401k Plan data: PERFORMANCE MATTERS LLC EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN plan

PERFORMANCE MATTERS LLC EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	PERFORMANCE MATTERS LLC EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN
Plan identification number	501

PERFORMANCE MATTERS LLC EMPLOYEE HEALTH AND WELFARE BENEFIT 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

IASSESSMENT, LLC DBA TRUENORTHLOGIC has sponsored the creation of one or more 401k plans.

Company Name: IASSESSMENT, LLC DBA TRUENORTHLOGIC

Employer identification number (EIN): 870647151

NAIC Classification: 541511
NAIC Description: Custom Computer Programming Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PERFORMANCE MATTERS LLC EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2017-01-01

Plan Statistics for PERFORMANCE MATTERS LLC EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN

401k plan membership statisitcs for PERFORMANCE MATTERS LLC EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN

Measure Date Value
2017: PERFORMANCE MATTERS LLC EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 141
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 145
Number of retired or separated participants receiving benefits 2017-01-01 10
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 155

Measure	Date	Value
2017: PERFORMANCE MATTERS LLC EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	141
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	145
Number of retired or separated participants receiving benefits	2017-01-01	10
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	155

Form 5500 Responses for PERFORMANCE MATTERS LLC EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN

2017: PERFORMANCE MATTERS LLC EMPLOYEE HEALTH AND WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	First time form 5500 has been submitted	Yes
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	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

613615

Policy instance

Insurance contract or identification number	613615
Number of Individuals Covered	163
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $10,886
Total amount of fees paid to insurance company	USD $49,150
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,051,009
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,886
Amount paid for insurance broker fees	49150
Additional information about fees paid to insurance broker	BENEFIT ADVISOR FEES AND INCENTIVE COMPENSATION PAYMENTS
Insurance broker organization code?	3
Insurance broker name	LOVITT AND TOUCHE INC

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

10007401001

Policy instance

Insurance contract or identification number	10007401001
Number of Individuals Covered	243
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $1,588
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Welfare Benefit Premiums Paid to Carrier	USD $13,324
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,323
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	JOHNSON RESOURCES

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGD606710

Policy instance

Insurance contract or identification number	SGD606710
Number of Individuals Covered	145
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $7,856
Total amount of fees paid to insurance company	USD $1,204
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT,EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to Carrier	USD $78,560
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $7,856
Amount paid for insurance broker fees	1204
Additional information about fees paid to insurance broker	OVERRIDE
Insurance broker organization code?	3
Insurance broker name	LOVITT AND TOUCHE INC

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Company Name:	IASSESSMENT, LLC DBA TRUENORTHLOGIC
Employer identification number (EIN):	870647151
NAIC Classification:	541511
NAIC Description:	Custom Computer Programming Services