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PAVLOV MEDIA, INC. LIFE & DISABILITY PLAN 401k Plan overview

Plan NamePAVLOV MEDIA, INC. LIFE & DISABILITY PLAN
Plan identification number 502

PAVLOV MEDIA, INC. LIFE & DISABILITY PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

PAVLOV MEDIA, INC. has sponsored the creation of one or more 401k plans.

Company Name:PAVLOV MEDIA, INC.
Employer identification number (EIN):300239661
NAIC Classification:541512
NAIC Description:Computer Systems Design Services

Additional information about PAVLOV MEDIA, INC.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2004-09-07
Company Identification Number: 0800385771
Legal Registered Office Address: PO BOX 25

CHAMPAIGN
United States of America (USA)
61824

More information about PAVLOV MEDIA, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PAVLOV MEDIA, INC. LIFE & DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022020-01-01LISA FRANZEN2021-07-15
5022019-01-01LISA FRANZEN2020-10-14
5022018-01-01LISA FRANZEN2020-10-14
5022014-01-01WILLIAM CLAVEY

Plan Statistics for PAVLOV MEDIA, INC. LIFE & DISABILITY PLAN

401k plan membership statisitcs for PAVLOV MEDIA, INC. LIFE & DISABILITY PLAN

Measure Date Value
2020: PAVLOV MEDIA, INC. LIFE & DISABILITY PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01163
Total number of active participants reported on line 7a of the Form 55002020-01-010
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-010
Number of employers contributing to the scheme2020-01-010
2019: PAVLOV MEDIA, INC. LIFE & DISABILITY PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01135
Total number of active participants reported on line 7a of the Form 55002019-01-01163
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01163
Number of employers contributing to the scheme2019-01-010
2018: PAVLOV MEDIA, INC. LIFE & DISABILITY PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01108
Total number of active participants reported on line 7a of the Form 55002018-01-01132
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01132
Number of employers contributing to the scheme2018-01-010
2014: PAVLOV MEDIA, INC. LIFE & DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01108
Total number of active participants reported on line 7a of the Form 55002014-01-0196
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-0196

Form 5500 Responses for PAVLOV MEDIA, INC. LIFE & DISABILITY PLAN

2020: PAVLOV MEDIA, INC. LIFE & DISABILITY PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01This submission is the final filingYes
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: PAVLOV MEDIA, INC. LIFE & DISABILITY PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: PAVLOV MEDIA, INC. LIFE & DISABILITY PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2014: PAVLOV MEDIA, INC. LIFE & DISABILITY PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01First time form 5500 has been submittedYes
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number239551
Policy instance 1
Insurance contract or identification number239551
Number of Individuals Covered209
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $7,723
Total amount of fees paid to insurance companyUSD $4,381
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $83,323
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,723
Amount paid for insurance broker fees4381
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number239551
Policy instance 1
Insurance contract or identification number239551
Number of Individuals Covered163
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $6,176
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $58,868
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,080
Amount paid for insurance broker fees0
Insurance broker organization code?3
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number239551
Policy instance 1
Insurance contract or identification number239551
Number of Individuals Covered135
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $4,931
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $42,484
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,931
Amount paid for insurance broker fees0
Insurance broker organization code?3

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