401k Plan data: CRISTO REY JESUIT HIGH SCHOOL LIFE AND DISABILITY PLAN plan

CRISTO REY JESUIT HIGH SCHOOL LIFE AND DISABILITY PLAN 401k Plan overview

Plan Name	CRISTO REY JESUIT HIGH SCHOOL LIFE AND DISABILITY PLAN
Plan identification number	501

CRISTO REY JESUIT HIGH SCHOOL LIFE AND DISABILITY PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Dental Temporary disability (accident and sickness) Long-term disability cover Other welfare benefit cover

401k Sponsoring company profile

CRISTO REY JESUIT HIGH SCHOOL has sponsored the creation of one or more 401k plans.

Company Name: CRISTO REY JESUIT HIGH SCHOOL

Employer identification number (EIN): 364067306

NAIC Classification: 611000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CRISTO REY JESUIT HIGH SCHOOL LIFE AND DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-01-01 MAGGIE MARTENSEN 2024-07-12

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2023-01-01	MAGGIE MARTENSEN	2024-07-12

Plan Statistics for CRISTO REY JESUIT HIGH SCHOOL LIFE AND DISABILITY PLAN

401k plan membership statisitcs for CRISTO REY JESUIT HIGH SCHOOL LIFE AND DISABILITY PLAN

Measure Date Value
2023: CRISTO REY JESUIT HIGH SCHOOL LIFE AND DISABILITY PLAN 2023 401k membership
Total participants, beginning-of-year 2023-01-01 126
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 125
Number of retired or separated participants receiving benefits 2023-01-01 5
Number of other retired or separated participants entitled to future benefits 2023-01-01 0
Total of all active and inactive participants 2023-01-01 130

Measure	Date	Value
2023: CRISTO REY JESUIT HIGH SCHOOL LIFE AND DISABILITY PLAN 2023 401k membership
Total participants, beginning-of-year	2023-01-01	126
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	125
Number of retired or separated participants receiving benefits	2023-01-01	5
Number of other retired or separated participants entitled to future benefits	2023-01-01	0
Total of all active and inactive participants	2023-01-01	130

Form 5500 Responses for CRISTO REY JESUIT HIGH SCHOOL LIFE AND DISABILITY PLAN

2023: CRISTO REY JESUIT HIGH SCHOOL LIFE AND DISABILITY 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	Submission has been amended	No
2023-01-01	This submission is the final filing	No
2023-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2023-01-01	Plan is a collectively bargained plan	No
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

400887

Policy instance

Insurance contract or identification number	400887
Number of Individuals Covered	125
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $15,494
Total amount of fees paid to insurance company	USD $5,239
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	Yes
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	AD&D,ACCIDENT
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 $153,058
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	CRISTO REY JESUIT HIGH SCHOOL
Employer identification number (EIN):	364067306
NAIC Classification:	611000