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PARK PLACE INTERNATIONAL, LLC DBA CLOUDWAVE WELFARE BENEFIT PLAN 401k Plan overview

Plan NamePARK PLACE INTERNATIONAL, LLC DBA CLOUDWAVE WELFARE BENEFIT PLAN
Plan identification number 501

PARK PLACE INTERNATIONAL, LLC DBA CLOUDWAVE WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover

401k Sponsoring company profile

PARK PLACE INTERNATIONAL LLC DBA CLOUDWAVE has sponsored the creation of one or more 401k plans.

Company Name:PARK PLACE INTERNATIONAL LLC DBA CLOUDWAVE
Employer identification number (EIN):271322377
NAIC Classification:541512
NAIC Description:Computer Systems Design Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PARK PLACE INTERNATIONAL, LLC DBA CLOUDWAVE WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-08-01
5012020-08-01
5012019-08-01
5012018-08-01
5012017-08-01LYNNE SAIA
5012016-08-01LYNNE SAIA
5012015-08-01LYNNE SAIA

Plan Statistics for PARK PLACE INTERNATIONAL, LLC DBA CLOUDWAVE WELFARE BENEFIT PLAN

401k plan membership statisitcs for PARK PLACE INTERNATIONAL, LLC DBA CLOUDWAVE WELFARE BENEFIT PLAN

Measure Date Value
2021: PARK PLACE INTERNATIONAL, LLC DBA CLOUDWAVE WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-08-01137
Total number of active participants reported on line 7a of the Form 55002021-08-01135
Number of retired or separated participants receiving benefits2021-08-010
Total of all active and inactive participants2021-08-01135
2020: PARK PLACE INTERNATIONAL, LLC DBA CLOUDWAVE WELFARE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-08-01128
Total number of active participants reported on line 7a of the Form 55002020-08-01136
Number of retired or separated participants receiving benefits2020-08-011
Total of all active and inactive participants2020-08-01137
2019: PARK PLACE INTERNATIONAL, LLC DBA CLOUDWAVE WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-08-01126
Total number of active participants reported on line 7a of the Form 55002019-08-01128
Total of all active and inactive participants2019-08-01128
2018: PARK PLACE INTERNATIONAL, LLC DBA CLOUDWAVE WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-08-01130
Total number of active participants reported on line 7a of the Form 55002018-08-01124
Number of retired or separated participants receiving benefits2018-08-012
Total of all active and inactive participants2018-08-01126
2017: PARK PLACE INTERNATIONAL, LLC DBA CLOUDWAVE WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-08-01114
Total number of active participants reported on line 7a of the Form 55002017-08-01127
Number of retired or separated participants receiving benefits2017-08-013
Total of all active and inactive participants2017-08-01130
Total participants2017-08-01130
2016: PARK PLACE INTERNATIONAL, LLC DBA CLOUDWAVE WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-08-01124
Total number of active participants reported on line 7a of the Form 55002016-08-01114
Total of all active and inactive participants2016-08-01114
Total participants2016-08-01114
2015: PARK PLACE INTERNATIONAL, LLC DBA CLOUDWAVE WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-08-01123
Total number of active participants reported on line 7a of the Form 55002015-08-01124
Number of retired or separated participants receiving benefits2015-08-010
Number of other retired or separated participants entitled to future benefits2015-08-010
Total of all active and inactive participants2015-08-01124
Total participants2015-08-01124

Form 5500 Responses for PARK PLACE INTERNATIONAL, LLC DBA CLOUDWAVE WELFARE BENEFIT PLAN

2021: PARK PLACE INTERNATIONAL, LLC DBA CLOUDWAVE WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-08-01Type of plan entitySingle employer plan
2021-08-01Plan funding arrangement – InsuranceYes
2021-08-01Plan benefit arrangement – InsuranceYes
2020: PARK PLACE INTERNATIONAL, LLC DBA CLOUDWAVE WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-08-01Type of plan entitySingle employer plan
2020-08-01Plan funding arrangement – InsuranceYes
2020-08-01Plan benefit arrangement – InsuranceYes
2019: PARK PLACE INTERNATIONAL, LLC DBA CLOUDWAVE WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-08-01Type of plan entitySingle employer plan
2019-08-01Plan funding arrangement – InsuranceYes
2019-08-01Plan benefit arrangement – InsuranceYes
2018: PARK PLACE INTERNATIONAL, LLC DBA CLOUDWAVE WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-08-01Type of plan entitySingle employer plan
2018-08-01Plan funding arrangement – InsuranceYes
2018-08-01Plan benefit arrangement – InsuranceYes
2017: PARK PLACE INTERNATIONAL, LLC DBA CLOUDWAVE WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-08-01Type of plan entitySingle employer plan
2017-08-01Plan funding arrangement – InsuranceYes
2017-08-01Plan benefit arrangement – InsuranceYes
2016: PARK PLACE INTERNATIONAL, LLC DBA CLOUDWAVE WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-08-01Type of plan entitySingle employer plan
2016-08-01Plan funding arrangement – InsuranceYes
2016-08-01Plan benefit arrangement – InsuranceYes
2015: PARK PLACE INTERNATIONAL, LLC DBA CLOUDWAVE WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-08-01Type of plan entitySingle employer plan
2015-08-01First time form 5500 has been submittedYes
2015-08-01Plan funding arrangement – InsuranceYes
2015-08-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number99154551001
Policy instance 3
Insurance contract or identification number99154551001
Number of Individuals Covered352
Insurance policy start date2022-08-01
Insurance policy end date2023-07-31
Total amount of commissions paid to insurance brokerUSD $1,849
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,850
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,849
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number4957557
Policy instance 2
Insurance contract or identification number4957557
Number of Individuals Covered144
Insurance policy start date2022-08-01
Insurance policy end date2023-07-31
Total amount of commissions paid to insurance brokerUSD $52,239
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $52,239
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000B2VT
Policy instance 1
Insurance contract or identification numberG000B2VT
Number of Individuals Covered161
Insurance policy start date2022-08-01
Insurance policy end date2023-07-31
Total amount of commissions paid to insurance brokerUSD $18,940
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $172,075
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,857
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number99154551001
Policy instance 3
Insurance contract or identification number99154551001
Number of Individuals Covered325
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $1,661
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,363
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,661
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number4957557
Policy instance 2
Insurance contract or identification number4957557
Number of Individuals Covered126
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $50,758
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $50,758
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000B2VT
Policy instance 1
Insurance contract or identification numberG000B2VT
Number of Individuals Covered135
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $22,375
Total amount of fees paid to insurance companyUSD $2,014
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $160,002
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $22,375
Insurance broker organization code?3
Amount paid for insurance broker fees2014
Additional information about fees paid to insurance brokerOTHER COMPENSATION
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000B2VT
Policy instance 1
Insurance contract or identification numberG000B2VT
Number of Individuals Covered136
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $16,599
Total amount of fees paid to insurance companyUSD $11,000
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $154,375
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,599
Insurance broker organization code?3
Amount paid for insurance broker fees7251
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number4957557
Policy instance 2
Insurance contract or identification number4957557
Number of Individuals Covered124
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $40,668
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $40,668
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number99154551001
Policy instance 3
Insurance contract or identification number99154551001
Number of Individuals Covered315
Insurance policy start date2020-08-01
Insurance policy end date2021-07-31
Total amount of commissions paid to insurance brokerUSD $1,425
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,635
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,425
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number99154551001
Policy instance 5
Insurance contract or identification number99154551001
Number of Individuals Covered296
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $1,447
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,336
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,447
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number4957557
Policy instance 6
Insurance contract or identification number4957557
Number of Individuals Covered118
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $40,907
Total amount of fees paid to insurance companyUSD $4,025
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $40,907
Amount paid for insurance broker fees4025
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract number46
Policy instance 4
Insurance contract or identification number46
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $6,420
Total amount of fees paid to insurance companyUSD $1,570
Commission paid to Insurance BrokerUSD $6,420
Amount paid for insurance broker fees1570
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000B2VT
Policy instance 3
Insurance contract or identification numberG000B2VT
Number of Individuals Covered128
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $1,460
Total amount of fees paid to insurance companyUSD $486
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,604
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,460
Amount paid for insurance broker fees486
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000B2VT
Policy instance 2
Insurance contract or identification numberG000B2VT
Number of Individuals Covered128
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $1,880
Total amount of fees paid to insurance companyUSD $609
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,803
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,880
Amount paid for insurance broker fees609
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000B2VT
Policy instance 1
Insurance contract or identification numberG000B2VT
Number of Individuals Covered128
Insurance policy start date2019-08-01
Insurance policy end date2020-07-31
Total amount of commissions paid to insurance brokerUSD $3,661
Total amount of fees paid to insurance companyUSD $1,095
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $33,211
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,661
Amount paid for insurance broker fees1095
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number99154551001
Policy instance 4
Insurance contract or identification number99154551001
Number of Individuals Covered298
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $1,452
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,590
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,452
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number4957557
Policy instance 3
Insurance contract or identification number4957557
Number of Individuals Covered116
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $41,461
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,876
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000B2VT
Policy instance 2
Insurance contract or identification numberG000B2VT
Number of Individuals Covered124
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $6,614
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $61,578
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,614
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000B2VT
Policy instance 1
Insurance contract or identification numberG000B2VT
Number of Individuals Covered44
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $5,497
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,078
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,497
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUG0B2VT
Policy instance 2
Insurance contract or identification numberGUG0B2VT
Number of Individuals Covered127
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $1,318
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,177
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,318
Insurance broker nameINNOVO BENEFITS GROUP
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0B2VT
Policy instance 4
Insurance contract or identification numberGVTL0B2VT
Number of Individuals Covered45
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $5,865
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $45,162
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,865
Insurance broker nameINNOVO BENEFITS GROUP
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0B2VT
Policy instance 3
Insurance contract or identification numberGLUG0B2VT
Number of Individuals Covered127
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $1,619
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,189
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,619
Insurance broker nameINNOVO BENEFITS GROUP
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number4957557
Policy instance 5
Insurance contract or identification number4957557
Number of Individuals Covered307
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $42,894
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $42,894
Insurance broker nameERIC GULKO
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number99154551001
Policy instance 6
Insurance contract or identification number99154551001
Number of Individuals Covered299
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $1,307
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,139
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,307
Insurance broker nameINNOVO BENEFITS GROUP
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLTD0B2VT
Policy instance 1
Insurance contract or identification numberGLTD0B2VT
Insurance policy start date2017-08-01
Insurance policy end date2018-07-31
Total amount of commissions paid to insurance brokerUSD $3,482
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $29,636
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,482
Insurance broker nameINNOVO BENEFITS GROUP

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