401k Plan data: NOVELLA CLINICAL, INC. WELFARE BENEFITS PLAN plan

NOVELLA CLINICAL, INC. WELFARE BENEFITS PLAN 401k Plan overview

Plan Name	NOVELLA CLINICAL, INC. WELFARE BENEFITS PLAN
Plan identification number	501

NOVELLA CLINICAL, INC. WELFARE BENEFITS 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

401k Sponsoring company profile

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

Company Name: NOVELLA CLINICAL INC.

Employer identification number (EIN): 562095062

NAIC Classification: 621510
NAIC Description: Medical and Diagnostic Laboratories

Additional information about NOVELLA CLINICAL INC.

Jurisdiction of Incorporation: State of Delaware Division of Corporations

Incorporation Date:

Company Identification Number: 3225023

More information about NOVELLA CLINICAL INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NOVELLA CLINICAL, INC. WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2017-02-01
501 2016-02-01 AMY LENDA
501 2015-02-01 AMY LENDA
501 2014-02-01 AMY LENDA
501 2013-02-01 MICHELLE MCNALLY
501 2012-02-01 MICHELLE MCNALLY
501 2011-02-01 MICHELLE MCNALLY
501 2009-02-01 STEPHANIE SPENCER

Plan Statistics for NOVELLA CLINICAL, INC. WELFARE BENEFITS PLAN

401k plan membership statisitcs for NOVELLA CLINICAL, INC. WELFARE BENEFITS PLAN

Measure Date Value
2017: NOVELLA CLINICAL, INC. WELFARE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-02-01 806
Total number of active participants reported on line 7a of the Form 5500 2017-02-01 0
Number of retired or separated participants receiving benefits 2017-02-01 0
Number of other retired or separated participants entitled to future benefits 2017-02-01 0
Total of all active and inactive participants 2017-02-01 0
2016: NOVELLA CLINICAL, INC. WELFARE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-02-01 648
Total number of active participants reported on line 7a of the Form 5500 2016-02-01 811
Number of retired or separated participants receiving benefits 2016-02-01 2
Number of other retired or separated participants entitled to future benefits 2016-02-01 0
Total of all active and inactive participants 2016-02-01 813
2015: NOVELLA CLINICAL, INC. WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-02-01 562
Total number of active participants reported on line 7a of the Form 5500 2015-02-01 666
Number of retired or separated participants receiving benefits 2015-02-01 2
Number of other retired or separated participants entitled to future benefits 2015-02-01 0
Total of all active and inactive participants 2015-02-01 668
2014: NOVELLA CLINICAL, INC. WELFARE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-02-01 509
Total number of active participants reported on line 7a of the Form 5500 2014-02-01 533
Number of retired or separated participants receiving benefits 2014-02-01 2
Number of other retired or separated participants entitled to future benefits 2014-02-01 0
Total of all active and inactive participants 2014-02-01 535
2013: NOVELLA CLINICAL, INC. WELFARE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-02-01 500
Total number of active participants reported on line 7a of the Form 5500 2013-02-01 504
Number of retired or separated participants receiving benefits 2013-02-01 5
Number of other retired or separated participants entitled to future benefits 2013-02-01 0
Total of all active and inactive participants 2013-02-01 509
2012: NOVELLA CLINICAL, INC. WELFARE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-02-01 369
Total number of active participants reported on line 7a of the Form 5500 2012-02-01 427
Number of retired or separated participants receiving benefits 2012-02-01 4
Number of other retired or separated participants entitled to future benefits 2012-02-01 0
Total of all active and inactive participants 2012-02-01 431
2011: NOVELLA CLINICAL, INC. WELFARE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-02-01 409
Total number of active participants reported on line 7a of the Form 5500 2011-02-01 402
Number of retired or separated participants receiving benefits 2011-02-01 0
Number of other retired or separated participants entitled to future benefits 2011-02-01 0
Total of all active and inactive participants 2011-02-01 402
2009: NOVELLA CLINICAL, INC. WELFARE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-02-01 226
Total number of active participants reported on line 7a of the Form 5500 2009-02-01 295
Number of retired or separated participants receiving benefits 2009-02-01 8
Number of other retired or separated participants entitled to future benefits 2009-02-01 0
Total of all active and inactive participants 2009-02-01 303

Measure	Date	Value
2017: NOVELLA CLINICAL, INC. WELFARE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-02-01	806
Total number of active participants reported on line 7a of the Form 5500	2017-02-01	0
Number of retired or separated participants receiving benefits	2017-02-01	0
Number of other retired or separated participants entitled to future benefits	2017-02-01	0
Total of all active and inactive participants	2017-02-01	0
2016: NOVELLA CLINICAL, INC. WELFARE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-02-01	648
Total number of active participants reported on line 7a of the Form 5500	2016-02-01	811
Number of retired or separated participants receiving benefits	2016-02-01	2
Number of other retired or separated participants entitled to future benefits	2016-02-01	0
Total of all active and inactive participants	2016-02-01	813
2015: NOVELLA CLINICAL, INC. WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-02-01	562
Total number of active participants reported on line 7a of the Form 5500	2015-02-01	666
Number of retired or separated participants receiving benefits	2015-02-01	2
Number of other retired or separated participants entitled to future benefits	2015-02-01	0
Total of all active and inactive participants	2015-02-01	668
2014: NOVELLA CLINICAL, INC. WELFARE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-02-01	509
Total number of active participants reported on line 7a of the Form 5500	2014-02-01	533
Number of retired or separated participants receiving benefits	2014-02-01	2
Number of other retired or separated participants entitled to future benefits	2014-02-01	0
Total of all active and inactive participants	2014-02-01	535
2013: NOVELLA CLINICAL, INC. WELFARE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-02-01	500
Total number of active participants reported on line 7a of the Form 5500	2013-02-01	504
Number of retired or separated participants receiving benefits	2013-02-01	5
Number of other retired or separated participants entitled to future benefits	2013-02-01	0
Total of all active and inactive participants	2013-02-01	509
2012: NOVELLA CLINICAL, INC. WELFARE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-02-01	369
Total number of active participants reported on line 7a of the Form 5500	2012-02-01	427
Number of retired or separated participants receiving benefits	2012-02-01	4
Number of other retired or separated participants entitled to future benefits	2012-02-01	0
Total of all active and inactive participants	2012-02-01	431
2011: NOVELLA CLINICAL, INC. WELFARE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-02-01	409
Total number of active participants reported on line 7a of the Form 5500	2011-02-01	402
Number of retired or separated participants receiving benefits	2011-02-01	0
Number of other retired or separated participants entitled to future benefits	2011-02-01	0
Total of all active and inactive participants	2011-02-01	402
2009: NOVELLA CLINICAL, INC. WELFARE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-02-01	226
Total number of active participants reported on line 7a of the Form 5500	2009-02-01	295
Number of retired or separated participants receiving benefits	2009-02-01	8
Number of other retired or separated participants entitled to future benefits	2009-02-01	0
Total of all active and inactive participants	2009-02-01	303

Form 5500 Responses for NOVELLA CLINICAL, INC. WELFARE BENEFITS PLAN

2017: NOVELLA CLINICAL, INC. WELFARE BENEFITS PLAN 2017 form 5500 responses
2017-02-01	Type of plan entity	Single employer plan
2017-02-01	Submission has been amended	No
2017-02-01	This submission is the final filing	Yes
2017-02-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2017-02-01	Plan is a collectively bargained plan	No
2017-02-01	Plan funding arrangement – Insurance	Yes
2017-02-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-02-01	Plan benefit arrangement – Insurance	Yes
2017-02-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: NOVELLA CLINICAL, INC. WELFARE BENEFITS PLAN 2016 form 5500 responses
2016-02-01	Type of plan entity	Single employer plan
2016-02-01	Submission has been amended	No
2016-02-01	This submission is the final filing	No
2016-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-02-01	Plan is a collectively bargained plan	No
2016-02-01	Plan funding arrangement – Insurance	Yes
2016-02-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-02-01	Plan benefit arrangement – Insurance	Yes
2016-02-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: NOVELLA CLINICAL, INC. WELFARE BENEFITS PLAN 2015 form 5500 responses
2015-02-01	Type of plan entity	Single employer plan
2015-02-01	Submission has been amended	No
2015-02-01	This submission is the final filing	No
2015-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-02-01	Plan is a collectively bargained plan	No
2015-02-01	Plan funding arrangement – Insurance	Yes
2015-02-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-02-01	Plan benefit arrangement – Insurance	Yes
2015-02-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: NOVELLA CLINICAL, INC. WELFARE BENEFITS PLAN 2014 form 5500 responses
2014-02-01	Type of plan entity	Single employer plan
2014-02-01	Submission has been amended	No
2014-02-01	This submission is the final filing	No
2014-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-02-01	Plan is a collectively bargained plan	No
2014-02-01	Plan funding arrangement – Insurance	Yes
2014-02-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-02-01	Plan benefit arrangement – Insurance	Yes
2014-02-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: NOVELLA CLINICAL, INC. WELFARE BENEFITS PLAN 2013 form 5500 responses
2013-02-01	Type of plan entity	Single employer plan
2013-02-01	Submission has been amended	No
2013-02-01	This submission is the final filing	No
2013-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-02-01	Plan is a collectively bargained plan	No
2013-02-01	Plan funding arrangement – Insurance	Yes
2013-02-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-02-01	Plan benefit arrangement – Insurance	Yes
2013-02-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: NOVELLA CLINICAL, INC. WELFARE BENEFITS PLAN 2012 form 5500 responses
2012-02-01	Type of plan entity	Single employer plan
2012-02-01	Submission has been amended	No
2012-02-01	This submission is the final filing	No
2012-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-02-01	Plan is a collectively bargained plan	No
2012-02-01	Plan funding arrangement – Insurance	Yes
2012-02-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-02-01	Plan benefit arrangement – Insurance	Yes
2012-02-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: NOVELLA CLINICAL, INC. WELFARE BENEFITS PLAN 2011 form 5500 responses
2011-02-01	Type of plan entity	Single employer plan
2011-02-01	Submission has been amended	No
2011-02-01	This submission is the final filing	No
2011-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-02-01	Plan is a collectively bargained plan	No
2011-02-01	Plan funding arrangement – Insurance	Yes
2011-02-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-02-01	Plan benefit arrangement – Insurance	Yes
2011-02-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: NOVELLA CLINICAL, INC. WELFARE BENEFITS PLAN 2009 form 5500 responses
2009-02-01	Type of plan entity	Single employer plan
2009-02-01	Submission has been amended	No
2009-02-01	This submission is the final filing	No
2009-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-02-01	Plan is a collectively bargained plan	No
2009-02-01	Plan funding arrangement – Insurance	Yes
2009-02-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-02-01	Plan benefit arrangement – Insurance	Yes
2009-02-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )

Policy contract number

V68044

Policy instance

Insurance contract or identification number	V68044
Number of Individuals Covered	1606
Insurance policy start date	2017-02-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $9,009
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $91,090
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,009
Insurance broker organization code?	3
Insurance broker name	ALAN N OVERBEY

RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )

Policy contract number

69380-4

Policy instance

Insurance contract or identification number	69380-4
Number of Individuals Covered	889
Insurance policy start date	2017-02-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $64,636
Total amount of fees paid to insurance company	USD $21,669
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $433,369
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $48,360
Insurance broker organization code?	3
Amount paid for insurance broker fees	21669
Additional information about fees paid to insurance broker	FEES
Insurance broker name	MOSAIC GROUP SERVICES, LLC

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Company Name:	NOVELLA CLINICAL INC.
Employer identification number (EIN):	562095062
NAIC Classification:	621510
NAIC Description:	Medical and Diagnostic Laboratories

Jurisdiction of Incorporation:	State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number:	3225023

Plan id#	Filing Submission Date	Name of Administrator
501	2017-02-01
501	2016-02-01	AMY LENDA
501	2015-02-01	AMY LENDA
501	2014-02-01	AMY LENDA
501	2013-02-01	MICHELLE MCNALLY
501	2012-02-01	MICHELLE MCNALLY
501	2011-02-01	MICHELLE MCNALLY
501	2009-02-01	STEPHANIE SPENCER