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TRIVIUM MANAGEMENT GROUP, LLC HEALTH & WELFARE PLAN 401k Plan overview

Plan NameTRIVIUM MANAGEMENT GROUP, LLC HEALTH & WELFARE PLAN
Plan identification number 502

TRIVIUM MANAGEMENT GROUP, LLC HEALTH & WELFARE PLAN Benefits

401k Plan TypeWelfare 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)

401k Sponsoring company profile

TRIVIUM MANAGEMENT GROUP, LLC has sponsored the creation of one or more 401k plans.

Company Name:TRIVIUM MANAGEMENT GROUP, LLC
Employer identification number (EIN):464468842
NAIC Classification:621610
NAIC Description:Home Health Care Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TRIVIUM MANAGEMENT GROUP, LLC HEALTH & WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022021-09-01LISA SCOTT2023-02-06
5022020-09-01LISA SCOTT2022-05-19

Plan Statistics for TRIVIUM MANAGEMENT GROUP, LLC HEALTH & WELFARE PLAN

401k plan membership statisitcs for TRIVIUM MANAGEMENT GROUP, LLC HEALTH & WELFARE PLAN

Measure Date Value
2021: TRIVIUM MANAGEMENT GROUP, LLC HEALTH & WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-09-01177
Total number of active participants reported on line 7a of the Form 55002021-09-01125
Number of retired or separated participants receiving benefits2021-09-010
Number of other retired or separated participants entitled to future benefits2021-09-010
Total of all active and inactive participants2021-09-01125
Number of employers contributing to the scheme2021-09-010
2020: TRIVIUM MANAGEMENT GROUP, LLC HEALTH & WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year2020-09-01100
Total number of active participants reported on line 7a of the Form 55002020-09-01177
Number of retired or separated participants receiving benefits2020-09-010
Number of other retired or separated participants entitled to future benefits2020-09-010
Total of all active and inactive participants2020-09-01177
Number of employers contributing to the scheme2020-09-010

Form 5500 Responses for TRIVIUM MANAGEMENT GROUP, LLC HEALTH & WELFARE PLAN

2021: TRIVIUM MANAGEMENT GROUP, LLC HEALTH & WELFARE PLAN 2021 form 5500 responses
2021-09-01Type of plan entitySingle employer plan
2021-09-01Plan funding arrangement – InsuranceYes
2021-09-01Plan benefit arrangement – InsuranceYes
2020: TRIVIUM MANAGEMENT GROUP, LLC HEALTH & WELFARE PLAN 2020 form 5500 responses
2020-09-01Type of plan entitySingle employer plan
2020-09-01First time form 5500 has been submittedYes
2020-09-01Plan funding arrangement – InsuranceYes
2020-09-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number552592
Policy instance 1
Insurance contract or identification number552592
Number of Individuals Covered125
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $18,487
Total amount of fees paid to insurance companyUSD $5,437
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $130,937
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,334
Amount paid for insurance broker fees5437
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )
Policy contract number129058
Policy instance 2
Insurance contract or identification number129058
Number of Individuals Covered162
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $38,984
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $845,610
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,984
Amount paid for insurance broker fees0
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number552592
Policy instance 1
Insurance contract or identification number552592
Number of Individuals Covered150
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $21,056
Total amount of fees paid to insurance companyUSD $2,208
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $150,002
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,597
Amount paid for insurance broker fees2208
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )
Policy contract number129058
Policy instance 2
Insurance contract or identification number129058
Number of Individuals Covered177
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $33,386
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $901,936
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,020
Amount paid for insurance broker fees0
Insurance broker organization code?3

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