401k Plan data: CELULARITY, INC. WWELFARE BENEFITS PLAN plan

CELULARITY, INC. WWELFARE BENEFITS PLAN 401k Plan overview

Plan Name	CELULARITY, INC. WWELFARE BENEFITS PLAN
Plan identification number	501

CELULARITY, INC. WWELFARE 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) Long-term disability cover Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

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

Company Name: CELULARITY INC.

Employer identification number (EIN): 813931841

NAIC Classification: 541700

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CELULARITY, INC. WWELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2020-01-01 JOHN TESTA 2021-10-04

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2020-01-01	JOHN TESTA	2021-10-04

Plan Statistics for CELULARITY, INC. WWELFARE BENEFITS PLAN

401k plan membership statisitcs for CELULARITY, INC. WWELFARE BENEFITS PLAN

Measure Date Value
2020: CELULARITY, INC. WWELFARE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 160
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 164
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 164
Number of employers contributing to the scheme 2020-01-01 0

Measure	Date	Value
2020: CELULARITY, INC. WWELFARE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	160
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	164
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	164
Number of employers contributing to the scheme	2020-01-01	0

Form 5500 Responses for CELULARITY, INC. WWELFARE BENEFITS PLAN

2020: CELULARITY, INC. WWELFARE BENEFITS PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	First time form 5500 has been submitted	Yes
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

618433

Policy instance

Insurance contract or identification number	618433
Number of Individuals Covered	138
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $14,407
Total amount of fees paid to insurance company	USD $6,737
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $191,196
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,407
Amount paid for insurance broker fees	95
Additional information about fees paid to insurance broker	GENERAL AGENT PAYMENTS
Insurance broker organization code?	3

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

Policy contract number

SGM609886

Policy instance

Insurance contract or identification number	SGM609886
Number of Individuals Covered	164
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $12,712
Total amount of fees paid to insurance company	USD $9,292
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
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	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $129,927
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $12,712
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	SALES & SERVICE OVERRIDE

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Company Name:	CELULARITY INC.
Employer identification number (EIN):	813931841
NAIC Classification:	541700