401k Plan data: HEALTHMAP SOLUTIONS, INC. HEALTH AND WELFARE PLAN plan

HEALTHMAP SOLUTIONS, INC. HEALTH AND WELFARE PLAN 401k Plan overview

Plan Name	HEALTHMAP SOLUTIONS, INC. HEALTH AND WELFARE PLAN
Plan identification number	501

HEALTHMAP SOLUTIONS, INC. HEALTH AND WELFARE 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

HEALTHMAP SOLUTIONS, INC. has sponsored the creation of one or more 401k plans.

Company Name: HEALTHMAP SOLUTIONS, INC.

Employer identification number (EIN): 463618409

NAIC Classification: 621492
NAIC Description: Kidney Dialysis Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEALTHMAP SOLUTIONS, INC. HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-02-01 JILL MARTEN 2023-08-16
501 2021-02-01 JILL MARTEN 2022-08-30

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2022-02-01	JILL MARTEN	2023-08-16
501	2021-02-01	JILL MARTEN	2022-08-30

Plan Statistics for HEALTHMAP SOLUTIONS, INC. HEALTH AND WELFARE PLAN

401k plan membership statisitcs for HEALTHMAP SOLUTIONS, INC. HEALTH AND WELFARE PLAN

Measure Date Value
2022: HEALTHMAP SOLUTIONS, INC. HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year 2022-02-01 135
Total number of active participants reported on line 7a of the Form 5500 2022-02-01 367
Number of retired or separated participants receiving benefits 2022-02-01 0
Number of other retired or separated participants entitled to future benefits 2022-02-01 0
Total of all active and inactive participants 2022-02-01 367
Number of employers contributing to the scheme 2022-02-01 0
2021: HEALTHMAP SOLUTIONS, INC. HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year 2021-02-01 100
Total number of active participants reported on line 7a of the Form 5500 2021-02-01 135
Number of retired or separated participants receiving benefits 2021-02-01 0
Number of other retired or separated participants entitled to future benefits 2021-02-01 0
Total of all active and inactive participants 2021-02-01 135
Number of employers contributing to the scheme 2021-02-01 0

Measure	Date	Value
2022: HEALTHMAP SOLUTIONS, INC. HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year	2022-02-01	135
Total number of active participants reported on line 7a of the Form 5500	2022-02-01	367
Number of retired or separated participants receiving benefits	2022-02-01	0
Number of other retired or separated participants entitled to future benefits	2022-02-01	0
Total of all active and inactive participants	2022-02-01	367
Number of employers contributing to the scheme	2022-02-01	0
2021: HEALTHMAP SOLUTIONS, INC. HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year	2021-02-01	100
Total number of active participants reported on line 7a of the Form 5500	2021-02-01	135
Number of retired or separated participants receiving benefits	2021-02-01	0
Number of other retired or separated participants entitled to future benefits	2021-02-01	0
Total of all active and inactive participants	2021-02-01	135
Number of employers contributing to the scheme	2021-02-01	0

Form 5500 Responses for HEALTHMAP SOLUTIONS, INC. HEALTH AND WELFARE PLAN

2022: HEALTHMAP SOLUTIONS, INC. HEALTH AND WELFARE PLAN 2022 form 5500 responses
2022-02-01	Type of plan entity	Single employer plan
2022-02-01	Plan funding arrangement – Insurance	Yes
2022-02-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-02-01	Plan benefit arrangement – Insurance	Yes
2022-02-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: HEALTHMAP SOLUTIONS, INC. HEALTH AND WELFARE PLAN 2021 form 5500 responses
2021-02-01	Type of plan entity	Single employer plan
2021-02-01	First time form 5500 has been submitted	Yes
2021-02-01	Plan funding arrangement – Insurance	Yes
2021-02-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

635641

Policy instance

Insurance contract or identification number	635641
Number of Individuals Covered	536
Insurance policy start date	2022-02-01
Insurance policy end date	2023-01-31
Total amount of commissions paid to insurance broker	USD $22,908
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $44,799
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $22,908
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

760790

Policy instance

Insurance contract or identification number	760790
Number of Individuals Covered	212
Insurance policy start date	2022-02-01
Insurance policy end date	2023-01-31
Total amount of commissions paid to insurance broker	USD $21,498
Total amount of fees paid to insurance company	USD $1
Other welfare benefits provided	ACCIDENT, CRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to Carrier	USD $116,628
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $21,498
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	ADMINISTRATION

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

Policy contract number

SGM612203

Policy instance

Insurance contract or identification number	SGM612203
Number of Individuals Covered	367
Insurance policy start date	2022-02-01
Insurance policy end date	2023-01-31
Total amount of commissions paid to insurance broker	USD $45,209
Total amount of fees paid to insurance company	USD $0
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	EMPLOYEE ASSISTANCE PROGRAM,ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $301,391
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $45,209
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

UNITED HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: N/A )

Policy contract number

5400-28849

Policy instance

Insurance contract or identification number	5400-28849
Number of Individuals Covered	135
Insurance policy start date	2021-02-01
Insurance policy end date	2022-01-31
Total amount of commissions paid to insurance broker	USD $42,262
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $112,299
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $36,826
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

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Company Name:	HEALTHMAP SOLUTIONS, INC.
Employer identification number (EIN):	463618409
NAIC Classification:	621492
NAIC Description:	Kidney Dialysis Centers