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AMPLIFYBIO LIFE AND DISABILITY BENEFIT PLAN 401k Plan overview

Plan NameAMPLIFYBIO LIFE AND DISABILITY BENEFIT PLAN
Plan identification number 502

AMPLIFYBIO LIFE AND DISABILITY BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

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

Company Name:AMPLIFYBIO
Employer identification number (EIN):862301671
NAIC Classification:339900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AMPLIFYBIO LIFE AND DISABILITY BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-05-01JEVE WILLIS2023-10-11
5022021-05-01JEVE WILLIS2023-01-30

Plan Statistics for AMPLIFYBIO LIFE AND DISABILITY BENEFIT PLAN

401k plan membership statisitcs for AMPLIFYBIO LIFE AND DISABILITY BENEFIT PLAN

Measure Date Value
2022: AMPLIFYBIO LIFE AND DISABILITY BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-05-01216
Total number of active participants reported on line 7a of the Form 55002022-05-01272
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 participants2022-05-01272
Number of employers contributing to the scheme2022-05-010
2021: AMPLIFYBIO LIFE AND DISABILITY BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-05-01147
Total number of active participants reported on line 7a of the Form 55002021-05-01216
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 participants2021-05-01216
Number of employers contributing to the scheme2021-05-010

Form 5500 Responses for AMPLIFYBIO LIFE AND DISABILITY BENEFIT PLAN

2022: AMPLIFYBIO LIFE AND DISABILITY BENEFIT PLAN 2022 form 5500 responses
2022-05-01Type of plan entitySingle employer plan
2022-05-01This return/report is a short plan year return/report (less than 12 months)Yes
2022-05-01Plan funding arrangement – InsuranceYes
2022-05-01Plan benefit arrangement – InsuranceYes
2021: AMPLIFYBIO LIFE AND DISABILITY BENEFIT PLAN 2021 form 5500 responses
2021-05-01Type of plan entitySingle employer plan
2021-05-01First time form 5500 has been submittedYes
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5977754
Policy instance 1
Insurance contract or identification number5977754
Number of Individuals Covered272
Insurance policy start date2022-05-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $14,391
Total amount of fees paid to insurance companyUSD $1,199
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 $88,803
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,391
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5977754
Policy instance 1
Insurance contract or identification number5977754
Number of Individuals Covered216
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $14,764
Total amount of fees paid to insurance companyUSD $3,086
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 $120,268
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,532
Amount paid for insurance broker fees71
Additional information about fees paid to insurance brokerNON-MONETARY COMPENSATION
Insurance broker organization code?3

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