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ATTITUDE WELLNESS LLC WELFARE BENEFIT PLAN 401k Plan overview

Plan NameATTITUDE WELLNESS LLC WELFARE BENEFIT PLAN
Plan identification number 501

ATTITUDE WELLNESS LLC WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare 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

ATTITUDE WELLNESS LLC has sponsored the creation of one or more 401k plans.

Company Name:ATTITUDE WELLNESS LLC
Employer identification number (EIN):832272670
NAIC Classification:453990

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ATTITUDE WELLNESS LLC WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-05-01JESSICA GARNICK2023-10-09
5012021-05-01JESSICA GARNICK2023-10-09

Plan Statistics for ATTITUDE WELLNESS LLC WELFARE BENEFIT PLAN

401k plan membership statisitcs for ATTITUDE WELLNESS LLC WELFARE BENEFIT PLAN

Measure Date Value
2022: ATTITUDE WELLNESS LLC WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-05-011,028
Total number of active participants reported on line 7a of the Form 55002022-05-01929
Number of retired or separated participants receiving benefits2022-05-010
Number of other retired or separated participants entitled to future benefits2022-05-010
Total of all active and inactive participants2022-05-01929
Number of employers contributing to the scheme2022-05-010
2021: ATTITUDE WELLNESS LLC WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-05-01370
Total number of active participants reported on line 7a of the Form 55002021-05-011,028
Number of retired or separated participants receiving benefits2021-05-010
Number of other retired or separated participants entitled to future benefits2021-05-010
Total of all active and inactive participants2021-05-011,028
Number of employers contributing to the scheme2021-05-010

Form 5500 Responses for ATTITUDE WELLNESS LLC WELFARE BENEFIT PLAN

2022: ATTITUDE WELLNESS LLC WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-05-01Type of plan entitySingle employer plan
2022-05-01Plan funding arrangement – InsuranceYes
2022-05-01Plan funding arrangement – General assets of the sponsorYes
2022-05-01Plan benefit arrangement – InsuranceYes
2022-05-01Plan benefit arrangement – General assets of the sponsorYes
2021: ATTITUDE WELLNESS LLC WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-05-01Type of plan entitySingle employer plan
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan funding arrangement – General assets of the sponsorYes
2021-05-01Plan benefit arrangement – InsuranceYes
2021-05-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number290109
Policy instance 1
Insurance contract or identification number290109
Number of Individuals Covered141
Insurance policy start date2022-05-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $17,134
Total amount of fees paid to insurance companyUSD $3,060
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,726
Amount paid for insurance broker fees3060
Additional information about fees paid to insurance brokerINCENTIVE PAYMENTS
Insurance broker organization code?3
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberEAB2598882
Policy instance 2
Insurance contract or identification numberEAB2598882
Number of Individuals Covered929
Insurance policy start date2022-05-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $16,832
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $338,626
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,832
Amount paid for insurance broker fees0
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number290109
Policy instance 3
Insurance contract or identification number290109
Number of Individuals Covered913
Insurance policy start date2022-05-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $130,130
Total amount of fees paid to insurance companyUSD $21,165
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $124,133
Amount paid for insurance broker fees21165
Additional information about fees paid to insurance brokerINCENTIVE PAYMENTS
Insurance broker organization code?3
BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )
Policy contract number290109
Policy instance 1
Insurance contract or identification number290109
Number of Individuals Covered153
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $11,782
Total amount of fees paid to insurance companyUSD $893
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,272
Amount paid for insurance broker fees893
Additional information about fees paid to insurance brokerINCENTIVE PAYMENTS
Insurance broker organization code?3
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberEAB1000198
Policy instance 2
Insurance contract or identification numberEAB1000198
Number of Individuals Covered1028
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $18,413
Total amount of fees paid to insurance companyUSD $11,136
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $417,770
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,413
Amount paid for insurance broker fees11136
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )
Policy contract number290109
Policy instance 3
Insurance contract or identification number290109
Number of Individuals Covered981
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $96,849
Total amount of fees paid to insurance companyUSD $3,574
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $73,390
Amount paid for insurance broker fees3574
Additional information about fees paid to insurance brokerINCENTIVE PAYMENTS
Insurance broker organization code?3

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