401k Plan data: MAHONEY, ULBRICH, CHRISTIANSEN, RUSS, P.A. HEALTH AND WELFARE PLAN plan

MAHONEY, ULBRICH, CHRISTIANSEN, RUSS, P.A. HEALTH AND WELFARE PLAN 401k Plan overview

Plan Name	MAHONEY, ULBRICH, CHRISTIANSEN, RUSS, P.A. HEALTH AND WELFARE PLAN
Plan identification number	501

MAHONEY, ULBRICH, CHRISTIANSEN, RUSS, P.A. HEALTH AND WELFARE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental 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

MAHONEY, ULBRICH, CHRISTIANSEN & RUSS, P.A. has sponsored the creation of one or more 401k plans.

Company Name: MAHONEY, ULBRICH, CHRISTIANSEN & RUSS, P.A.

Employer identification number (EIN): 411647057

NAIC Classification: 541211
NAIC Description: Offices of Certified Public Accountants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MAHONEY, ULBRICH, CHRISTIANSEN, RUSS, P.A. HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-01-01 KEVIN WOLD 2023-08-10
501 2021-01-01 KRISSANN SCHMIDT 2022-07-06
501 2020-01-01 LANCE BROCK 2021-03-23

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2022-01-01	KEVIN WOLD	2023-08-10
501	2021-01-01	KRISSANN SCHMIDT	2022-07-06
501	2020-01-01	LANCE BROCK	2021-03-23

Form 5500 Responses for MAHONEY, ULBRICH, CHRISTIANSEN, RUSS, P.A. HEALTH AND WELFARE PLAN

2022: MAHONEY, ULBRICH, CHRISTIANSEN, RUSS, P.A. HEALTH AND WELFARE PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: MAHONEY, ULBRICH, CHRISTIANSEN, RUSS, P.A. HEALTH AND WELFARE PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2020: MAHONEY, ULBRICH, CHRISTIANSEN, RUSS, P.A. HEALTH AND WELFARE PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	First time form 5500 has been submitted	Yes
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 95766 )

Policy contract number

664

Policy instance

Insurance contract or identification number	664
Number of Individuals Covered	113
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $21,723
Total amount of fees paid to insurance company	USD $31
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $677,971
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

GL160144

Policy instance

Insurance contract or identification number	GL160144
Number of Individuals Covered	70
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $4,736
Total amount of fees paid to insurance company	USD $437
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
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 $40,918
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 95766 )

Policy contract number

664

Policy instance

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

Policy contract number

GL160144

Policy instance

HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 95766 )

Policy contract number

664

Policy instance

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

Policy contract number

GL160144

Policy instance

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Company Name:	MAHONEY, ULBRICH, CHRISTIANSEN & RUSS, P.A.
Employer identification number (EIN):	411647057
NAIC Classification:	541211
NAIC Description:	Offices of Certified Public Accountants