401k Plan data: SCREEN-IT GRAPHICS OF LAWRENCE, INC. HEALTH PLAN plan

SCREEN-IT GRAPHICS OF LAWRENCE, INC. HEALTH PLAN 401k Plan overview

Plan Name	SCREEN-IT GRAPHICS OF LAWRENCE, INC. HEALTH PLAN
Plan identification number	501

SCREEN-IT GRAPHICS OF LAWRENCE, INC. HEALTH PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Dental Other welfare benefit cover

401k Sponsoring company profile

SCREEN-IT GRAPHICS OF LAWRENCE, has sponsored the creation of one or more 401k plans.

Company Name: SCREEN-IT GRAPHICS OF LAWRENCE,

Employer identification number (EIN): 481053811

NAIC Classification: 323100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SCREEN-IT GRAPHICS OF LAWRENCE, INC. HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2017-03-01 BRANDON PETZ
501 2016-03-01 BRANDON PETZ
501 2015-03-01 BRANDON PETZ
501 2014-03-01 BRANDON PETZ

Plan id#	Filing Submission Date	Name of Administrator
501	2017-03-01	BRANDON PETZ
501	2016-03-01	BRANDON PETZ
501	2015-03-01	BRANDON PETZ
501	2014-03-01	BRANDON PETZ

Plan Statistics for SCREEN-IT GRAPHICS OF LAWRENCE, INC. HEALTH PLAN

401k plan membership statisitcs for SCREEN-IT GRAPHICS OF LAWRENCE, INC. HEALTH PLAN

Measure Date Value
2017: SCREEN-IT GRAPHICS OF LAWRENCE, INC. HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year 2017-03-01 167
Total number of active participants reported on line 7a of the Form 5500 2017-03-01 189
Number of retired or separated participants receiving benefits 2017-03-01 1
Number of other retired or separated participants entitled to future benefits 2017-03-01 0
Total of all active and inactive participants 2017-03-01 190
2016: SCREEN-IT GRAPHICS OF LAWRENCE, INC. HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year 2016-03-01 150
Total number of active participants reported on line 7a of the Form 5500 2016-03-01 165
Number of retired or separated participants receiving benefits 2016-03-01 1
Number of other retired or separated participants entitled to future benefits 2016-03-01 0
Total of all active and inactive participants 2016-03-01 166
2015: SCREEN-IT GRAPHICS OF LAWRENCE, INC. HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year 2015-03-01 137
Total number of active participants reported on line 7a of the Form 5500 2015-03-01 149
Number of retired or separated participants receiving benefits 2015-03-01 1
Number of other retired or separated participants entitled to future benefits 2015-03-01 0
Total of all active and inactive participants 2015-03-01 150
2014: SCREEN-IT GRAPHICS OF LAWRENCE, INC. HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year 2014-03-01 103
Total number of active participants reported on line 7a of the Form 5500 2014-03-01 124
Number of retired or separated participants receiving benefits 2014-03-01 0
Number of other retired or separated participants entitled to future benefits 2014-03-01 0
Total of all active and inactive participants 2014-03-01 124

Measure	Date	Value
2017: SCREEN-IT GRAPHICS OF LAWRENCE, INC. HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year	2017-03-01	167
Total number of active participants reported on line 7a of the Form 5500	2017-03-01	189
Number of retired or separated participants receiving benefits	2017-03-01	1
Number of other retired or separated participants entitled to future benefits	2017-03-01	0
Total of all active and inactive participants	2017-03-01	190
2016: SCREEN-IT GRAPHICS OF LAWRENCE, INC. HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year	2016-03-01	150
Total number of active participants reported on line 7a of the Form 5500	2016-03-01	165
Number of retired or separated participants receiving benefits	2016-03-01	1
Number of other retired or separated participants entitled to future benefits	2016-03-01	0
Total of all active and inactive participants	2016-03-01	166
2015: SCREEN-IT GRAPHICS OF LAWRENCE, INC. HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year	2015-03-01	137
Total number of active participants reported on line 7a of the Form 5500	2015-03-01	149
Number of retired or separated participants receiving benefits	2015-03-01	1
Number of other retired or separated participants entitled to future benefits	2015-03-01	0
Total of all active and inactive participants	2015-03-01	150
2014: SCREEN-IT GRAPHICS OF LAWRENCE, INC. HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year	2014-03-01	103
Total number of active participants reported on line 7a of the Form 5500	2014-03-01	124
Number of retired or separated participants receiving benefits	2014-03-01	0
Number of other retired or separated participants entitled to future benefits	2014-03-01	0
Total of all active and inactive participants	2014-03-01	124

Form 5500 Responses for SCREEN-IT GRAPHICS OF LAWRENCE, INC. HEALTH PLAN

2017: SCREEN-IT GRAPHICS OF LAWRENCE, INC. HEALTH PLAN 2017 form 5500 responses
2017-03-01	Type of plan entity	Single employer plan
2017-03-01	Plan funding arrangement – Insurance	Yes
2017-03-01	Plan benefit arrangement – Insurance	Yes
2016: SCREEN-IT GRAPHICS OF LAWRENCE, INC. HEALTH PLAN 2016 form 5500 responses
2016-03-01	Type of plan entity	Single employer plan
2016-03-01	Plan funding arrangement – Insurance	Yes
2016-03-01	Plan benefit arrangement – Insurance	Yes
2015: SCREEN-IT GRAPHICS OF LAWRENCE, INC. HEALTH PLAN 2015 form 5500 responses
2015-03-01	Type of plan entity	Single employer plan
2015-03-01	Plan funding arrangement – Insurance	Yes
2015-03-01	Plan benefit arrangement – Insurance	Yes
2014: SCREEN-IT GRAPHICS OF LAWRENCE, INC. HEALTH PLAN 2014 form 5500 responses
2014-03-01	Type of plan entity	Single employer plan
2014-03-01	First time form 5500 has been submitted	Yes
2014-03-01	Plan funding arrangement – Insurance	Yes
2014-03-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF KANSAS (National Association of Insurance Commissioners NAIC id number: 70729 )
Policy contract number	27631
Policy instance	1
BLUE CROSS BLUE SHIELD OF KANSAS (National Association of Insurance Commissioners NAIC id number: 70729 )
Policy contract number	27631
Policy instance	1
BLUE CROSS BLUE SHIELD OF KANSAS (National Association of Insurance Commissioners NAIC id number: 70729 )
Policy contract number	27631
Policy instance	1

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Company Name:	SCREEN-IT GRAPHICS OF LAWRENCE,
Employer identification number (EIN):	481053811
NAIC Classification:	323100