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FSA 401k Plan overview

Plan NameFSA
Plan identification number 704

FSA Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

INCLUSA, INC. has sponsored the creation of one or more 401k plans.

Company Name:INCLUSA, INC.
Employer identification number (EIN):813565570
NAIC Classification:624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FSA

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
7042022-01-01
7042021-01-01JASON TAYLOR2022-09-30
7042020-01-01
7042019-01-01
7042018-01-01
7042018-01-01
7042017-01-01

Plan Statistics for FSA

401k plan membership statisitcs for FSA

Measure Date Value
2022: FSA 2022 401k membership
Total participants, beginning-of-year2022-01-01432
Total number of active participants reported on line 7a of the Form 55002022-01-01481
Total of all active and inactive participants2022-01-01481
Total participants2022-01-01481
2021: FSA 2021 401k membership
Total participants, beginning-of-year2021-01-01524
Total number of active participants reported on line 7a of the Form 55002021-01-01524
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01524
Number of employers contributing to the scheme2021-01-010
2020: FSA 2020 401k membership
Total participants, beginning-of-year2020-01-01490
Total number of active participants reported on line 7a of the Form 55002020-01-01524
Total of all active and inactive participants2020-01-01524
Total participants2020-01-01524
2019: FSA 2019 401k membership
Total participants, beginning-of-year2019-01-01551
Total number of active participants reported on line 7a of the Form 55002019-01-01575
Total of all active and inactive participants2019-01-01575
Total participants2019-01-01575
2018: FSA 2018 401k membership
Total participants, beginning-of-year2018-01-01577
Total number of active participants reported on line 7a of the Form 55002018-01-01586
Total of all active and inactive participants2018-01-01586
Total participants2018-01-01586
2017: FSA 2017 401k membership
Total participants, beginning-of-year2017-01-01596
Total number of active participants reported on line 7a of the Form 55002017-01-01635
Total of all active and inactive participants2017-01-01635
Total participants2017-01-01635

Form 5500 Responses for FSA

2022: FSA 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: FSA 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: FSA 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: FSA 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: FSA 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01First time form 5500 has been submittedYes
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: FSA 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedYes
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

DIVERSIFIED BENEFIT SERVICES INC (National Association of Insurance Commissioners NAIC id number: 54161 )
Policy contract numberNA
Policy instance 1
Insurance contract or identification numberNA
Number of Individuals Covered586
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of fees paid to insurance companyUSD $32,558
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedFLEX BENEFITS
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Amount paid for insurance broker fees32558
Insurance broker organization code?0

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