Policy instance

Insurance contract or identification number	30105316
Number of Individuals Covered	414
Insurance policy start date	2021-11-01
Insurance policy end date	2022-10-31
Total amount of commissions paid to insurance broker	USD $5,453
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $52,233
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,163
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )

Policy contract number

GHP 4851102

Policy instance

Insurance contract or identification number	GHP 4851102
Number of Individuals Covered	21
Insurance policy start date	2021-11-01
Insurance policy end date	2022-10-31
Total amount of commissions paid to insurance broker	USD $4,665
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $16,370
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,930
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

70726

Policy instance

Insurance contract or identification number	70726
Number of Individuals Covered	995
Insurance policy start date	2021-11-01
Insurance policy end date	2022-10-31
Total amount of commissions paid to insurance broker	USD $33,722
Total amount of fees paid to insurance company	USD $33,069
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 $337,210
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $33,722
Amount paid for insurance broker fees	32890
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMMISSIONS
Insurance broker organization code?	3

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

633651

Policy instance

Insurance contract or identification number	633651
Number of Individuals Covered	392
Insurance policy start date	2022-02-01
Insurance policy end date	2022-10-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $141,882
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 number

3344411

Policy instance

Insurance contract or identification number	3344411
Number of Individuals Covered	798
Insurance policy start date	2021-11-01
Insurance policy end date	2022-01-31
Total amount of commissions paid to insurance broker	USD $5,749
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $100,421
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,749
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

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Company Name:	SINGER EQUITIES
Employer identification number (EIN):	262672368
NAIC Classification:	326200