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| Plan Name | INDEPENDENT II LLC |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | INDEPENDENT II, LLC |
| Employer identification number (EIN): | 204580134 |
| NAIC Classification: | 561900 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2022-12-01 | MICHAEL BARNETT | 2024-07-08 | ||
| 501 | 2021-12-01 | MICHAEL BARNETT | 2023-08-29 | ||
| 501 | 2020-12-01 | MICHAEL BARNETT | 2022-10-17 | ||
| 501 | 2020-12-01 | MICHAEL BARNETT | 2022-09-12 |
| Measure | Date | Value |
|---|---|---|
| 2022: INDEPENDENT II LLC 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-12-01 | 132 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-12-01 | 121 |
| Number of retired or separated participants receiving benefits | 2022-12-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-12-01 | 0 |
| Total of all active and inactive participants | 2022-12-01 | 121 |
| Number of employers contributing to the scheme | 2022-12-01 | 0 |
| 2021: INDEPENDENT II LLC 2021 401k membership | ||
| Total participants, beginning-of-year | 2021-12-01 | 103 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-12-01 | 132 |
| Number of retired or separated participants receiving benefits | 2021-12-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-12-01 | 0 |
| Total of all active and inactive participants | 2021-12-01 | 132 |
| Number of employers contributing to the scheme | 2021-12-01 | 0 |
| 2020: INDEPENDENT II LLC 2020 401k membership | ||
| Total participants, beginning-of-year | 2020-12-01 | 103 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-12-01 | 103 |
| Number of retired or separated participants receiving benefits | 2020-12-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-12-01 | 0 |
| Total of all active and inactive participants | 2020-12-01 | 103 |
| Number of employers contributing to the scheme | 2020-12-01 | 0 |
| 2022: INDEPENDENT II LLC 2022 form 5500 responses | ||
|---|---|---|
| 2022-12-01 | Type of plan entity | Single employer plan |
| 2022-12-01 | Plan funding arrangement – Insurance | Yes |
| 2022-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: INDEPENDENT II LLC 2021 form 5500 responses | ||
| 2021-12-01 | Type of plan entity | Single employer plan |
| 2021-12-01 | Plan funding arrangement – Insurance | Yes |
| 2021-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: INDEPENDENT II LLC 2020 form 5500 responses | ||
| 2020-12-01 | Type of plan entity | Single employer plan |
| 2020-12-01 | First time form 5500 has been submitted | Yes |
| 2020-12-01 | Submission has been amended | Yes |
| 2020-12-01 | Plan funding arrangement – Insurance | Yes |
| 2020-12-01 | Plan benefit arrangement – Insurance | Yes |
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) | |
| Policy contract number | 78122 |
| Policy instance | 3 |
| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) | |
| Policy contract number | 240927 |
| Policy instance | 2 |
| ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 ) | |
| Policy contract number | L04175 |
| Policy instance | 1 |
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) | |
| Policy contract number | 78122 |
| Policy instance | 4 |
| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) | |
| Policy contract number | 240927 |
| Policy instance | 3 |
| ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 ) | |
| Policy contract number | L04175 |
| Policy instance | 2 |
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) | |
| Policy contract number | CPA47 |
| Policy instance | 1 |
| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) | |
| Policy contract number | 240927 |
| Policy instance | 7 |
| COMPBENEFITS (National Association of Insurance Commissioners NAIC id number: 54739 ) | |
| Policy contract number | 792781 |
| Policy instance | 6 |
| HUMANA HEALTH PLAN, INC. (National Association of Insurance Commissioners NAIC id number: 95885 ) | |
| Policy contract number | 792781 |
| Policy instance | 5 |
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) | |
| Policy contract number | CPA47 |
| Policy instance | 4 |
| CENTRAL UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61883 ) | |
| Policy contract number | 897859 |
| Policy instance | 3 |
| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) | |
| Policy contract number | 240927 |
| Policy instance | 2 |
| HUMANA INSURANCE COMPANY OF KENTUCKY INC (National Association of Insurance Commissioners NAIC id number: 60219 ) | |
| Policy contract number | 792781 |
| Policy instance | 1 |
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