401k Plan data: YORK SPACE SYSTEMS, LLC. WELFARE BENEFIT PLAN plan

YORK SPACE SYSTEMS, LLC. WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	YORK SPACE SYSTEMS, LLC. WELFARE BENEFIT PLAN
Plan identification number	501

YORK SPACE SYSTEMS, LLC. WELFARE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

YORK SPACE SYSTEMS has sponsored the creation of one or more 401k plans.

Company Name: YORK SPACE SYSTEMS

Employer identification number (EIN): 454590519

NAIC Classification: 541990
NAIC Description: All Other Professional, Scientific, and Technical Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan YORK SPACE SYSTEMS, LLC. WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-07-01 ANGELINA SMITH 2023-12-12

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2022-07-01	ANGELINA SMITH	2023-12-12

Plan Statistics for YORK SPACE SYSTEMS, LLC. WELFARE BENEFIT PLAN

401k plan membership statisitcs for YORK SPACE SYSTEMS, LLC. WELFARE BENEFIT PLAN

Measure Date Value
2022: YORK SPACE SYSTEMS, LLC. WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-07-01 148
Total number of active participants reported on line 7a of the Form 5500 2022-07-01 228
Number of retired or separated participants receiving benefits 2022-07-01 1
Number of other retired or separated participants entitled to future benefits 2022-07-01 3
Total of all active and inactive participants 2022-07-01 232
Number of employers contributing to the scheme 2022-07-01 0

Measure	Date	Value
2022: YORK SPACE SYSTEMS, LLC. WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-07-01	148
Total number of active participants reported on line 7a of the Form 5500	2022-07-01	228
Number of retired or separated participants receiving benefits	2022-07-01	1
Number of other retired or separated participants entitled to future benefits	2022-07-01	3
Total of all active and inactive participants	2022-07-01	232
Number of employers contributing to the scheme	2022-07-01	0

Form 5500 Responses for YORK SPACE SYSTEMS, LLC. WELFARE BENEFIT PLAN

2022: YORK SPACE SYSTEMS, LLC. WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-07-01	Type of plan entity	Single employer plan
2022-07-01	First time form 5500 has been submitted	Yes
2022-07-01	Plan funding arrangement – Insurance	Yes
2022-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-07-01	Plan benefit arrangement – Insurance	Yes
2022-07-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

KAISER FOUNDATION HEALTH PLAN OF COLORADO (National Association of Insurance Commissioners NAIC id number: 95669 )

Policy contract number

40229

Policy instance

Insurance contract or identification number	40229
Number of Individuals Covered	391
Insurance policy start date	2022-07-01
Insurance policy end date	2023-06-30
Total amount of commissions paid to insurance broker	USD $102,237
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,835,628
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $94,379
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

DELTA DENTAL OF COLORADO (National Association of Insurance Commissioners NAIC id number: 55875 )

Policy contract number

W0997

Policy instance

Insurance contract or identification number	W0997
Number of Individuals Covered	445
Insurance policy start date	2022-07-01
Insurance policy end date	2023-06-30
Total amount of commissions paid to insurance broker	USD $31,733
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $163,693
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $22,666
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30104549

Policy instance

Insurance contract or identification number	30104549
Number of Individuals Covered	215
Insurance policy start date	2022-07-01
Insurance policy end date	2023-06-30
Total amount of commissions paid to insurance broker	USD $5,096
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $50,890
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,096
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )

Policy contract number

914694

Policy instance

Insurance contract or identification number	914694
Number of Individuals Covered	228
Insurance policy start date	2022-07-21
Insurance policy end date	2023-06-30
Total amount of commissions paid to insurance broker	USD $7,562
Total amount of fees paid to insurance company	USD $3,667
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, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to Carrier	USD $73,337
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,562
Amount paid for insurance broker fees	3667
Additional information about fees paid to insurance broker	ADDITIONAL COMPENSATION
Insurance broker organization code?	3

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Company Name:	YORK SPACE SYSTEMS
Employer identification number (EIN):	454590519
NAIC Classification:	541990
NAIC Description:	All Other Professional, Scientific, and Technical Services