401k Plan data: SAI GLOBAL HEALTH INSURANCE PLAN plan

SAI GLOBAL HEALTH INSURANCE PLAN 401k Plan overview

Plan Name	SAI GLOBAL HEALTH INSURANCE PLAN
Plan identification number	501

SAI GLOBAL HEALTH INSURANCE 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

SAI GLOBAL COMPLIANCE, INC. has sponsored the creation of one or more 401k plans.

Company Name: SAI GLOBAL COMPLIANCE, INC.

Employer identification number (EIN): 731688805

NAIC Classification: 541600

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SAI GLOBAL HEALTH INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2017-07-01 KERI GREENBLATT

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2017-07-01	KERI GREENBLATT

Plan Statistics for SAI GLOBAL HEALTH INSURANCE PLAN

401k plan membership statisitcs for SAI GLOBAL HEALTH INSURANCE PLAN

Measure Date Value
2017: SAI GLOBAL HEALTH INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year 2017-07-01 364
Total number of active participants reported on line 7a of the Form 5500 2017-07-01 391
Total of all active and inactive participants 2017-07-01 391

Measure	Date	Value
2017: SAI GLOBAL HEALTH INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year	2017-07-01	364
Total number of active participants reported on line 7a of the Form 5500	2017-07-01	391
Total of all active and inactive participants	2017-07-01	391

Form 5500 Responses for SAI GLOBAL HEALTH INSURANCE PLAN

2017: SAI GLOBAL HEALTH INSURANCE PLAN 2017 form 5500 responses
2017-07-01	Type of plan entity	Single employer plan
2017-07-01	Submission has been amended	No
2017-07-01	This submission is the final filing	No
2017-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-07-01	Plan is a collectively bargained plan	No
2017-07-01	Plan funding arrangement – Insurance	Yes
2017-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-07-01	Plan benefit arrangement – Insurance	Yes
2017-07-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX966090

Policy instance

Insurance contract or identification number	FLX966090
Number of Individuals Covered	391
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $9,793
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	SUPP LIFE & DEPENDENT LIFE
Welfare Benefit Premiums Paid to Carrier	USD $101,648
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

10118661001

Policy instance

Insurance contract or identification number	10118661001
Number of Individuals Covered	555
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $2,680
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $29,676
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

OK967641

Policy instance

Insurance contract or identification number	OK967641
Number of Individuals Covered	391
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $1,223
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $12,232
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

LK751596

Policy instance

Insurance contract or identification number	LK751596
Number of Individuals Covered	391
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $3,872
Total amount of fees paid to insurance company	USD $0
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $92,234
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

LK964181

Policy instance

Insurance contract or identification number	LK964181
Number of Individuals Covered	391
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $4,565
Total amount of fees paid to insurance company	USD $0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $56,529
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	SAI GLOBAL COMPLIANCE, INC.
Employer identification number (EIN):	731688805
NAIC Classification:	541600