401k Plan data: INTEGRATED SOLUTIONS FOR SYSTEMS WELFARE BENEFIT PLAN plan

INTEGRATED SOLUTIONS FOR SYSTEMS WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	INTEGRATED SOLUTIONS FOR SYSTEMS WELFARE BENEFIT PLAN
Plan identification number	501

INTEGRATED SOLUTIONS FOR SYSTEMS WELFARE BENEFIT PLAN 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

401k Sponsoring company profile

INTEGRATED SOLUTIONS FOR SYSTEMS, INC. has sponsored the creation of one or more 401k plans.

Company Name: INTEGRATED SOLUTIONS FOR SYSTEMS, INC.

Employer identification number (EIN): 261687937

NAIC Classification: 541600

Form 5500 Filing Information

Submission information for form 5500 for 401k plan INTEGRATED SOLUTIONS FOR SYSTEMS WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2024-01-01 GLENN ROLADER
501 2023-01-01
501 2023-01-01 GLENN ROLADER
501 2022-01-01
501 2022-01-01 GLENN ROLADER
501 2021-01-01
501 2021-01-01 GLENN ROLADER

Form 5500 Responses for INTEGRATED SOLUTIONS FOR SYSTEMS WELFARE BENEFIT PLAN

2023: INTEGRATED SOLUTIONS FOR SYSTEMS WELFARE BENEFIT PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2022: INTEGRATED SOLUTIONS FOR SYSTEMS WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	Yes
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2021: INTEGRATED SOLUTIONS FOR SYSTEMS WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	First time form 5500 has been submitted	Yes
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

71322

Policy instance

Insurance contract or identification number	71322
Number of Individuals Covered	2
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $146
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AXIS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 37273 )

Policy contract number

GAPPAGI3064

Policy instance

Insurance contract or identification number	GAPPAGI3064
Number of Individuals Covered	117
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $77,159
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $256,612
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )

Policy contract number

AL14058

Policy instance

Insurance contract or identification number	AL14058
Number of Individuals Covered	706
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $21,380
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $213,801
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

71322

Policy instance

Insurance contract or identification number	71322
Number of Individuals Covered	265
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $16,815
Total amount of fees paid to insurance company	USD $43
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $28,143
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

71322

Policy instance

Insurance contract or identification number	71322
Number of Individuals Covered	92
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $38,302
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

71322

Policy instance

Insurance contract or identification number	71322
Number of Individuals Covered	265
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $2,680
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

71322

Policy instance

Insurance contract or identification number	71322
Number of Individuals Covered	58
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $5,161
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

71322

Policy instance

Insurance contract or identification number	71322
Number of Individuals Covered	35
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $563
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

71322

Policy instance

Insurance contract or identification number	71322
Number of Individuals Covered	264
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $60,270
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )

Policy contract number

71322

Policy instance

Insurance contract or identification number	71322
Number of Individuals Covered	265
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $32,881
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AMFIRST INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60250 )

Policy contract number

12046

Policy instance

Insurance contract or identification number	12046
Number of Individuals Covered	105
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $54,248
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $237,076
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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

Policy contract number

1152902

Policy instance

Insurance contract or identification number	1152902
Number of Individuals Covered	519
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $14,248
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $142,478
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GUG0AQGZ

Policy instance

Insurance contract or identification number	GUG0AQGZ
Number of Individuals Covered	216
Insurance policy start date	2022-01-01
Insurance policy end date	2023-01-01
Total amount of commissions paid to insurance broker	USD $1,968
Total amount of fees paid to insurance company	USD $1,051
Temporary Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $19,676
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G000AQGZ

Policy instance

Insurance contract or identification number	G000AQGZ
Number of Individuals Covered	218
Insurance policy start date	2022-01-01
Insurance policy end date	2023-01-01
Total amount of commissions paid to insurance broker	USD $3,697
Total amount of fees paid to insurance company	USD $1,956
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $36,971
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G000AQGZ

Policy instance

Insurance contract or identification number	G000AQGZ
Number of Individuals Covered	218
Insurance policy start date	2022-01-01
Insurance policy end date	2023-01-01
Total amount of commissions paid to insurance broker	USD $6,295
Total amount of fees paid to insurance company	USD $3,285
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $62,946
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30055663

Policy instance

Insurance contract or identification number	30055663
Number of Individuals Covered	148
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $3,085
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $30,851
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )

Policy contract number

0088319

Policy instance

Insurance contract or identification number	0088319
Number of Individuals Covered	431
Insurance policy start date	2021-09-01
Insurance policy end date	2022-08-31
Health Insurance Welfare Benefit	Yes
Other welfare benefits provided	C-PLUS,/MEDICARE, BABY , AIRMED
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30055663

Policy instance

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G000AQGZ

Policy instance

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G000AQGZ

Policy instance

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GUG0AQGZ

Policy instance

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5937621

Policy instance

AMFIRST INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60250 )

Policy contract number

261687937

Policy instance

BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 )

Policy contract number

0088319

Policy instance

Potentially related plans

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Company Name:	INTEGRATED SOLUTIONS FOR SYSTEMS, INC.
Employer identification number (EIN):	261687937
NAIC Classification:	541600

Plan id#	Filing Submission Date	Name of Administrator
501	2024-01-01	GLENN ROLADER
501	2023-01-01
501	2023-01-01	GLENN ROLADER
501	2022-01-01
501	2022-01-01	GLENN ROLADER
501	2021-01-01
501	2021-01-01	GLENN ROLADER