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VERISTOR SYSTEMS, INC. LIFE, DISABILITY, MEDICAL, DENTAL PLAN 401k Plan overview

Plan NameVERISTOR SYSTEMS, INC. LIFE, DISABILITY, MEDICAL, DENTAL PLAN
Plan identification number 501

VERISTOR SYSTEMS, INC. LIFE, DISABILITY, MEDICAL, DENTAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

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

Company Name:VERISTOR SYSTEMS INC
Employer identification number (EIN):582666393
NAIC Classification:541519
NAIC Description:Other Computer Related Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan VERISTOR SYSTEMS, INC. LIFE, DISABILITY, MEDICAL, DENTAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012019-12-01
5012018-12-01
5012017-12-01DEBORAH LOVETT

Plan Statistics for VERISTOR SYSTEMS, INC. LIFE, DISABILITY, MEDICAL, DENTAL PLAN

401k plan membership statisitcs for VERISTOR SYSTEMS, INC. LIFE, DISABILITY, MEDICAL, DENTAL PLAN

Measure Date Value
2019: VERISTOR SYSTEMS, INC. LIFE, DISABILITY, MEDICAL, DENTAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-12-01111
Total number of active participants reported on line 7a of the Form 55002019-12-01106
Total of all active and inactive participants2019-12-01106
2018: VERISTOR SYSTEMS, INC. LIFE, DISABILITY, MEDICAL, DENTAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-12-01102
Total number of active participants reported on line 7a of the Form 55002018-12-01111
Total of all active and inactive participants2018-12-01111
2017: VERISTOR SYSTEMS, INC. LIFE, DISABILITY, MEDICAL, DENTAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-12-01103
Total number of active participants reported on line 7a of the Form 55002017-12-01100
Total of all active and inactive participants2017-12-01100

Form 5500 Responses for VERISTOR SYSTEMS, INC. LIFE, DISABILITY, MEDICAL, DENTAL PLAN

2019: VERISTOR SYSTEMS, INC. LIFE, DISABILITY, MEDICAL, DENTAL PLAN 2019 form 5500 responses
2019-12-01Type of plan entitySingle employer plan
2019-12-01Submission has been amendedNo
2019-12-01This submission is the final filingNo
2019-12-01This return/report is a short plan year return/report (less than 12 months)No
2019-12-01Plan is a collectively bargained planNo
2019-12-01Plan funding arrangement – InsuranceYes
2019-12-01Plan benefit arrangement – InsuranceYes
2018: VERISTOR SYSTEMS, INC. LIFE, DISABILITY, MEDICAL, DENTAL PLAN 2018 form 5500 responses
2018-12-01Type of plan entitySingle employer plan
2018-12-01Submission has been amendedNo
2018-12-01This submission is the final filingNo
2018-12-01This return/report is a short plan year return/report (less than 12 months)No
2018-12-01Plan is a collectively bargained planNo
2018-12-01Plan funding arrangement – InsuranceYes
2018-12-01Plan benefit arrangement – InsuranceYes
2017: VERISTOR SYSTEMS, INC. LIFE, DISABILITY, MEDICAL, DENTAL PLAN 2017 form 5500 responses
2017-12-01Type of plan entitySingle employer plan
2017-12-01First time form 5500 has been submittedYes
2017-12-01Submission has been amendedNo
2017-12-01This submission is the final filingNo
2017-12-01This return/report is a short plan year return/report (less than 12 months)No
2017-12-01Plan is a collectively bargained planNo
2017-12-01Plan funding arrangement – InsuranceYes
2017-12-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number623972
Policy instance 1
Insurance contract or identification number623972
Number of Individuals Covered170
Insurance policy start date2019-12-01
Insurance policy end date2020-11-30
Total amount of commissions paid to insurance brokerUSD $9,119
Total amount of fees paid to insurance companyUSD $32,920
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,087,565
Commission paid to Insurance BrokerUSD $1,873
Amount paid for insurance broker fees567
Additional information about fees paid to insurance brokerSERVICE FEES
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number623972
Policy instance 1
Insurance contract or identification number623972
Number of Individuals Covered173
Insurance policy start date2018-12-01
Insurance policy end date2019-11-30
Total amount of commissions paid to insurance brokerUSD $10,268
Total amount of fees paid to insurance companyUSD $32,368
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,059,195
Commission paid to Insurance BrokerUSD $10,268
Amount paid for insurance broker fees32368
Additional information about fees paid to insurance brokerBENEFIT ADVISOR FEES
Insurance broker organization code?3
HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC. (National Association of Insurance Commissioners NAIC id number: 95519 )
Policy contract number737311
Policy instance 1
Insurance contract or identification number737311
Number of Individuals Covered100
Insurance policy start date2017-12-01
Insurance policy end date2018-11-30
Total amount of commissions paid to insurance brokerUSD $41,278
Total amount of fees paid to insurance companyUSD $7,224
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,080,311

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