401k Plan data: CONSULTING SOLUTIONS GROUP VISION & DISABILITY PLAN plan

CONSULTING SOLUTIONS GROUP VISION & DISABILITY PLAN 401k Plan overview

Plan Name	CONSULTING SOLUTIONS GROUP VISION & DISABILITY PLAN
Plan identification number	504

CONSULTING SOLUTIONS GROUP VISION & DISABILITY PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Vision Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

CSI IT, LLC has sponsored the creation of one or more 401k plans.

Company Name: CSI IT, LLC

Employer identification number (EIN): 812264132

NAIC Classification: 541600

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CONSULTING SOLUTIONS GROUP VISION & DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
504 2019-01-01 KRISTEN KITE 2020-07-14

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
504	2019-01-01	KRISTEN KITE	2020-07-14

Plan Statistics for CONSULTING SOLUTIONS GROUP VISION & DISABILITY PLAN

401k plan membership statisitcs for CONSULTING SOLUTIONS GROUP VISION & DISABILITY PLAN

Measure Date Value
2019: CONSULTING SOLUTIONS GROUP VISION & DISABILITY PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 155
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 0
Total of all active and inactive participants 2019-01-01 0

Measure	Date	Value
2019: CONSULTING SOLUTIONS GROUP VISION & DISABILITY PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	155
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	0
Total of all active and inactive participants	2019-01-01	0

Form 5500 Responses for CONSULTING SOLUTIONS GROUP VISION & DISABILITY PLAN

2019: CONSULTING SOLUTIONS GROUP VISION & DISABILITY PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	First time form 5500 has been submitted	Yes
2019-01-01	This submission is the final filing	Yes
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

GL 652326

Policy instance

Insurance contract or identification number	GL 652326
Number of Individuals Covered	159
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $1,854
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $12,363
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,854
Insurance broker organization code?	3

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

VG 658950

Policy instance

Insurance contract or identification number	VG 658950
Number of Individuals Covered	7
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $36
Other welfare benefits provided	VOLUNTARY LIFE
Welfare Benefit Premiums Paid to Carrier	USD $242
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $36
Insurance broker organization code?	3

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

G 656426

Policy instance

Insurance contract or identification number	G 656426
Number of Individuals Covered	160
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $3,924
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $26,163
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,924
Insurance broker organization code?	3

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

LTD 654335

Policy instance

Insurance contract or identification number	LTD 654335
Number of Individuals Covered	160
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $7,166
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $47,771
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,166
Insurance broker organization code?	3

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )

Policy contract number

136-413704

Policy instance

Insurance contract or identification number	136-413704
Number of Individuals Covered	510
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $2,171
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $30,594
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,171
Insurance broker organization code?	3

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Company Name:	CSI IT, LLC
Employer identification number (EIN):	812264132
NAIC Classification:	541600