401k Plan data: CCFI COMPANIES, LLC WELFARE BENEFIT PLAN plan

CCFI COMPANIES, LLC WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	CCFI COMPANIES, LLC WELFARE BENEFIT PLAN
Plan identification number	501

CCFI COMPANIES, LLC 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 Other welfare benefit cover

401k Sponsoring company profile

CCFI COMPANIES, LLC has sponsored the creation of one or more 401k plans.

Company Name: CCFI COMPANIES, LLC

Employer identification number (EIN): 872161861

NAIC Classification: 812990
NAIC Description: All Other Personal Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CCFI COMPANIES, LLC WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-01-01 LEE CODY 2023-07-13

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2022-01-01	LEE CODY	2023-07-13

Plan Statistics for CCFI COMPANIES, LLC WELFARE BENEFIT PLAN

401k plan membership statisitcs for CCFI COMPANIES, LLC WELFARE BENEFIT PLAN

Measure Date Value
2022: CCFI COMPANIES, LLC WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 1,627
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 2,413
Number of retired or separated participants receiving benefits 2022-01-01 10
Total of all active and inactive participants 2022-01-01 2,423

Measure	Date	Value
2022: CCFI COMPANIES, LLC WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	1,627
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	2,413
Number of retired or separated participants receiving benefits	2022-01-01	10
Total of all active and inactive participants	2022-01-01	2,423

Form 5500 Responses for CCFI COMPANIES, LLC WELFARE BENEFIT PLAN

2022: CCFI COMPANIES, LLC WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )

Policy contract number

155853

Policy instance

Insurance contract or identification number	155853
Number of Individuals Covered	1158
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Other welfare benefits provided	TELEMEDICINE
Welfare Benefit Premiums Paid to Carrier	USD $1,277,193
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

DELTA DENTAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 54402 )

Policy contract number

226

Policy instance

Insurance contract or identification number	226
Number of Individuals Covered	2068
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $7,315
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $7,315
Insurance broker organization code?	3

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 62146 )

Policy contract number

98024061001

Policy instance

Insurance contract or identification number	98024061001
Number of Individuals Covered	1943
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $14,501
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $140,085
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,501
Insurance broker organization code?	3

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

305871

Policy instance

Insurance contract or identification number	305871
Number of Individuals Covered	2413
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $75,565
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACC, CI, VOL LIFE
Welfare Benefit Premiums Paid to Carrier	USD $2,570,548
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $75,565
Insurance broker organization code?	3

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Company Name:	CCFI COMPANIES, LLC
Employer identification number (EIN):	872161861
NAIC Classification:	812990
NAIC Description:	All Other Personal Services