401k Plan data: DISPLAYMAX HEALTH AND WELFARE BENEFITS PLAN plan

DISPLAYMAX HEALTH AND WELFARE BENEFITS PLAN 401k Plan overview

Plan Name	DISPLAYMAX HEALTH AND WELFARE BENEFITS PLAN
Plan identification number	501

DISPLAYMAX HEALTH AND WELFARE BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision

401k Sponsoring company profile

DISPLAYMAX INC has sponsored the creation of one or more 401k plans.

Company Name: DISPLAYMAX INC

Employer identification number (EIN): 550852601

NAIC Classification: 561490

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DISPLAYMAX HEALTH AND WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-01-01 MIKE MYHER 2023-09-22

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2022-01-01	MIKE MYHER	2023-09-22

Plan Statistics for DISPLAYMAX HEALTH AND WELFARE BENEFITS PLAN

401k plan membership statisitcs for DISPLAYMAX HEALTH AND WELFARE BENEFITS PLAN

Measure Date Value
2022: DISPLAYMAX HEALTH AND WELFARE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 191
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 238
Total of all active and inactive participants 2022-01-01 238

Measure	Date	Value
2022: DISPLAYMAX HEALTH AND WELFARE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	191
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	238
Total of all active and inactive participants	2022-01-01	238

Form 5500 Responses for DISPLAYMAX HEALTH AND WELFARE BENEFITS PLAN

2022: DISPLAYMAX HEALTH AND WELFARE BENEFITS 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

BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )

Policy contract number

274213

Policy instance

Insurance contract or identification number	274213
Number of Individuals Covered	120
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $39,231
Total amount of fees paid to insurance company	USD $778
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $38,111
Insurance broker organization code?	3
Amount paid for insurance broker fees	778
Additional information about fees paid to insurance broker	BROKER BONUS

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

1060725

Policy instance

Insurance contract or identification number	1060725
Number of Individuals Covered	297
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $7,174
Total amount of fees paid to insurance company	USD $3,184
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $101,641
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,174
Amount paid for insurance broker fees	2942
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3

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Company Name:	DISPLAYMAX INC
Employer identification number (EIN):	550852601
NAIC Classification:	561490