401k Plan data: VERVE TALENT AND LITERARY AGENCY, LLC HEALTH & WELFARE BENEFIT PLAN plan

VERVE TALENT AND LITERARY AGENCY, LLC HEALTH & WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	VERVE TALENT AND LITERARY AGENCY, LLC HEALTH & WELFARE BENEFIT PLAN
Plan identification number	501

VERVE TALENT AND LITERARY AGENCY, LLC HEALTH & WELFARE BENEFIT PLAN Benefits

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

401k Sponsoring company profile

VERVE TALENT & LITERARY AGENCY has sponsored the creation of one or more 401k plans.

Company Name: VERVE TALENT & LITERARY AGENCY

Employer identification number (EIN): 271423261

NAIC Classification: 711510
NAIC Description: Independent Artists, Writers, and Performers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan VERVE TALENT AND LITERARY AGENCY, LLC HEALTH & WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-01-01 ELIZABETH JACOBS 2024-07-25

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2023-01-01	ELIZABETH JACOBS	2024-07-25

Form 5500 Responses for VERVE TALENT AND LITERARY AGENCY, LLC HEALTH & WELFARE BENEFIT PLAN

2023: VERVE TALENT AND LITERARY AGENCY, LLC HEALTH & WELFARE BENEFIT PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	First time form 5500 has been submitted	Yes
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

GL 166372

Policy instance

Insurance contract or identification number	GL 166372
Number of Individuals Covered	147
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $2,250
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to Carrier	USD $17,302
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 )

Policy contract number

W0020581

Policy instance

Insurance contract or identification number	W0020581
Number of Individuals Covered	92
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $36,218
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $593,276
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

347930

Policy instance

Insurance contract or identification number	347930
Number of Individuals Covered	10
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $4,238
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $70,489
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

1137113

Policy instance

Insurance contract or identification number	1137113
Number of Individuals Covered	95
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $6,237
Total amount of fees paid to insurance company	USD $327
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $60,159
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	VERVE TALENT & LITERARY AGENCY
Employer identification number (EIN):	271423261
NAIC Classification:	711510
NAIC Description:	Independent Artists, Writers, and Performers