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| Plan Name | CELLECTIS CIGNA MED |
| Plan identification number | 503 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | CELLECTIS BIOLOGICS |
| Employer identification number (EIN): | 384102683 |
| NAIC Classification: | 424210 |
| NAIC Description: | Drugs and Druggists' Sundries Merchant Wholesalers |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 503 | 2021-06-01 | TIMOTHY SULLIVAN | 2022-04-11 | ||
| 503 | 2021-06-01 | KYUNG NAM WORTMAN | 2023-07-17 |
| Measure | Date | Value |
|---|---|---|
| 2021: CELLECTIS CIGNA MED 2021 401k membership | ||
| Total participants, beginning-of-year | 2021-06-01 | 107 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-06-01 | 0 |
| Number of retired or separated participants receiving benefits | 2021-06-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-06-01 | 0 |
| Total of all active and inactive participants | 2021-06-01 | 0 |
| Number of employers contributing to the scheme | 2021-06-01 | 0 |
| 2021: CELLECTIS CIGNA MED 2021 form 5500 responses | ||
|---|---|---|
| 2021-06-01 | Type of plan entity | Single employer plan |
| 2021-06-01 | First time form 5500 has been submitted | Yes |
| 2021-06-01 | Submission has been amended | Yes |
| 2021-06-01 | This submission is the final filing | Yes |
| 2021-06-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2021-06-01 | Plan funding arrangement – Insurance | Yes |
| 2021-06-01 | Plan benefit arrangement – Insurance | Yes |
| UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||||||||||||
| Policy contract number | 632663 | ||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||
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| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |||||||||||||||||||||||||||||
| Policy contract number | 632663 | ||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||
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| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |||||||||||||||||||||||||||||
| Policy contract number | 632663 | ||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||
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