401k Plan data: GROUP SHORT TERM DISABILITY PLAN plan

GROUP SHORT TERM DISABILITY PLAN 401k Plan overview

Plan Name	GROUP SHORT TERM DISABILITY PLAN
Plan identification number	506

GROUP SHORT TERM DISABILITY PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Temporary disability (accident and sickness)

401k Sponsoring company profile

NTT SECURITY US INC. has sponsored the creation of one or more 401k plans.

Company Name: NTT SECURITY US INC.

Employer identification number (EIN): 061357425

NAIC Classification: 541512
NAIC Description: Computer Systems Design Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP SHORT TERM DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
506 2017-01-01 SARAH KOCA SARAH KOCA 2018-10-10
506 2016-01-01 SARAH KOCA

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
506	2017-01-01	SARAH KOCA		SARAH KOCA	2018-10-10
506	2016-01-01	SARAH KOCA

Plan Statistics for GROUP SHORT TERM DISABILITY PLAN

401k plan membership statisitcs for GROUP SHORT TERM DISABILITY PLAN

Measure Date Value
2017: GROUP SHORT TERM DISABILITY PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 295
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 0
Number of retired or separated participants receiving benefits 2017-01-01 0
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 0
2016: GROUP SHORT TERM DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 323
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 295
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 295

Measure	Date	Value
2017: GROUP SHORT TERM DISABILITY PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	295
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	0
Number of retired or separated participants receiving benefits	2017-01-01	0
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	0
2016: GROUP SHORT TERM DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	323
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	295
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	295

Form 5500 Responses for GROUP SHORT TERM DISABILITY PLAN

2017: GROUP SHORT TERM DISABILITY PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	Yes
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: GROUP SHORT TERM DISABILITY PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )

Policy contract number

220345

Policy instance

Insurance contract or identification number	220345
Number of Individuals Covered	280
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $2,969
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $49,825
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,185
Insurance broker organization code?	3
Insurance broker name	AON RISK SERVICES CENTRAL INC.

Potentially related plans

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Company Name:	NTT SECURITY US INC.
Employer identification number (EIN):	061357425
NAIC Classification:	541512
NAIC Description:	Computer Systems Design Services