401k Plan data: OUTSELL CORPORATION ERISA WRAP PLAN plan

OUTSELL CORPORATION ERISA WRAP PLAN 401k Plan overview

Plan Name	OUTSELL CORPORATION ERISA WRAP PLAN
Plan identification number	502

OUTSELL CORPORATION ERISA WRAP 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 Other welfare benefit cover

401k Sponsoring company profile

OUTSELL CORPORATION has sponsored the creation of one or more 401k plans.

Company Name: OUTSELL CORPORATION

Employer identification number (EIN): 472617815

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

Additional information about OUTSELL CORPORATION

Jurisdiction of Incorporation: State of Delaware Division of Corporations

Incorporation Date:

Company Identification Number: 5666195

More information about OUTSELL CORPORATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan OUTSELL CORPORATION ERISA WRAP PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2022-01-01
502 2021-01-01

Plan Statistics for OUTSELL CORPORATION ERISA WRAP PLAN

401k plan membership statisitcs for OUTSELL CORPORATION ERISA WRAP PLAN

Measure Date Value
2022: OUTSELL CORPORATION ERISA WRAP PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 110
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 130
Number of retired or separated participants receiving benefits 2022-01-01 7
Total of all active and inactive participants 2022-01-01 137
Total participants 2022-01-01 137
2021: OUTSELL CORPORATION ERISA WRAP PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 101
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 110
Total of all active and inactive participants 2021-01-01 110
Total participants 2021-01-01 110

Measure	Date	Value
2022: OUTSELL CORPORATION ERISA WRAP PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	110
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	130
Number of retired or separated participants receiving benefits	2022-01-01	7
Total of all active and inactive participants	2022-01-01	137
Total participants	2022-01-01	137
2021: OUTSELL CORPORATION ERISA WRAP PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	101
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	110
Total of all active and inactive participants	2021-01-01	110
Total participants	2021-01-01	110

Form 5500 Responses for OUTSELL CORPORATION ERISA WRAP PLAN

2022: OUTSELL CORPORATION ERISA WRAP PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2021: OUTSELL CORPORATION ERISA WRAP PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	First time form 5500 has been submitted	Yes
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

DELTA DENTAL OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 )

Policy contract number

108232

Policy instance

Insurance contract or identification number	108232
Number of Individuals Covered	104
Total amount of commissions paid to insurance broker	USD $6,418
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $64,836
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,418
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00024487

Policy instance

Insurance contract or identification number	00024487
Number of Individuals Covered	130
Total amount of commissions paid to insurance broker	USD $6,392
Total amount of fees paid to insurance company	USD $394
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D; OPT AD&D; OPT LIFE
Welfare Benefit Premiums Paid to Carrier	USD $44,609
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,392
Amount paid for insurance broker fees	394
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

99443801001

Policy instance

Insurance contract or identification number	99443801001
Number of Individuals Covered	89
Total amount of commissions paid to insurance broker	USD $595
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $6,053
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $595
Insurance broker organization code?	3

BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )

Policy contract number

283450

Policy instance

Insurance contract or identification number	283450
Number of Individuals Covered	118
Total amount of commissions paid to insurance broker	USD $39,424
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $964,895
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $39,424
Insurance broker organization code?	3

HEALTHPARTNERS INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 44547 )

Policy contract number

4719

Policy instance

Insurance contract or identification number	4719
Number of Individuals Covered	103
Total amount of commissions paid to insurance broker	USD $31,460
Total amount of fees paid to insurance company	USD $55
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $909,437
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $31,460
Amount paid for insurance broker fees	55
Additional information about fees paid to insurance broker	INDIRECT COMPENSSATION
Insurance broker organization code?	3

DELTA DENTAL OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 )

Policy contract number

108232

Policy instance

Insurance contract or identification number	108232
Number of Individuals Covered	84
Total amount of commissions paid to insurance broker	USD $6,869
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $64,538
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $6,869
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00024487

Policy instance

Insurance contract or identification number	00024487
Number of Individuals Covered	110
Total amount of commissions paid to insurance broker	USD $1,885
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D; OPT AD&D; OPT LIFE
Welfare Benefit Premiums Paid to Carrier	USD $13,145
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,885
Insurance broker organization code?	3

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

99443801001

Policy instance

Insurance contract or identification number	99443801001
Number of Individuals Covered	74
Total amount of commissions paid to insurance broker	USD $570
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $5,013
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $570
Insurance broker organization code?	3

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Company Name:	OUTSELL CORPORATION
Employer identification number (EIN):	472617815
NAIC Classification:	541990
NAIC Description:	All Other Professional, Scientific, and Technical Services

Jurisdiction of Incorporation:	State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number:	5666195