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| Plan Name | OMNI INVICTUS DBA ARRAY |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | OMNI INVICTUS DBA ARRAY |
| Employer identification number (EIN): | 850748969 |
| NAIC Classification: | 561410 |
| NAIC Description: | Document Preparation Services |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2023-05-01 | ||||
| 501 | 2023-05-01 | KIMBERLY WAYNE | |||
| 501 | 2022-05-01 | ||||
| 501 | 2022-05-01 | LYNELL TUTOR | |||
| 501 | 2021-05-01 | ||||
| 501 | 2021-05-01 | LYNELL TUTOR |
| 2023: OMNI INVICTUS DBA ARRAY 2023 form 5500 responses | ||
|---|---|---|
| 2023-05-01 | Type of plan entity | Single employer plan |
| 2023-05-01 | Submission has been amended | No |
| 2023-05-01 | This submission is the final filing | No |
| 2023-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2023-05-01 | Plan is a collectively bargained plan | No |
| 2023-05-01 | Plan funding arrangement – Insurance | Yes |
| 2023-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2023-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2023-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2022: OMNI INVICTUS DBA ARRAY 2022 form 5500 responses | ||
| 2022-05-01 | Type of plan entity | Single employer plan |
| 2022-05-01 | Submission has been amended | No |
| 2022-05-01 | This submission is the final filing | No |
| 2022-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-05-01 | Plan is a collectively bargained plan | No |
| 2022-05-01 | Plan funding arrangement – Insurance | Yes |
| 2022-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: OMNI INVICTUS DBA ARRAY 2021 form 5500 responses | ||
| 2021-05-01 | Type of plan entity | Single employer plan |
| 2021-05-01 | Submission has been amended | No |
| 2021-05-01 | This submission is the final filing | No |
| 2021-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-05-01 | Plan is a collectively bargained plan | No |
| 2021-05-01 | Plan funding arrangement – Insurance | Yes |
| 2021-05-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-05-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 921340 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
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| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | G000C4HG | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
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| BIND MEDICAL (National Association of Insurance Commissioners NAIC id number: 52429 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 78700171 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
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| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 921340 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | G000C4HG | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 921340 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 248068 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
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