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GALISO, INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN 401k Plan overview

Plan NameGALISO, INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN
Plan identification number 587

GALISO, INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN Benefits

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

401k Sponsoring company profile

GALISO INCORPORATED has sponsored the creation of one or more 401k plans.

Company Name:GALISO INCORPORATED
Employer identification number (EIN):841202690
NAIC Classification:333900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GALISO, INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5872022-03-01
5872021-03-01
5872020-03-01
5872019-03-01

Plan Statistics for GALISO, INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN

401k plan membership statisitcs for GALISO, INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN

Measure Date Value
2022: GALISO, INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2022 401k membership
Total participants, beginning-of-year2022-03-0116
Total number of active participants reported on line 7a of the Form 55002022-03-0115
Total of all active and inactive participants2022-03-0115
Total participants2022-03-0115
2021: GALISO, INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2021 401k membership
Total participants, beginning-of-year2021-03-0117
Total number of active participants reported on line 7a of the Form 55002021-03-0115
Total of all active and inactive participants2021-03-0115
Total participants2021-03-0115
2020: GALISO, INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2020 401k membership
Total participants, beginning-of-year2020-03-0118
Total number of active participants reported on line 7a of the Form 55002020-03-0117
Total of all active and inactive participants2020-03-0117
Total participants2020-03-0117
2019: GALISO, INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2019 401k membership
Total participants, beginning-of-year2019-03-0120
Total number of active participants reported on line 7a of the Form 55002019-03-0119
Number of retired or separated participants receiving benefits2019-03-010
Number of other retired or separated participants entitled to future benefits2019-03-010
Total of all active and inactive participants2019-03-0119
Total participants2019-03-0119

Financial Data on GALISO, INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN

Measure Date Value
2023 : GALISO, INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2023 401k financial data
Transfers to/from the plan2023-02-28$0
Total plan liabilities at end of year2023-02-28$0
Total plan liabilities at beginning of year2023-02-28$0
Total income from all sources2023-02-28$157,343
Expenses. Total of all expenses incurred2023-02-28$157,343
Benefits paid (including direct rollovers)2023-02-28$145,666
Total plan assets at end of year2023-02-28$0
Total plan assets at beginning of year2023-02-28$0
Value of fidelity bond covering the plan2023-02-28$250,000
Total contributions received or receivable from participants2023-02-28$42,090
Net income (gross income less expenses)2023-02-28$0
Net plan assets at end of year (total assets less liabilities)2023-02-28$0
Net plan assets at beginning of year (total assets less liabilities)2023-02-28$0
Total contributions received or receivable from employer(s)2023-02-28$115,253
Expenses. Administrative service providers (salaries,fees and commissions)2023-02-28$11,677
2022 : GALISO, INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2022 401k financial data
Total plan liabilities at end of year2022-02-28$0
Total plan liabilities at beginning of year2022-02-28$0
Total income from all sources2022-02-28$160,231
Expenses. Total of all expenses incurred2022-02-28$160,231
Benefits paid (including direct rollovers)2022-02-28$147,574
Total plan assets at end of year2022-02-28$0
Total plan assets at beginning of year2022-02-28$0
Value of fidelity bond covering the plan2022-02-28$250,000
Total contributions received or receivable from participants2022-02-28$51,970
Net income (gross income less expenses)2022-02-28$0
Net plan assets at end of year (total assets less liabilities)2022-02-28$0
Net plan assets at beginning of year (total assets less liabilities)2022-02-28$0
Total contributions received or receivable from employer(s)2022-02-28$108,261
Expenses. Administrative service providers (salaries,fees and commissions)2022-02-28$12,657
2021 : GALISO, INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2021 401k financial data
Transfers to/from the plan2021-02-28$0
Total income from all sources2021-02-28$181,475
Expenses. Total of all expenses incurred2021-02-28$181,475
Benefits paid (including direct rollovers)2021-02-28$168,361
Value of fidelity bond covering the plan2021-02-28$250,000
Total contributions received or receivable from participants2021-02-28$50,700
Net income (gross income less expenses)2021-02-28$0
Total contributions received or receivable from employer(s)2021-02-28$130,775
Expenses. Administrative service providers (salaries,fees and commissions)2021-02-28$13,114
2020 : GALISO, INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2020 401k financial data
Transfers to/from the plan2020-02-29$-9,515
Total plan liabilities at end of year2020-02-29$0
Total plan liabilities at beginning of year2020-02-29$0
Total income from all sources2020-02-29$197,068
Expenses. Total of all expenses incurred2020-02-29$187,553
Benefits paid (including direct rollovers)2020-02-29$167,777
Total plan assets at end of year2020-02-29$0
Total plan assets at beginning of year2020-02-29$0
Value of fidelity bond covering the plan2020-02-29$250,000
Total contributions received or receivable from participants2020-02-29$51,194
Other income received2020-02-29$0
Net income (gross income less expenses)2020-02-29$9,515
Net plan assets at end of year (total assets less liabilities)2020-02-29$0
Net plan assets at beginning of year (total assets less liabilities)2020-02-29$0
Total contributions received or receivable from employer(s)2020-02-29$145,874
Expenses. Administrative service providers (salaries,fees and commissions)2020-02-29$19,776

Form 5500 Responses for GALISO, INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN

2022: GALISO, INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2022 form 5500 responses
2022-03-01Type of plan entitySingle employer plan
2022-03-01Submission has been amendedNo
2022-03-01This submission is the final filingNo
2022-03-01This return/report is a short plan year return/report (less than 12 months)No
2022-03-01Plan is a collectively bargained planNo
2022-03-01Plan funding arrangement – InsuranceYes
2022-03-01Plan benefit arrangement – InsuranceYes
2021: GALISO, INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2021 form 5500 responses
2021-03-01Type of plan entitySingle employer plan
2021-03-01Submission has been amendedNo
2021-03-01This submission is the final filingNo
2021-03-01This return/report is a short plan year return/report (less than 12 months)No
2021-03-01Plan is a collectively bargained planNo
2021-03-01Plan funding arrangement – InsuranceYes
2021-03-01Plan benefit arrangement – InsuranceYes
2020: GALISO, INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2020 form 5500 responses
2020-03-01Type of plan entitySingle employer plan
2020-03-01Submission has been amendedNo
2020-03-01This submission is the final filingNo
2020-03-01This return/report is a short plan year return/report (less than 12 months)No
2020-03-01Plan is a collectively bargained planNo
2020-03-01Plan funding arrangement – InsuranceYes
2020-03-01Plan benefit arrangement – InsuranceYes
2019: GALISO, INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2019 form 5500 responses
2019-03-01Type of plan entitySingle employer plan
2019-03-01First time form 5500 has been submittedYes
2019-03-01Submission has been amendedNo
2019-03-01This submission is the final filingNo
2019-03-01This return/report is a short plan year return/report (less than 12 months)No
2019-03-01Plan is a collectively bargained planNo
2019-03-01Plan funding arrangement – InsuranceYes
2019-03-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00625587
Policy instance 1
Insurance contract or identification number00625587
Number of Individuals Covered15
Insurance policy start date2022-03-01
Insurance policy end date2023-02-28
Total amount of commissions paid to insurance brokerUSD $5,730
Total amount of fees paid to insurance companyUSD $5,947
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 BenefitYes
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
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $98,317
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,730
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00625587
Policy instance 1
Insurance contract or identification number00625587
Number of Individuals Covered15
Insurance policy start date2021-03-01
Insurance policy end date2022-02-28
Total amount of commissions paid to insurance brokerUSD $5,970
Total amount of fees paid to insurance companyUSD $6,687
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 BenefitYes
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
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $110,559
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,970
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00625587
Policy instance 1
Insurance contract or identification number00625587
Number of Individuals Covered17
Insurance policy start date2020-03-01
Insurance policy end date2021-02-28
Total amount of commissions paid to insurance brokerUSD $6,330
Total amount of fees paid to insurance companyUSD $6,784
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 BenefitYes
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
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $101,815
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,330
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number00625587
Policy instance 1
Insurance contract or identification number00625587
Number of Individuals Covered19
Insurance policy start date2019-03-01
Insurance policy end date2020-02-29
Total amount of commissions paid to insurance brokerUSD $7,170
Total amount of fees paid to insurance companyUSD $12,606
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 BenefitYes
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
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $97,792
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,170
Insurance broker organization code?3

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