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VIRTEVA LLC EMPLOYEE WELFARE BENEFIT PLAN 401k Plan overview

Plan NameVIRTEVA LLC EMPLOYEE WELFARE BENEFIT PLAN
Plan identification number 507

VIRTEVA LLC EMPLOYEE WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare 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)

401k Sponsoring company profile

INERGEX, LLC DBA CROSSFUZE has sponsored the creation of one or more 401k plans.

Company Name:INERGEX, LLC DBA CROSSFUZE
Employer identification number (EIN):200479750
NAIC Classification:541519
NAIC Description:Other Computer Related Services

Additional information about INERGEX, LLC DBA CROSSFUZE

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2017-08-17
Company Identification Number: 0802793794
Legal Registered Office Address: 6110 GOLDEN HILLS DR

MINNEAPOLIS
United States of America (USA)
55416

More information about INERGEX, LLC DBA CROSSFUZE

Form 5500 Filing Information

Submission information for form 5500 for 401k plan VIRTEVA LLC EMPLOYEE WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5072019-01-01
5072018-01-01MARTHA KIEFFER MARTHA KIEFFER2019-05-29

Plan Statistics for VIRTEVA LLC EMPLOYEE WELFARE BENEFIT PLAN

401k plan membership statisitcs for VIRTEVA LLC EMPLOYEE WELFARE BENEFIT PLAN

Measure Date Value
2019: VIRTEVA LLC EMPLOYEE WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01124
Total number of active participants reported on line 7a of the Form 55002019-01-010
Total of all active and inactive participants2019-01-010
2018: VIRTEVA LLC EMPLOYEE WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01149
Total number of active participants reported on line 7a of the Form 55002018-01-01122
Number of retired or separated participants receiving benefits2018-01-012
Total of all active and inactive participants2018-01-01124

Form 5500 Responses for VIRTEVA LLC EMPLOYEE WELFARE BENEFIT PLAN

2019: VIRTEVA LLC EMPLOYEE WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01This submission is the final filingYes
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: VIRTEVA LLC EMPLOYEE WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

HEALTHPARTNERS INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 44547 )
Policy contract number24159
Policy instance 1
Insurance contract or identification number24159
Number of Individuals Covered163
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $37,122
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $868,606
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees25420
Additional information about fees paid to insurance brokerBROKER SERVICE FEE, BONUS AND INDIRECT COMP
Insurance broker organization code?3
DELTA DENTAL OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 )
Policy contract number4905
Policy instance 2
Insurance contract or identification number4905
Number of Individuals Covered137
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $5,585
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $50,512
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,045
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM605694
Policy instance 3
Insurance contract or identification numberSGM605694
Number of Individuals Covered124
Insurance policy start date2019-01-01
Insurance policy end date2020-01-01
Total amount of commissions paid to insurance brokerUSD $6,373
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $42,488
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,471
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10141211001
Policy instance 4
Insurance contract or identification number10141211001
Number of Individuals Covered77
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $326
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,370
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $210
Insurance broker organization code?3
HEALTHPARTNERS INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 44547 )
Policy contract number24159
Policy instance 1
Insurance contract or identification number24159
Number of Individuals Covered170
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $41,178
Total amount of fees paid to insurance companyUSD $7,278
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $876,211
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $41,178
Amount paid for insurance broker fees7278
Additional information about fees paid to insurance brokerMARKETING ALLOWANCE
Insurance broker organization code?3
DELTA DENTAL OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 )
Policy contract number69140
Policy instance 2
Insurance contract or identification number69140
Number of Individuals Covered149
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $6,632
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $65,335
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,632
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM605694
Policy instance 3
Insurance contract or identification numberSGM605694
Number of Individuals Covered149
Insurance policy start date2018-01-01
Insurance policy end date2019-01-01
Total amount of commissions paid to insurance brokerUSD $7,595
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $50,635
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,595
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10141211001
Policy instance 4
Insurance contract or identification number10141211001
Number of Individuals Covered59
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $236
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,346
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $236
Insurance broker organization code?3

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