401k Plan data: SINGLE SOURCE SECURITY, INC DBA PROTOS SECURITY HEALTH AND WELLNESS plan

SINGLE SOURCE SECURITY, INC DBA PROTOS SECURITY HEALTH AND WELLNESS 401k Plan overview

Plan Name	SINGLE SOURCE SECURITY, INC DBA PROTOS SECURITY HEALTH AND WELLNESS
Plan identification number	501

SINGLE SOURCE SECURITY, INC DBA PROTOS SECURITY HEALTH AND WELLNESS Benefits

401k Plan Type	Welfare 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) Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

PROTOS SECURITY has sponsored the creation of one or more 401k plans.

Company Name: PROTOS SECURITY

Employer identification number (EIN): 204373685

NAIC Classification: 561600

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SINGLE SOURCE SECURITY, INC DBA PROTOS SECURITY HEALTH AND WELLNESS

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2020-01-01 ANGELA FLOOD 2021-10-13
501 2020-01-01 ANGELA FLOOD 2021-11-24

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2020-01-01	ANGELA FLOOD	2021-10-13
501	2020-01-01	ANGELA FLOOD	2021-11-24

Plan Statistics for SINGLE SOURCE SECURITY, INC DBA PROTOS SECURITY HEALTH AND WELLNESS

401k plan membership statisitcs for SINGLE SOURCE SECURITY, INC DBA PROTOS SECURITY HEALTH AND WELLNESS

Measure Date Value
2020: SINGLE SOURCE SECURITY, INC DBA PROTOS SECURITY HEALTH AND WELLNESS 2020 401k membership
Total participants, beginning-of-year 2020-01-01 100
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 100
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 100
Number of employers contributing to the scheme 2020-01-01 0

Measure	Date	Value
2020: SINGLE SOURCE SECURITY, INC DBA PROTOS SECURITY HEALTH AND WELLNESS 2020 401k membership
Total participants, beginning-of-year	2020-01-01	100
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	100
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	100
Number of employers contributing to the scheme	2020-01-01	0

Form 5500 Responses for SINGLE SOURCE SECURITY, INC DBA PROTOS SECURITY HEALTH AND WELLNESS

2020: SINGLE SOURCE SECURITY, INC DBA PROTOS SECURITY HEALTH AND WELLNESS 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	First time form 5500 has been submitted	Yes
2020-01-01	Submission has been amended	Yes
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – General assets of the sponsor	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

533493

Policy instance

Insurance contract or identification number	533493
Number of Individuals Covered	71
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $15,462
Total amount of fees paid to insurance company	USD $4,655
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $90,748
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $7,672
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	FEES

UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

0209255

Policy instance

Insurance contract or identification number	0209255
Number of Individuals Covered	100
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

533493

Policy instance

Insurance contract or identification number	533493
Number of Individuals Covered	100
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

Potentially related plans

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Company Name:	PROTOS SECURITY
Employer identification number (EIN):	204373685
NAIC Classification:	561600