401k Plan data: COLORADO HEALTH BENEFIT EXCHANGE EMPLOYER STD plan

COLORADO HEALTH BENEFIT EXCHANGE EMPLOYER STD 401k Plan overview

Plan Name	COLORADO HEALTH BENEFIT EXCHANGE EMPLOYER STD
Plan identification number	507

COLORADO HEALTH BENEFIT EXCHANGE EMPLOYER STD Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance

401k Sponsoring company profile

COLORADO HEALTH BENEFIT EXCHANGE has sponsored the creation of one or more 401k plans.

Company Name: COLORADO HEALTH BENEFIT EXCHANGE

Employer identification number (EIN): 453733823

NAIC Classification: 524290

Additional information about COLORADO HEALTH BENEFIT EXCHANGE

Jurisdiction of Incorporation: Colorado Department of State

Incorporation Date: 2011-12-21

Company Identification Number: 20111699188

Legal Registered Office Address: 4600 South Ulster
Suite 300
Denver
United States of America (USA)
80237

More information about COLORADO HEALTH BENEFIT EXCHANGE

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COLORADO HEALTH BENEFIT EXCHANGE EMPLOYER STD

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
507 2020-01-01

Plan Statistics for COLORADO HEALTH BENEFIT EXCHANGE EMPLOYER STD

401k plan membership statisitcs for COLORADO HEALTH BENEFIT EXCHANGE EMPLOYER STD

Measure Date Value
2020: COLORADO HEALTH BENEFIT EXCHANGE EMPLOYER STD 2020 401k membership
Total participants, beginning-of-year 2020-01-01 115
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 146
Total of all active and inactive participants 2020-01-01 146
Total participants 2020-01-01 146

Measure	Date	Value
2020: COLORADO HEALTH BENEFIT EXCHANGE EMPLOYER STD 2020 401k membership
Total participants, beginning-of-year	2020-01-01	115
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	146
Total of all active and inactive participants	2020-01-01	146
Total participants	2020-01-01	146

Form 5500 Responses for COLORADO HEALTH BENEFIT EXCHANGE EMPLOYER STD

2020: COLORADO HEALTH BENEFIT EXCHANGE EMPLOYER STD 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	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010238629

Policy instance

Insurance contract or identification number	000010238629
Number of Individuals Covered	146
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $2,428
Total amount of fees paid to insurance company	USD $3,229
Are there contracts with allocated funds for individual policies?	0
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	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 $27,379
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,428
Amount paid for insurance broker fees	3229
Additional information about fees paid to insurance broker	CONSULTING
Insurance broker organization code?	3

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Company Name:	COLORADO HEALTH BENEFIT EXCHANGE
Employer identification number (EIN):	453733823
NAIC Classification:	524290

Jurisdiction of Incorporation:	Colorado Department of State
Incorporation Date:	2011-12-21
Company Identification Number:	20111699188
Legal Registered Office Address:	4600 South Ulster Suite 300 Denver United States of America (USA) 80237