401k Plan data: ASTIN EXECUTIVE SERVICES LLC HEALTH AND WELFARE PLAN plan

ASTIN EXECUTIVE SERVICES LLC HEALTH AND WELFARE PLAN 401k Plan overview

Plan Name	ASTIN EXECUTIVE SERVICES LLC HEALTH AND WELFARE PLAN
Plan identification number	501

ASTIN EXECUTIVE SERVICES LLC 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)

401k Sponsoring company profile

ASTIN EXECUTIVE SERVICES, LLC has sponsored the creation of one or more 401k plans.

Company Name: ASTIN EXECUTIVE SERVICES, LLC

Employer identification number (EIN): 464471600

NAIC Classification: 541700

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ASTIN EXECUTIVE SERVICES LLC HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-01-01 PHILIP BEARD 2023-08-14

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2022-01-01	PHILIP BEARD	2023-08-14

Plan Statistics for ASTIN EXECUTIVE SERVICES LLC HEALTH AND WELFARE PLAN

401k plan membership statisitcs for ASTIN EXECUTIVE SERVICES LLC HEALTH AND WELFARE PLAN

Measure Date Value
2022: ASTIN EXECUTIVE SERVICES LLC HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 172
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 157
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 157
Number of employers contributing to the scheme 2022-01-01 0

Measure	Date	Value
2022: ASTIN EXECUTIVE SERVICES LLC HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	172
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	157
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	157
Number of employers contributing to the scheme	2022-01-01	0

Form 5500 Responses for ASTIN EXECUTIVE SERVICES LLC HEALTH AND WELFARE PLAN

2022: ASTIN EXECUTIVE SERVICES LLC HEALTH AND WELFARE PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	First time form 5500 has been submitted	Yes
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

278297

Policy instance

Insurance contract or identification number	278297
Number of Individuals Covered	251
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $57,600
Total amount of fees paid to insurance company	USD $1,539
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,031,794
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $57,600
Amount paid for insurance broker fees	1539
Additional information about fees paid to insurance broker	SPECIAL PROGRAMS
Insurance broker organization code?	3

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

605187

Policy instance

Insurance contract or identification number	605187
Number of Individuals Covered	221
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $2,346
Total amount of fees paid to insurance company	USD $41
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $15,699
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,346
Amount paid for insurance broker fees	41
Additional information about fees paid to insurance broker	2021 PINNACLE VISION RETENTION INCENTIVE RISCK
Insurance broker organization code?	3

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

Policy contract number

1D040182

Policy instance

Insurance contract or identification number	1D040182
Number of Individuals Covered	184
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $16,530
Total amount of fees paid to insurance company	USD $3,089
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	Yes
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	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $132,466
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $16,530
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	BROKER BONUS

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Company Name:	ASTIN EXECUTIVE SERVICES, LLC
Employer identification number (EIN):	464471600
NAIC Classification:	541700