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INFORMATION TECHNOLOGY COALITION INC WRAP EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan NameINFORMATION TECHNOLOGY COALITION INC WRAP EMPLOYEE BENEFIT PLAN
Plan identification number 502

INFORMATION TECHNOLOGY COALITION INC WRAP EMPLOYEE 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
  • Other welfare benefit cover

401k Sponsoring company profile

ITC FEDERAL LLC has sponsored the creation of one or more 401k plans.

Company Name:ITC FEDERAL LLC
Employer identification number (EIN):205581516
NAIC Classification:111100
NAIC Description:Oilseed and Grain Farming

Form 5500 Filing Information

Submission information for form 5500 for 401k plan INFORMATION TECHNOLOGY COALITION INC WRAP EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022023-07-01JANET HANOFEE
5022022-07-01
5022022-07-01STEPHEN GAIR
5022021-07-01
5022021-07-01STEPHEN GAIR
5022020-07-01
5022020-07-01STEPHEN GAIR

Financial Data on INFORMATION TECHNOLOGY COALITION INC WRAP EMPLOYEE BENEFIT PLAN

Measure Date Value
2025 : INFORMATION TECHNOLOGY COALITION INC WRAP EMPLOYEE BENEFIT PLAN 2025 401k financial data
Total expenses incurred by plan in this plan year2025-10-2744534
Net assets as of the end of the plan year2025-10-279310
Total assets as of the beginning of the plan year2025-10-270
Value of plan covered by a fidelity bond2025-10-271000
Plan net income in this plan year2025-10-279310
Net assets as of the end of the plan year2025-10-279310
Net assets as of the beginning of the plan year2025-10-270
Employer contributions to plan in this plan year2025-10-2753844
Expensese paid to adminstrative service provicers from plan in this plan year2025-10-272533
2023 : INFORMATION TECHNOLOGY COALITION INC WRAP EMPLOYEE BENEFIT PLAN 2023 401k financial data
Total unrealized appreciation/depreciation of assets2023-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-06-30$1,138,116
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2023-06-30$990,894
Total income from all sources (including contributions)2023-06-30$6,330,979
Total loss/gain on sale of assets2023-06-30$0
Total of all expenses incurred2023-06-30$6,887,422
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2023-06-30$6,621,751
Total contributions o plan (from employers,participants, others, non cash contrinutions)2023-06-30$6,310,693
Value of total assets at end of year2023-06-30$699,078
Value of total assets at beginning of year2023-06-30$1,108,299
Total of administrative expenses incurred including professional, contract, advisory and management fees2023-06-30$265,671
Total interest from all sources2023-06-30$20,286
Total dividends received (eg from common stock, registered investment company shares)2023-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2023-06-30No
Administrative expenses professional fees incurred2023-06-30$29,096
Was this plan covered by a fidelity bond2023-06-30Yes
Value of fidelity bond cover2023-06-30$500,000
If this is an individual account plan, was there a blackout period2023-06-30No
Were there any nonexempt tranactions with any party-in-interest2023-06-30No
Contributions received from participants2023-06-30$1,221,350
Value of other receiveables (less allowance for doubtful accounts) at end of year2023-06-30$266,200
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2023-06-30$257,917
Liabilities. Value of operating payables at end of year2023-06-30$559,327
Liabilities. Value of operating payables at beginning of year2023-06-30$718,202
Total non interest bearing cash at end of year2023-06-30$0
Total non interest bearing cash at beginning of year2023-06-30$2,786
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2023-06-30No
Value of net income/loss2023-06-30$-556,443
Value of net assets at end of year (total assets less liabilities)2023-06-30$-439,038
Value of net assets at beginning of year (total assets less liabilities)2023-06-30$117,405
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2023-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2023-06-30No
Were any leases to which the plan was party in default or uncollectible2023-06-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2023-06-30$262,979
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2023-06-30$847,596
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2023-06-30$847,596
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2023-06-30$20,286
Expenses. Payments to insurance carriers foe the provision of benefits2023-06-30$2,628,673
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2023-06-30No
Was there a failure to transmit to the plan any participant contributions2023-06-30No
Has the plan failed to provide any benefit when due under the plan2023-06-30No
Contributions received in cash from employer2023-06-30$5,089,343
Employer contributions (assets) at end of year2023-06-30$169,899
Employer contributions (assets) at beginning of year2023-06-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2023-06-30$3,993,078
Contract administrator fees2023-06-30$236,575
Liabilities. Value of benefit claims payable at end of year2023-06-30$578,789
Liabilities. Value of benefit claims payable at beginning of year2023-06-30$272,692
Did the plan have assets held for investment2023-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2023-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2023-06-30No
Opinion of an independent qualified public accountant for this plan2023-06-30Unqualified
Accountancy firm name2023-06-30PLANTE & MORAN PLLC
Accountancy firm EIN2023-06-30381357951
2022 : INFORMATION TECHNOLOGY COALITION INC WRAP EMPLOYEE BENEFIT PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-07-01$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-07-01$1,138,116
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-07-01$990,894
Total income from all sources (including contributions)2022-07-01$6,330,979
Total loss/gain on sale of assets2022-07-01$0
Total of all expenses incurred2022-07-01$6,887,422
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-07-01$6,621,751
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-07-01$6,310,693
Value of total assets at end of year2022-07-01$699,078
Value of total assets at beginning of year2022-07-01$1,108,299
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-07-01$265,671
Total interest from all sources2022-07-01$20,286
Total dividends received (eg from common stock, registered investment company shares)2022-07-01$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-07-01No
Administrative expenses professional fees incurred2022-07-01$29,096
Was this plan covered by a fidelity bond2022-07-01Yes
Value of fidelity bond cover2022-07-01$500,000
If this is an individual account plan, was there a blackout period2022-07-01No
Were there any nonexempt tranactions with any party-in-interest2022-07-01No
Contributions received from participants2022-07-01$1,221,350
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-07-01$266,200
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-07-01$257,917
Liabilities. Value of operating payables at end of year2022-07-01$559,327
Liabilities. Value of operating payables at beginning of year2022-07-01$718,202
Total non interest bearing cash at end of year2022-07-01$0
Total non interest bearing cash at beginning of year2022-07-01$2,786
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-07-01No
Value of net income/loss2022-07-01$-556,443
Value of net assets at end of year (total assets less liabilities)2022-07-01$-439,038
Value of net assets at beginning of year (total assets less liabilities)2022-07-01$117,405
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-07-01No
Were any loans by the plan or fixed income obligations due to the plan in default2022-07-01No
Were any leases to which the plan was party in default or uncollectible2022-07-01No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-07-01$262,979
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-07-01$20,286
Expenses. Payments to insurance carriers foe the provision of benefits2022-07-01$2,628,673
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-07-01No
Was there a failure to transmit to the plan any participant contributions2022-07-01No
Has the plan failed to provide any benefit when due under the plan2022-07-01No
Contributions received in cash from employer2022-07-01$5,089,343
Employer contributions (assets) at end of year2022-07-01$169,899
Employer contributions (assets) at beginning of year2022-07-01$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-07-01$3,993,078
Contract administrator fees2022-07-01$236,575
Liabilities. Value of benefit claims payable at end of year2022-07-01$578,789
Liabilities. Value of benefit claims payable at beginning of year2022-07-01$272,692
Did the plan have assets held for investment2022-07-01No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-07-01No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-07-01No
Opinion of an independent qualified public accountant for this plan2022-07-011
Accountancy firm name2022-07-01PLANTE & MORAN PLLC
Accountancy firm EIN2022-07-01381357951
Total unrealized appreciation/depreciation of assets2022-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-06-30$990,894
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-06-30$1,128,731
Total income from all sources (including contributions)2022-06-30$6,000,739
Total loss/gain on sale of assets2022-06-30$0
Total of all expenses incurred2022-06-30$5,605,244
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-06-30$5,424,505
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-06-30$5,999,794
Value of total assets at end of year2022-06-30$1,108,299
Value of total assets at beginning of year2022-06-30$850,641
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-06-30$180,739
Total interest from all sources2022-06-30$945
Total dividends received (eg from common stock, registered investment company shares)2022-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-06-30No
Was this plan covered by a fidelity bond2022-06-30Yes
Value of fidelity bond cover2022-06-30$500,000
If this is an individual account plan, was there a blackout period2022-06-30No
Were there any nonexempt tranactions with any party-in-interest2022-06-30No
Contributions received from participants2022-06-30$1,056,374
Value of other receiveables (less allowance for doubtful accounts) at end of year2022-06-30$257,917
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2022-06-30$87,631
Liabilities. Value of operating payables at end of year2022-06-30$718,202
Liabilities. Value of operating payables at beginning of year2022-06-30$610,675
Total non interest bearing cash at end of year2022-06-30$2,786
Total non interest bearing cash at beginning of year2022-06-30$86,541
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-06-30No
Value of net income/loss2022-06-30$395,495
Value of net assets at end of year (total assets less liabilities)2022-06-30$117,405
Value of net assets at beginning of year (total assets less liabilities)2022-06-30$-278,090
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2022-06-30No
Were any leases to which the plan was party in default or uncollectible2022-06-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2022-06-30$847,596
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2022-06-30$391,092
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2022-06-30$391,092
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2022-06-30$945
Expenses. Payments to insurance carriers foe the provision of benefits2022-06-30$1,947,047
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-06-30No
Was there a failure to transmit to the plan any participant contributions2022-06-30No
Has the plan failed to provide any benefit when due under the plan2022-06-30No
Contributions received in cash from employer2022-06-30$4,943,420
Employer contributions (assets) at end of year2022-06-30$0
Employer contributions (assets) at beginning of year2022-06-30$285,377
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-06-30$3,477,458
Contract administrator fees2022-06-30$180,739
Liabilities. Value of benefit claims payable at end of year2022-06-30$272,692
Liabilities. Value of benefit claims payable at beginning of year2022-06-30$518,056
Did the plan have assets held for investment2022-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-06-30No
Opinion of an independent qualified public accountant for this plan2022-06-30Unqualified
Accountancy firm name2022-06-30PLANTE & MORAN PLLC
Accountancy firm EIN2022-06-30381357951
2021 : INFORMATION TECHNOLOGY COALITION INC WRAP EMPLOYEE BENEFIT PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-06-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-06-30$1,128,731
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-06-30$0
Total income from all sources (including contributions)2021-06-30$5,787,101
Total loss/gain on sale of assets2021-06-30$0
Total of all expenses incurred2021-06-30$6,065,191
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-06-30$5,897,973
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-06-30$5,787,026
Value of total assets at end of year2021-06-30$850,641
Value of total assets at beginning of year2021-06-30$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-06-30$167,218
Total interest from all sources2021-06-30$75
Total dividends received (eg from common stock, registered investment company shares)2021-06-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-06-30No
Was this plan covered by a fidelity bond2021-06-30Yes
Value of fidelity bond cover2021-06-30$500,000
If this is an individual account plan, was there a blackout period2021-06-30No
Were there any nonexempt tranactions with any party-in-interest2021-06-30No
Contributions received from participants2021-06-30$1,142,112
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-06-30$87,631
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-06-30$0
Liabilities. Value of operating payables at end of year2021-06-30$610,675
Liabilities. Value of operating payables at beginning of year2021-06-30$0
Total non interest bearing cash at end of year2021-06-30$86,541
Total non interest bearing cash at beginning of year2021-06-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-06-30No
Value of net income/loss2021-06-30$-278,090
Value of net assets at end of year (total assets less liabilities)2021-06-30$-278,090
Value of net assets at beginning of year (total assets less liabilities)2021-06-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2021-06-30No
Were any leases to which the plan was party in default or uncollectible2021-06-30No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2021-06-30$391,092
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2021-06-30$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2021-06-30$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2021-06-30$75
Expenses. Payments to insurance carriers foe the provision of benefits2021-06-30$1,739,551
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-06-30No
Was there a failure to transmit to the plan any participant contributions2021-06-30No
Has the plan failed to provide any benefit when due under the plan2021-06-30No
Contributions received in cash from employer2021-06-30$4,644,914
Employer contributions (assets) at end of year2021-06-30$285,377
Employer contributions (assets) at beginning of year2021-06-30$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-06-30$4,158,422
Contract administrator fees2021-06-30$167,218
Liabilities. Value of benefit claims payable at end of year2021-06-30$518,056
Liabilities. Value of benefit claims payable at beginning of year2021-06-30$0
Did the plan have assets held for investment2021-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-06-30No
Opinion of an independent qualified public accountant for this plan2021-06-30Unqualified
Accountancy firm name2021-06-30PLANTE & MORAN PLLC
Accountancy firm EIN2021-06-30381357951
2020 : INFORMATION TECHNOLOGY COALITION INC WRAP EMPLOYEE BENEFIT PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-07-01$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-07-01$1,128,731
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-07-01$0
Total income from all sources (including contributions)2020-07-01$5,787,101
Total loss/gain on sale of assets2020-07-01$0
Total of all expenses incurred2020-07-01$6,065,191
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-07-01$5,897,973
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-07-01$5,787,026
Value of total assets at end of year2020-07-01$850,641
Value of total assets at beginning of year2020-07-01$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-07-01$167,218
Total interest from all sources2020-07-01$75
Total dividends received (eg from common stock, registered investment company shares)2020-07-01$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-07-01No
Was this plan covered by a fidelity bond2020-07-01Yes
Value of fidelity bond cover2020-07-01$500,000
If this is an individual account plan, was there a blackout period2020-07-01No
Were there any nonexempt tranactions with any party-in-interest2020-07-01No
Contributions received from participants2020-07-01$1,142,112
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-07-01$87,631
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-07-01$0
Liabilities. Value of operating payables at end of year2020-07-01$610,675
Liabilities. Value of operating payables at beginning of year2020-07-01$0
Total non interest bearing cash at end of year2020-07-01$86,541
Total non interest bearing cash at beginning of year2020-07-01$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-07-01No
Value of net income/loss2020-07-01$-278,090
Value of net assets at end of year (total assets less liabilities)2020-07-01$-278,090
Value of net assets at beginning of year (total assets less liabilities)2020-07-01$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-07-01No
Were any loans by the plan or fixed income obligations due to the plan in default2020-07-01No
Were any leases to which the plan was party in default or uncollectible2020-07-01No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2020-07-01$391,092
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2020-07-01$75
Expenses. Payments to insurance carriers foe the provision of benefits2020-07-01$1,739,551
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-07-01No
Was there a failure to transmit to the plan any participant contributions2020-07-01No
Has the plan failed to provide any benefit when due under the plan2020-07-01No
Contributions received in cash from employer2020-07-01$4,644,914
Employer contributions (assets) at end of year2020-07-01$285,377
Employer contributions (assets) at beginning of year2020-07-01$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-07-01$4,158,422
Contract administrator fees2020-07-01$167,218
Liabilities. Value of benefit claims payable at end of year2020-07-01$518,056
Liabilities. Value of benefit claims payable at beginning of year2020-07-01$0
Did the plan have assets held for investment2020-07-01No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-07-01No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-07-01No
Opinion of an independent qualified public accountant for this plan2020-07-011
Accountancy firm name2020-07-01PLANTE & MORAN PLLC
Accountancy firm EIN2020-07-01381357951

Form 5500 Responses for INFORMATION TECHNOLOGY COALITION INC WRAP EMPLOYEE BENEFIT PLAN

2022: INFORMATION TECHNOLOGY COALITION INC WRAP EMPLOYEE BENEFIT PLAN 2022 form 5500 responses
2022-07-01Type of plan entitySingle employer plan
2022-07-01Submission has been amendedYes
2022-07-01This submission is the final filingNo
2022-07-01This return/report is a short plan year return/report (less than 12 months)No
2022-07-01Plan is a collectively bargained planNo
2022-07-01Plan funding arrangement – InsuranceYes
2022-07-01Plan funding arrangement – TrustYes
2022-07-01Plan funding arrangement – General assets of the sponsorYes
2022-07-01Plan benefit arrangement – InsuranceYes
2022-07-01Plan benefit arrangement - TrustYes
2022-07-01Plan benefit arrangement – General assets of the sponsorYes
2021: INFORMATION TECHNOLOGY COALITION INC WRAP EMPLOYEE BENEFIT PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Submission has been amendedYes
2021-07-01This submission is the final filingNo
2021-07-01This return/report is a short plan year return/report (less than 12 months)No
2021-07-01Plan is a collectively bargained planNo
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan funding arrangement – TrustYes
2021-07-01Plan funding arrangement – General assets of the sponsorYes
2021-07-01Plan benefit arrangement – InsuranceYes
2021-07-01Plan benefit arrangement - TrustYes
2021-07-01Plan benefit arrangement – General assets of the sponsorYes
2020: INFORMATION TECHNOLOGY COALITION INC WRAP EMPLOYEE BENEFIT PLAN 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01First time form 5500 has been submittedYes
2020-07-01Submission has been amendedYes
2020-07-01This submission is the final filingNo
2020-07-01This return/report is a short plan year return/report (less than 12 months)No
2020-07-01Plan is a collectively bargained planNo
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan funding arrangement – TrustYes
2020-07-01Plan funding arrangement – General assets of the sponsorYes
2020-07-01Plan benefit arrangement – InsuranceYes
2020-07-01Plan benefit arrangement - TrustYes
2020-07-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 )
Policy contract number428110
Policy instance 1
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number08279A
Policy instance 11
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number235437
Policy instance 10
TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 )
Policy contract numberSP0006396
Policy instance 9
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number2501061 3343604
Policy instance 8
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0816082
Policy instance 7
STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 )
Policy contract number428115
Policy instance 6
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number428114
Policy instance 5
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number428113
Policy instance 4
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number428112
Policy instance 3
PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 )
Policy contract number428111
Policy instance 2
TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 )
Policy contract numberSP0006396
Policy instance 9
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number2501061 3343604
Policy instance 8
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0816082
Policy instance 7
STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 )
Policy contract number428115
Policy instance 6
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number428114
Policy instance 5
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number428113
Policy instance 4
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number428112
Policy instance 3
PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 )
Policy contract number428111
Policy instance 2
PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 )
Policy contract number428110
Policy instance 1
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract numberR0816082
Policy instance 8
Insurance contract or identification numberR0816082
Number of Individuals Covered198
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $15,673
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedGROUP HOSPITAL INDEMNITY
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 CarrierUSD $37,727
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 )
Policy contract number428110
Policy instance 7
Insurance contract or identification number428110
Number of Individuals Covered183
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $6,809
Total amount of fees paid to insurance companyUSD $92
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedGROUP 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 CarrierUSD $26,176
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PAUL REVERE VARIABLE ANNUITY INS. CO. (National Association of Insurance Commissioners NAIC id number: 67601 )
Policy contract number428111
Policy instance 6
Insurance contract or identification number428111
Number of Individuals Covered186
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $6,689
Total amount of fees paid to insurance companyUSD $277
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedATTAINED AGE CRITICAL ILLNESS
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 CarrierUSD $47,851
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number428114
Policy instance 5
Insurance contract or identification number428114
Number of Individuals Covered285
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $15,348
Total amount of fees paid to insurance companyUSD $4,004
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedSELECT LONG TERM DISABILITY AND SELECT SHORT TERM DISABILITY
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 CarrierUSD $66,730
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number428113
Policy instance 4
Insurance contract or identification number428113
Number of Individuals Covered279
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $18,656
Total amount of fees paid to insurance companyUSD $4,866
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedLIFESTYLE LIFE AND LIFESTYLE ACCIDENTAL DEATH & DISMEMBERMENT
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 CarrierUSD $87,888
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number428112
Policy instance 3
Insurance contract or identification number428112
Number of Individuals Covered329
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $21,045
Total amount of fees paid to insurance companyUSD $6,314
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedAD&D
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 CarrierUSD $114,452
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 )
Policy contract number428115
Policy instance 2
Insurance contract or identification number428115
Number of Individuals Covered714
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $71,713
Total amount of fees paid to insurance companyUSD $14,915
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $479,390
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number2501061 3343604
Policy instance 1
Insurance contract or identification number2501061 3343604
Number of Individuals Covered780
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $112,213
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $817,648
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
TRIPLE S (National Association of Insurance Commissioners NAIC id number: 55816 )
Policy contract numberSP0006396
Policy instance 9
Insurance contract or identification numberSP0006396
Number of Individuals Covered17
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $2,250
Total amount of fees paid to insurance companyUSD $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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedORGAN/TISSUE TRANSPLANT AND TELECONSULTA
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 CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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