401k Plan data: FSISAC GROUP LIFE PLAN plan

FSISAC GROUP LIFE PLAN 401k Plan overview

Plan Name	FSISAC GROUP LIFE PLAN
Plan identification number	501

FSISAC GROUP LIFE 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 Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

FS-ISAC, INC has sponsored the creation of one or more 401k plans.

Company Name: FS-ISAC, INC

Employer identification number (EIN): 522204208

NAIC Classification: 813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Additional information about FS-ISAC, INC

Jurisdiction of Incorporation: State of Delaware Division of Corporations

Incorporation Date: 1999-08-13

Company Identification Number: 3083067

Legal Registered Office Address: 2711 Centerville Rd
Suite 400
Wilmington
United States of America (USA)
19808

More information about FS-ISAC, INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FSISAC GROUP LIFE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2019-11-01 DANIELLE METZLER 2021-02-09
501 2018-11-01 AMY BOERNER 2020-04-17

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2019-11-01	DANIELLE METZLER	2021-02-09
501	2018-11-01	AMY BOERNER	2020-04-17

Plan Statistics for FSISAC GROUP LIFE PLAN

401k plan membership statisitcs for FSISAC GROUP LIFE PLAN

Measure Date Value
2019: FSISAC GROUP LIFE PLAN 2019 401k membership
Total participants, beginning-of-year 2019-11-01 101
Total number of active participants reported on line 7a of the Form 5500 2019-11-01 76
Number of retired or separated participants receiving benefits 2019-11-01 7
Number of other retired or separated participants entitled to future benefits 2019-11-01 0
Total of all active and inactive participants 2019-11-01 83
Number of employers contributing to the scheme 2019-11-01 0
2018: FSISAC GROUP LIFE PLAN 2018 401k membership
Total participants, beginning-of-year 2018-11-01 102
Total number of active participants reported on line 7a of the Form 5500 2018-11-01 100
Number of retired or separated participants receiving benefits 2018-11-01 0
Number of other retired or separated participants entitled to future benefits 2018-11-01 0
Total of all active and inactive participants 2018-11-01 100
Number of employers contributing to the scheme 2018-11-01 0

Measure	Date	Value
2019: FSISAC GROUP LIFE PLAN 2019 401k membership
Total participants, beginning-of-year	2019-11-01	101
Total number of active participants reported on line 7a of the Form 5500	2019-11-01	76
Number of retired or separated participants receiving benefits	2019-11-01	7
Number of other retired or separated participants entitled to future benefits	2019-11-01	0
Total of all active and inactive participants	2019-11-01	83
Number of employers contributing to the scheme	2019-11-01	0
2018: FSISAC GROUP LIFE PLAN 2018 401k membership
Total participants, beginning-of-year	2018-11-01	102
Total number of active participants reported on line 7a of the Form 5500	2018-11-01	100
Number of retired or separated participants receiving benefits	2018-11-01	0
Number of other retired or separated participants entitled to future benefits	2018-11-01	0
Total of all active and inactive participants	2018-11-01	100
Number of employers contributing to the scheme	2018-11-01	0

Form 5500 Responses for FSISAC GROUP LIFE PLAN

2019: FSISAC GROUP LIFE PLAN 2019 form 5500 responses
2019-11-01	Type of plan entity	Single employer plan
2019-11-01	Plan funding arrangement – Insurance	Yes
2019-11-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-11-01	Plan benefit arrangement – Insurance	Yes
2019-11-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: FSISAC GROUP LIFE PLAN 2018 form 5500 responses
2018-11-01	Type of plan entity	Single employer plan
2018-11-01	First time form 5500 has been submitted	Yes
2018-11-01	Plan funding arrangement – Insurance	Yes
2018-11-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

DELTA DENTAL OF VIRGINIA (National Association of Insurance Commissioners NAIC id number: 55611 )

Policy contract number

402679

Policy instance

Insurance contract or identification number	402679
Number of Individuals Covered	153
Insurance policy start date	2019-11-01
Insurance policy end date	2020-10-31
Total amount of commissions paid to insurance broker	USD $3,214
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $63,247
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,214
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

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

Policy contract number

623635

Policy instance

Insurance contract or identification number	623635
Number of Individuals Covered	101
Insurance policy start date	2019-11-01
Insurance policy end date	2020-10-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $63,521
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,084,122
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	60860
Additional information about fees paid to insurance broker	BENEFIT ADVISOR FEES
Insurance broker organization code?	3

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

Policy contract number

10204468

Policy instance

Insurance contract or identification number	10204468
Number of Individuals Covered	76
Insurance policy start date	2019-11-01
Insurance policy end date	2020-10-31
Total amount of commissions paid to insurance broker	USD $9,671
Total amount of fees paid to insurance company	USD $1,150
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
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,EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to Carrier	USD $96,956
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,671
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	BROKER BONUS

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

Policy contract number

10204468

Policy instance

Insurance contract or identification number	10204468
Number of Individuals Covered	101
Insurance policy start date	2018-11-01
Insurance policy end date	2019-10-31
Total amount of commissions paid to insurance broker	USD $1,595
Total amount of fees paid to insurance company	USD $31
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $14,793
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,350
Amount paid for insurance broker fees	31
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3

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Company Name:	FS-ISAC, INC
Employer identification number (EIN):	522204208
NAIC Classification:	813000
NAIC Description:	Religious, Grantmaking, Civic, Professional, and Similar Organizations

Jurisdiction of Incorporation:	State of Delaware Division of Corporations
Incorporation Date:	1999-08-13
Company Identification Number:	3083067
Legal Registered Office Address:	2711 Centerville Rd Suite 400 Wilmington United States of America (USA) 19808