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| Plan Name | INTELLIGENT INSITES, INC. GROUP BENEFIT PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | INTELLIGENT INSITES |
| Employer identification number (EIN): | 450459906 |
| NAIC Classification: | 541512 |
| NAIC Description: | Computer Systems Design Services |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2016-01-01 | ||||
| 501 | 2015-11-01 | MARGARET ASHEIM |
| Measure | Date | Value |
|---|---|---|
| 2016: INTELLIGENT INSITES, INC. GROUP BENEFIT PLAN 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-01-01 | 109 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 83 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 8 |
| Total of all active and inactive participants | 2016-01-01 | 93 |
| 2015: INTELLIGENT INSITES, INC. GROUP BENEFIT PLAN 2015 401k membership | ||
| Total participants, beginning-of-year | 2015-11-01 | 104 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-11-01 | 105 |
| Number of retired or separated participants receiving benefits | 2015-11-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2015-11-01 | 1 |
| Total of all active and inactive participants | 2015-11-01 | 107 |
| 2016: INTELLIGENT INSITES, INC. GROUP BENEFIT PLAN 2016 form 5500 responses | ||
|---|---|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: INTELLIGENT INSITES, INC. GROUP BENEFIT PLAN 2015 form 5500 responses | ||
| 2015-11-01 | Type of plan entity | Single employer plan |
| 2015-11-01 | First time form 5500 has been submitted | Yes |
| 2015-11-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2015-11-01 | Plan funding arrangement – Insurance | Yes |
| 2015-11-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-11-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 ) | |||||||||||||||||||||||||
| Policy contract number | 70977 | ||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||
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| BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 ) | |||||||||||||||||||||||||
| Policy contract number | 70977 | ||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||
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| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) | |||||||||||||||||||||||||
| Policy contract number | 50790-202 | ||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||
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