401k Plan data: APERIO GROUP LLC HEALTH & WELFARE BENEFIT PLAN plan

APERIO GROUP LLC HEALTH & WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	APERIO GROUP LLC HEALTH & WELFARE BENEFIT PLAN
Plan identification number	501

APERIO GROUP LLC HEALTH & WELFARE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

APERIO GROUP LLC has sponsored the creation of one or more 401k plans.

Company Name: APERIO GROUP LLC

Employer identification number (EIN): 680436509

NAIC Classification: 523900

Additional information about APERIO GROUP LLC

Jurisdiction of Incorporation: California Department of State

Incorporation Date:

Company Identification Number: 199922610014

More information about APERIO GROUP LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan APERIO GROUP LLC HEALTH & WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2019-12-01 NANCY MALIK 2021-06-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2019-12-01	NANCY MALIK	2021-06-01

Plan Statistics for APERIO GROUP LLC HEALTH & WELFARE BENEFIT PLAN

401k plan membership statisitcs for APERIO GROUP LLC HEALTH & WELFARE BENEFIT PLAN

Measure Date Value
2019: APERIO GROUP LLC HEALTH & WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-12-01 100
Total number of active participants reported on line 7a of the Form 5500 2019-12-01 109
Number of retired or separated participants receiving benefits 2019-12-01 0
Number of other retired or separated participants entitled to future benefits 2019-12-01 0
Total of all active and inactive participants 2019-12-01 109
Number of employers contributing to the scheme 2019-12-01 0

Measure	Date	Value
2019: APERIO GROUP LLC HEALTH & WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-12-01	100
Total number of active participants reported on line 7a of the Form 5500	2019-12-01	109
Number of retired or separated participants receiving benefits	2019-12-01	0
Number of other retired or separated participants entitled to future benefits	2019-12-01	0
Total of all active and inactive participants	2019-12-01	109
Number of employers contributing to the scheme	2019-12-01	0

Form 5500 Responses for APERIO GROUP LLC HEALTH & WELFARE BENEFIT PLAN

2019: APERIO GROUP LLC HEALTH & WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-12-01	Type of plan entity	Single employer plan
2019-12-01	First time form 5500 has been submitted	Yes
2019-12-01	Plan funding arrangement – Insurance	Yes
2019-12-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-12-01	Plan benefit arrangement – Insurance	Yes
2019-12-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 )

Policy contract number

653411

Policy instance

Insurance contract or identification number	653411
Number of Individuals Covered	38
Insurance policy start date	2019-12-01
Insurance policy end date	2020-11-30
Total amount of commissions paid to insurance broker	USD $7,808
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $208,707
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,808
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

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

Policy contract number

919733

Policy instance

Insurance contract or identification number	919733
Number of Individuals Covered	76
Insurance policy start date	2019-12-01
Insurance policy end date	2020-11-30
Total amount of commissions paid to insurance broker	USD $40,471
Total amount of fees paid to insurance company	USD $1,649
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $759,464
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $40,471
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	BONUS

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

466548

Policy instance

Insurance contract or identification number	466548
Number of Individuals Covered	109
Insurance policy start date	2019-12-01
Insurance policy end date	2020-11-30
Total amount of commissions paid to insurance broker	USD $14,101
Total amount of fees paid to insurance company	USD $4,870
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to Carrier	USD $149,343
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,105
Amount paid for insurance broker fees	4870
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3

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Company Name:	APERIO GROUP LLC
Employer identification number (EIN):	680436509
NAIC Classification:	523900

Jurisdiction of Incorporation:	California Department of State
Incorporation Date:
Company Identification Number:	199922610014