401k Plan data: INTERIORS SAVINGS AND INVESTMENT 401(K) PLAN plan

INTERIORS SAVINGS AND INVESTMENT 401(K) PLAN 401k Plan overview

Plan Name	INTERIORS SAVINGS AND INVESTMENT 401(K) PLAN
Plan identification number	501

INTERIORS SAVINGS AND INVESTMENT 401(K) 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

JCIM US, LLC has sponsored the creation of one or more 401k plans.

Company Name: JCIM US, LLC

Employer identification number (EIN): 262545247

NAIC Classification: 336300

Additional information about JCIM US, LLC

Jurisdiction of Incorporation: State of Delaware Division of Corporations

Incorporation Date:

Company Identification Number: 4541047

More information about JCIM US, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan INTERIORS SAVINGS AND INVESTMENT 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2016-01-01 JEFF ANGELIU JEFF ANGELIU 2017-10-13
501 2015-01-01 KAARE A LEIN KAARE A LEIN 2016-10-13
501 2014-01-01 SHERRY WEINBERG SHERRY WEINBERG 2015-10-14
501 2013-01-01 JAMES FITZGERALD JAMES FITZGERALD 2014-11-11
501 2012-01-01 SHERRY WEINBERG SHERRY WEINBERG 2013-10-14
501 2011-01-01 SHERRY WEINBERG SHERRY WEINBERG 2012-10-15

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2016-01-01	JEFF ANGELIU	JEFF ANGELIU	2017-10-13
501	2015-01-01	KAARE A LEIN	KAARE A LEIN	2016-10-13
501	2014-01-01	SHERRY WEINBERG	SHERRY WEINBERG	2015-10-14
501	2013-01-01	JAMES FITZGERALD	JAMES FITZGERALD	2014-11-11
501	2012-01-01	SHERRY WEINBERG	SHERRY WEINBERG	2013-10-14
501	2011-01-01	SHERRY WEINBERG	SHERRY WEINBERG	2012-10-15

Plan Statistics for INTERIORS SAVINGS AND INVESTMENT 401(K) PLAN

401k plan membership statisitcs for INTERIORS SAVINGS AND INVESTMENT 401(K) PLAN

Measure Date Value
2016: INTERIORS SAVINGS AND INVESTMENT 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 13
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 7,241
Number of retired or separated participants receiving benefits 2016-01-01 10
Total of all active and inactive participants 2016-01-01 7,251
2015: INTERIORS SAVINGS AND INVESTMENT 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 4,166
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 6
Number of retired or separated participants receiving benefits 2015-01-01 7
Total of all active and inactive participants 2015-01-01 13
2014: INTERIORS SAVINGS AND INVESTMENT 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 4,544
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 3,979
Number of retired or separated participants receiving benefits 2014-01-01 187
Total of all active and inactive participants 2014-01-01 4,166
2013: INTERIORS SAVINGS AND INVESTMENT 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 4,936
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 4,503
Number of retired or separated participants receiving benefits 2013-01-01 41
Total of all active and inactive participants 2013-01-01 4,544
2012: INTERIORS SAVINGS AND INVESTMENT 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 5,061
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 4,884
Number of retired or separated participants receiving benefits 2012-01-01 52
Total of all active and inactive participants 2012-01-01 4,936
2011: INTERIORS SAVINGS AND INVESTMENT 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 0
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 5,033
Number of retired or separated participants receiving benefits 2011-01-01 28
Total of all active and inactive participants 2011-01-01 5,061

Measure	Date	Value
2016: INTERIORS SAVINGS AND INVESTMENT 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	13
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	7,241
Number of retired or separated participants receiving benefits	2016-01-01	10
Total of all active and inactive participants	2016-01-01	7,251
2015: INTERIORS SAVINGS AND INVESTMENT 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	4,166
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	6
Number of retired or separated participants receiving benefits	2015-01-01	7
Total of all active and inactive participants	2015-01-01	13
2014: INTERIORS SAVINGS AND INVESTMENT 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	4,544
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	3,979
Number of retired or separated participants receiving benefits	2014-01-01	187
Total of all active and inactive participants	2014-01-01	4,166
2013: INTERIORS SAVINGS AND INVESTMENT 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	4,936
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	4,503
Number of retired or separated participants receiving benefits	2013-01-01	41
Total of all active and inactive participants	2013-01-01	4,544
2012: INTERIORS SAVINGS AND INVESTMENT 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	5,061
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	4,884
Number of retired or separated participants receiving benefits	2012-01-01	52
Total of all active and inactive participants	2012-01-01	4,936
2011: INTERIORS SAVINGS AND INVESTMENT 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	0
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	5,033
Number of retired or separated participants receiving benefits	2011-01-01	28
Total of all active and inactive participants	2011-01-01	5,061

Form 5500 Responses for INTERIORS SAVINGS AND INVESTMENT 401(K) PLAN

2016: INTERIORS SAVINGS AND INVESTMENT 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: INTERIORS SAVINGS AND INVESTMENT 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: INTERIORS SAVINGS AND INVESTMENT 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: INTERIORS SAVINGS AND INVESTMENT 401(K) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Mulitple employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: INTERIORS SAVINGS AND INVESTMENT 401(K) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: INTERIORS SAVINGS AND INVESTMENT 401(K) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	First time form 5500 has been submitted	Yes
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

097400

Policy instance

Insurance contract or identification number	097400
Number of Individuals Covered	84858
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	JCIM US, LLC
Employer identification number (EIN):	262545247
NAIC Classification:	336300

Jurisdiction of Incorporation:	State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number:	4541047