401k Plan data: CSIDENTITY CORPORATION WELFARE BENEFITS PLAN plan

CSIDENTITY CORPORATION WELFARE BENEFITS PLAN 401k Plan overview

Plan Name	CSIDENTITY CORPORATION WELFARE BENEFITS PLAN
Plan identification number	503

CSIDENTITY CORPORATION WELFARE BENEFITS PLAN Benefits

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

401k Sponsoring company profile

CSIDENTITY CORPORATION has sponsored the creation of one or more 401k plans.

Company Name: CSIDENTITY CORPORATION

Employer identification number (EIN): 204318045

NAIC Classification: 518210
NAIC Description: Data Processing, Hosting, and Related Services

Additional information about CSIDENTITY CORPORATION

Jurisdiction of Incorporation: State of Delaware Division of Corporations

Incorporation Date:

Company Identification Number: 4110622

More information about CSIDENTITY CORPORATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CSIDENTITY CORPORATION WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2017-09-01 DONNA MARQUETTE

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
503	2017-09-01	DONNA MARQUETTE

Plan Statistics for CSIDENTITY CORPORATION WELFARE BENEFITS PLAN

401k plan membership statisitcs for CSIDENTITY CORPORATION WELFARE BENEFITS PLAN

Measure Date Value
2017: CSIDENTITY CORPORATION WELFARE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-09-01 162
Total number of active participants reported on line 7a of the Form 5500 2017-09-01 0
Number of retired or separated participants receiving benefits 2017-09-01 0
Number of other retired or separated participants entitled to future benefits 2017-09-01 0
Total of all active and inactive participants 2017-09-01 0

Measure	Date	Value
2017: CSIDENTITY CORPORATION WELFARE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-09-01	162
Total number of active participants reported on line 7a of the Form 5500	2017-09-01	0
Number of retired or separated participants receiving benefits	2017-09-01	0
Number of other retired or separated participants entitled to future benefits	2017-09-01	0
Total of all active and inactive participants	2017-09-01	0

Form 5500 Responses for CSIDENTITY CORPORATION WELFARE BENEFITS PLAN

2017: CSIDENTITY CORPORATION WELFARE BENEFITS PLAN 2017 form 5500 responses
2017-09-01	Type of plan entity	Single employer plan
2017-09-01	First time form 5500 has been submitted	Yes
2017-09-01	Submission has been amended	No
2017-09-01	This submission is the final filing	Yes
2017-09-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-09-01	Plan is a collectively bargained plan	No
2017-09-01	Plan funding arrangement – Insurance	Yes
2017-09-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

009092

Policy instance

Insurance contract or identification number	009092
Number of Individuals Covered	380
Insurance policy start date	2017-09-01
Insurance policy end date	2018-08-31
Total amount of commissions paid to insurance broker	USD $87,399
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 $1,927,407
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	CSIDENTITY CORPORATION
Employer identification number (EIN):	204318045
NAIC Classification:	518210
NAIC Description:	Data Processing, Hosting, and Related Services

Jurisdiction of Incorporation:	State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number:	4110622