401k Plan data: EARLY LEARNING INDIANA, INC

EARLY LEARNING INDIANA, INC - MEDICAL PLAN 401k Plan overview

Plan Name	EARLY LEARNING INDIANA, INC - MEDICAL PLAN
Plan identification number	506

EARLY LEARNING INDIANA, INC - MEDICAL PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision)

401k Sponsoring company profile

EARLY LEARNING INDIANA, INC has sponsored the creation of one or more 401k plans.

Company Name: EARLY LEARNING INDIANA, INC

Employer identification number (EIN): 350888763

NAIC Classification: 624410
NAIC Description: Child Day Care Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EARLY LEARNING INDIANA, INC - MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
506 2017-01-01 JULIE GOLDSBERRY JULIE GOLDSBERRY 2018-05-04
506 2016-01-01 JULIE GOLDSBERRY JULIE GOLDSBERRY 2017-06-14
506 2015-01-01 JULIE GOLDSBERRY JULIE GOLDSBERRY 2018-02-20
506 2014-01-01 ERIN SLACK ERIN SLACK 2015-06-30

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
506	2017-01-01	JULIE GOLDSBERRY	JULIE GOLDSBERRY	2018-05-04
506	2016-01-01	JULIE GOLDSBERRY	JULIE GOLDSBERRY	2017-06-14
506	2015-01-01	JULIE GOLDSBERRY	JULIE GOLDSBERRY	2018-02-20
506	2014-01-01	ERIN SLACK	ERIN SLACK	2015-06-30

Plan Statistics for EARLY LEARNING INDIANA, INC - MEDICAL PLAN

401k plan membership statisitcs for EARLY LEARNING INDIANA, INC - MEDICAL PLAN

Measure Date Value
2017: EARLY LEARNING INDIANA, INC - MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 225
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
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 0
2016: EARLY LEARNING INDIANA, INC - MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 174
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 225
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 2016-01-01 225
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 225
2015: EARLY LEARNING INDIANA, INC - MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 159
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 174
Total of all active and inactive participants 2015-01-01 174
Total participants 2015-01-01 174
2014: EARLY LEARNING INDIANA, INC - MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 122
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 124
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 124
Total participants 2014-01-01 124

Measure	Date	Value
2017: EARLY LEARNING INDIANA, INC - MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	225
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
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	0
2016: EARLY LEARNING INDIANA, INC - MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	174
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	225
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	225
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	225
2015: EARLY LEARNING INDIANA, INC - MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	159
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	174
Total of all active and inactive participants	2015-01-01	174
Total participants	2015-01-01	174
2014: EARLY LEARNING INDIANA, INC - MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	122
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	124
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	124
Total participants	2014-01-01	124

Form 5500 Responses for EARLY LEARNING INDIANA, INC - MEDICAL PLAN

2017: EARLY LEARNING INDIANA, INC - MEDICAL 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: EARLY LEARNING INDIANA, INC - MEDICAL 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
2015: EARLY LEARNING INDIANA, INC - MEDICAL PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: EARLY LEARNING INDIANA, INC - MEDICAL PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	First time form 5500 has been submitted	Yes
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

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

Policy contract number

909387

Policy instance

Insurance contract or identification number	909387
Number of Individuals Covered	337
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $9,001
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	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
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 $1,111,249
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,001
Amount paid for insurance broker fees	2716
Additional information about fees paid to insurance broker	BONUS
Insurance broker organization code?	3
Insurance broker name	FIRST PERSON INC

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Company Name:	EARLY LEARNING INDIANA, INC
Employer identification number (EIN):	350888763
NAIC Classification:	624410
NAIC Description:	Child Day Care Services