401k Plan data: PLANSOURCE FINANCIAL SERVICES, INC. HEALTH AND WELFARE BENEFITS PLAN plan

PLANSOURCE FINANCIAL SERVICES, INC. HEALTH AND WELFARE BENEFITS PLAN 401k Plan overview

Plan Name	PLANSOURCE FINANCIAL SERVICES, INC. HEALTH AND WELFARE BENEFITS PLAN
Plan identification number	512

PLANSOURCE FINANCIAL SERVICES, INC. HEALTH AND 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) Prepaid legal Long-term disability cover Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

PLANSOURCE FINANCIAL SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name: PLANSOURCE FINANCIAL SERVICES, INC.

Employer identification number (EIN): 593707284

NAIC Classification: 523900

Additional information about PLANSOURCE FINANCIAL SERVICES, INC.

Jurisdiction of Incorporation: Florida Department of State Division of Corporations

Incorporation Date: 2000-12-07

Company Identification Number: P00000112152

Legal Registered Office Address: 101 S. GARLAND AVE

ORLANDO

32801

More information about PLANSOURCE FINANCIAL SERVICES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PLANSOURCE FINANCIAL SERVICES, INC. HEALTH AND WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
512 2021-11-01 SHARON BRAND 2023-08-09

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
512	2021-11-01	SHARON BRAND	2023-08-09

Plan Statistics for PLANSOURCE FINANCIAL SERVICES, INC. HEALTH AND WELFARE BENEFITS PLAN

401k plan membership statisitcs for PLANSOURCE FINANCIAL SERVICES, INC. HEALTH AND WELFARE BENEFITS PLAN

Measure Date Value
2021: PLANSOURCE FINANCIAL SERVICES, INC. HEALTH AND WELFARE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-11-01 611
Total number of active participants reported on line 7a of the Form 5500 2021-11-01 562
Number of retired or separated participants receiving benefits 2021-11-01 6
Number of other retired or separated participants entitled to future benefits 2021-11-01 0
Total of all active and inactive participants 2021-11-01 568
Number of employers contributing to the scheme 2021-11-01 0

Measure	Date	Value
2021: PLANSOURCE FINANCIAL SERVICES, INC. HEALTH AND WELFARE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-11-01	611
Total number of active participants reported on line 7a of the Form 5500	2021-11-01	562
Number of retired or separated participants receiving benefits	2021-11-01	6
Number of other retired or separated participants entitled to future benefits	2021-11-01	0
Total of all active and inactive participants	2021-11-01	568
Number of employers contributing to the scheme	2021-11-01	0

Form 5500 Responses for PLANSOURCE FINANCIAL SERVICES, INC. HEALTH AND WELFARE BENEFITS PLAN

2021: PLANSOURCE FINANCIAL SERVICES, INC. HEALTH AND WELFARE BENEFITS PLAN 2021 form 5500 responses
2021-11-01	Type of plan entity	Single employer plan
2021-11-01	First time form 5500 has been submitted	Yes
2021-11-01	Plan funding arrangement – Insurance	Yes
2021-11-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-11-01	Plan benefit arrangement – Insurance	Yes
2021-11-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

HYATT LEGAL PLANS OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

9901970

Policy instance

Insurance contract or identification number	9901970
Number of Individuals Covered	151
Insurance policy start date	2021-11-01
Insurance policy end date	2022-10-31
Total amount of commissions paid to insurance broker	USD $2,805
Total amount of fees paid to insurance company	USD $246
Other welfare benefits provided	LEGAL
Welfare Benefit Premiums Paid to Carrier	USD $30,110
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,805
Amount paid for insurance broker fees	242
Additional information about fees paid to insurance broker	NON-MONETARY/SUPPLEMENTAL COMPENSATION
Insurance broker organization code?	3

MY IDEAL DOCTOR (National Association of Insurance Commissioners NAIC id number: 54161 )

Policy contract number

MYIDR1126

Policy instance

Insurance contract or identification number	MYIDR1126
Number of Individuals Covered	5815
Insurance policy start date	2021-11-01
Insurance policy end date	2022-10-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $5,815
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

903572

Policy instance

Insurance contract or identification number	903572
Number of Individuals Covered	906
Insurance policy start date	2021-11-01
Insurance policy end date	2022-10-31
Total amount of commissions paid to insurance broker	USD $4,811
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $39,990
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,811
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

212927

Policy instance

Insurance contract or identification number	212927
Number of Individuals Covered	994
Insurance policy start date	2021-11-01
Insurance policy end date	2022-10-31
Total amount of commissions paid to insurance broker	USD $107,204
Total amount of fees paid to insurance company	USD $21,570
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
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	CRITICAL ILLNESS,ACCIDENT,ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $746,099
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $77,296
Amount paid for insurance broker fees	9327
Additional information about fees paid to insurance broker	NON-MONETARY/SUPPLEMENTAL COMPENSATION, NON-MONETARY/SUPPLEMENTAL COMPENSATION, MARKETING FEES
Insurance broker organization code?	3

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Company Name:	PLANSOURCE FINANCIAL SERVICES, INC.
Employer identification number (EIN):	593707284
NAIC Classification:	523900

Jurisdiction of Incorporation:	Florida Department of State Division of Corporations
Incorporation Date:	2000-12-07
Company Identification Number:	P00000112152
Legal Registered Office Address:	101 S. GARLAND AVE ORLANDO 32801