401k Plan data: POWER TEAM, INC. DBA POWER OBJECTS ANCILLARY BENEFIT PLAN plan

POWER TEAM, INC. DBA POWER OBJECTS ANCILLARY BENEFIT PLAN 401k Plan overview

Plan Name	POWER TEAM, INC. DBA POWER OBJECTS ANCILLARY BENEFIT PLAN
Plan identification number	502

POWER TEAM, INC. DBA POWER OBJECTS ANCILLARY BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

POWER TEAM, LLC has sponsored the creation of one or more 401k plans.

Company Name: POWER TEAM, LLC

Employer identification number (EIN): 411761176

NAIC Classification: 541511
NAIC Description: Custom Computer Programming Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan POWER TEAM, INC. DBA POWER OBJECTS ANCILLARY BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2019-01-01 MORGAN LONG 2020-07-06
502 2018-01-01
502 2017-01-01
502 2016-01-01 JOANN BUCKHOLZ
502 2015-01-01 JO ANN BUCKHOLZ

Plan Statistics for POWER TEAM, INC. DBA POWER OBJECTS ANCILLARY BENEFIT PLAN

401k plan membership statisitcs for POWER TEAM, INC. DBA POWER OBJECTS ANCILLARY BENEFIT PLAN

Measure Date Value
2019: POWER TEAM, INC. DBA POWER OBJECTS ANCILLARY BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 286
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 369
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 369
Number of employers contributing to the scheme 2019-01-01 0
2018: POWER TEAM, INC. DBA POWER OBJECTS ANCILLARY BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 332
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 286
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 0
Total of all active and inactive participants 2018-01-01 286
Number of employers contributing to the scheme 2018-01-01 0
2017: POWER TEAM, INC. DBA POWER OBJECTS ANCILLARY BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 248
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 264
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 264
2016: POWER TEAM, INC. DBA POWER OBJECTS ANCILLARY BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 230
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 247
Number of retired or separated participants receiving benefits 2016-01-01 1
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 248
2015: POWER TEAM, INC. DBA POWER OBJECTS ANCILLARY BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 209
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 230
Number of retired or separated participants receiving benefits 2015-01-01 4
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 234

Measure	Date	Value
2019: POWER TEAM, INC. DBA POWER OBJECTS ANCILLARY BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	286
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	369
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	369
Number of employers contributing to the scheme	2019-01-01	0
2018: POWER TEAM, INC. DBA POWER OBJECTS ANCILLARY BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	332
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	286
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	0
Total of all active and inactive participants	2018-01-01	286
Number of employers contributing to the scheme	2018-01-01	0
2017: POWER TEAM, INC. DBA POWER OBJECTS ANCILLARY BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	248
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	264
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	264
2016: POWER TEAM, INC. DBA POWER OBJECTS ANCILLARY BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	230
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	247
Number of retired or separated participants receiving benefits	2016-01-01	1
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	248
2015: POWER TEAM, INC. DBA POWER OBJECTS ANCILLARY BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	209
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	230
Number of retired or separated participants receiving benefits	2015-01-01	4
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	234

Form 5500 Responses for POWER TEAM, INC. DBA POWER OBJECTS ANCILLARY BENEFIT PLAN

2019: POWER TEAM, INC. DBA POWER OBJECTS ANCILLARY BENEFIT PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: POWER TEAM, INC. DBA POWER OBJECTS ANCILLARY BENEFIT PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: POWER TEAM, INC. DBA POWER OBJECTS ANCILLARY BENEFIT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: POWER TEAM, INC. DBA POWER OBJECTS ANCILLARY BENEFIT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	First time form 5500 has been submitted	Yes
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: POWER TEAM, INC. DBA POWER OBJECTS ANCILLARY BENEFIT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	First time form 5500 has been submitted	Yes
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

KM05940780

Policy instance

Insurance contract or identification number	KM05940780
Number of Individuals Covered	533
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $32,268
Total amount of fees paid to insurance company	USD $2,730
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $172,804
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $32,268
Amount paid for insurance broker fees	41
Additional information about fees paid to insurance broker	NON-MONETARY COMPENSATION
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX968838

Policy instance

Insurance contract or identification number	FLX968838
Number of Individuals Covered	369
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $15,040
Total amount of fees paid to insurance company	USD $2,957
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
Welfare Benefit Premiums Paid to Carrier	USD $97,864
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $15,040
Amount paid for insurance broker fees	2957
Additional information about fees paid to insurance broker	OVERRIDE
Insurance broker organization code?	3

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

KM05940780

Policy instance

Insurance contract or identification number	KM05940780
Number of Individuals Covered	671
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $48,045
Total amount of fees paid to insurance company	USD $4,488
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $353,986
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $48,045
Amount paid for insurance broker fees	60
Additional information about fees paid to insurance broker	NON-MONETARY COMPENSATION
Insurance broker organization code?	3

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

KM05940780

Policy instance

Insurance contract or identification number	KM05940780
Number of Individuals Covered	621
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $40,766
Total amount of fees paid to insurance company	USD $6,978
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $255,178
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $40,766
Amount paid for insurance broker fees	51
Additional information about fees paid to insurance broker	NON-MONETARY COMPENSATION
Insurance broker organization code?	3
Insurance broker name	USI INSURANCE SERVICES, LLC

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )

Policy contract number

238238

Policy instance

Insurance contract or identification number	238238
Number of Individuals Covered	230
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $13,114
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	Yes
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
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $158,218
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $13,114
Insurance broker organization code?	3
Insurance broker name	HANRATTY AND ASSOCIATES, INC.

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Company Name:	POWER TEAM, LLC
Employer identification number (EIN):	411761176
NAIC Classification:	541511
NAIC Description:	Custom Computer Programming Services

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
502	2019-01-01	MORGAN LONG	2020-07-06
502	2018-01-01
502	2017-01-01
502	2016-01-01	JOANN BUCKHOLZ
502	2015-01-01	JO ANN BUCKHOLZ