401k Plan data: SURGICAL SOLUTIONS MEDICAL, DENTAL, VISION, GTL, VTL AND DISABILITY plan

SURGICAL SOLUTIONS MEDICAL, DENTAL, VISION, GTL, VTL AND DISABILITY 401k Plan overview

Plan Name	SURGICAL SOLUTIONS MEDICAL, DENTAL, VISION, GTL, VTL AND DISABILITY
Plan identification number	504

SURGICAL SOLUTIONS MEDICAL, DENTAL, VISION, GTL, VTL AND DISABILITY 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)

401k Sponsoring company profile

SURGICAL SOLUTIONS LLC has sponsored the creation of one or more 401k plans.

Company Name: SURGICAL SOLUTIONS LLC

Employer identification number (EIN): 260216903

NAIC Classification: 339110

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SURGICAL SOLUTIONS MEDICAL, DENTAL, VISION, GTL, VTL AND DISABILITY

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
504 2017-01-01

Plan Statistics for SURGICAL SOLUTIONS MEDICAL, DENTAL, VISION, GTL, VTL AND DISABILITY

401k plan membership statisitcs for SURGICAL SOLUTIONS MEDICAL, DENTAL, VISION, GTL, VTL AND DISABILITY

Measure Date Value
2017: SURGICAL SOLUTIONS MEDICAL, DENTAL, VISION, GTL, VTL AND DISABILITY 2017 401k membership
Total participants, beginning-of-year 2017-01-01 171
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 154
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 154

Measure	Date	Value
2017: SURGICAL SOLUTIONS MEDICAL, DENTAL, VISION, GTL, VTL AND DISABILITY 2017 401k membership
Total participants, beginning-of-year	2017-01-01	171
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	154
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	154

Form 5500 Responses for SURGICAL SOLUTIONS MEDICAL, DENTAL, VISION, GTL, VTL AND DISABILITY

2017: SURGICAL SOLUTIONS MEDICAL, DENTAL, VISION, GTL, VTL AND DISABILITY 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	First time form 5500 has been submitted	Yes
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 )

Policy contract number

00240825

Policy instance

Insurance contract or identification number	00240825
Number of Individuals Covered	207
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $31,320
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $722,215
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $31,320
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	PAYCHEX INSURANCE AGENCY, INC.

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

1060195

Policy instance

Insurance contract or identification number	1060195
Number of Individuals Covered	192
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $847
Total amount of fees paid to insurance company	USD $2,795
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $57,473
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	2795
Additional information about fees paid to insurance broker	BONUS
Insurance broker organization code?	3
Insurance broker name	PAYCHEX INSURANCE AGENCY, INC.

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

SGM607244

Policy instance

Insurance contract or identification number	SGM607244
Number of Individuals Covered	154
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $8,014
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $53,427
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $8,014
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	PAYCHEX INSURANCE AGENCY, INC.

Potentially related plans

Was this data useful?

If you found the data here useful, PLEASE HELP US. We are a start-up and believe in making information freely available. By linking to us, posting on twitter, facebook and linkedin about us and generally spreading the word, you'll help us to grow. Our vision is to provide high quality data about the activities of all the companies in the world and where possible make it free to use and view. Finding and integrating data from thousands of data sources is time consuming and needs lots of effort. By simply spreading the word about us, you will help us. Please use the share buttons. It will only take a few seconds of your time. Thanks for helping

Information Disclaimer

The information provided on this website is not advice, endorsement or recommendation
The information published is supplied by third parties so we make no warranty on the accuracy, completeness etc. This information is provided "as-is". The information is subject to change as we obtain updates and corrections from the primary information sources.
You are free to use the information for your own personal research on the understanding to do so is at your own risk.

See full terms and conditions

Company Name:	SURGICAL SOLUTIONS LLC
Employer identification number (EIN):	260216903
NAIC Classification:	339110