401k Plan data: ALTUS FIRE & LIFE SAFETY HEALTH AND WELFARE PLAN plan

ALTUS FIRE & LIFE SAFETY HEALTH AND WELFARE PLAN 401k Plan overview

Plan Name	ALTUS FIRE & LIFE SAFETY HEALTH AND WELFARE PLAN
Plan identification number	501

ALTUS FIRE & LIFE SAFETY HEALTH AND WELFARE 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) Other welfare benefit cover

401k Sponsoring company profile

NORTH AMERICAN FIRE HOLDINGS, LLC has sponsored the creation of one or more 401k plans.

Company Name: NORTH AMERICAN FIRE HOLDINGS, LLC

Employer identification number (EIN): 863614531

NAIC Classification: 238290
NAIC Description: Other Building Equipment Contractors

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ALTUS FIRE & LIFE SAFETY HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2024-01-01 ROBERT BELL
501 2023-01-01 RONALD L. MCCRUMMEN 2024-07-09

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2024-01-01	ROBERT BELL
501	2023-01-01	RONALD L. MCCRUMMEN	2024-07-09

Form 5500 Responses for ALTUS FIRE & LIFE SAFETY HEALTH AND WELFARE PLAN

2023: ALTUS FIRE & LIFE SAFETY HEALTH AND WELFARE PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	First time form 5500 has been submitted	Yes
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2023-01-01	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

637897

Policy instance

Insurance contract or identification number	637897
Number of Individuals Covered	200
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $87,028
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,263,848
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5398846

Policy instance

Insurance contract or identification number	5398846
Number of Individuals Covered	254
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $9,379
Total amount of fees paid to insurance company	USD $1,269
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $111,476
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

71464

Policy instance

Insurance contract or identification number	71464
Number of Individuals Covered	226
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $16,343
Total amount of fees paid to insurance company	USD $451
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM, ACCIDENT, CRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to Carrier	USD $116,296
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	NORTH AMERICAN FIRE HOLDINGS, LLC
Employer identification number (EIN):	863614531
NAIC Classification:	238290
NAIC Description:	Other Building Equipment Contractors