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| Plan Name | LIFE AND DISABILITY COVERAGES |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | JSL TECHNOLOGIES INC |
| Employer identification number (EIN): | 263102603 |
| NAIC Classification: | 541330 |
| NAIC Description: | Engineering Services |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2017-12-01 | ALISSA BORSUK | 2019-06-24 | ||
| 502 | 2016-12-01 |
| Measure | Date | Value |
|---|---|---|
| 2017: LIFE AND DISABILITY COVERAGES 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-12-01 | 135 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-12-01 | 0 |
| Number of retired or separated participants receiving benefits | 2017-12-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-12-01 | 0 |
| Total of all active and inactive participants | 2017-12-01 | 0 |
| Number of employers contributing to the scheme | 2017-12-01 | 0 |
| 2016: LIFE AND DISABILITY COVERAGES 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-12-01 | 115 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-12-01 | 135 |
| Number of retired or separated participants receiving benefits | 2016-12-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-12-01 | 0 |
| Total of all active and inactive participants | 2016-12-01 | 135 |
| 2017: LIFE AND DISABILITY COVERAGES 2017 form 5500 responses | ||
|---|---|---|
| 2017-12-01 | Type of plan entity | Single employer plan |
| 2017-12-01 | This submission is the final filing | Yes |
| 2017-12-01 | Plan funding arrangement – Insurance | Yes |
| 2017-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: LIFE AND DISABILITY COVERAGES 2016 form 5500 responses | ||
| 2016-12-01 | Type of plan entity | Single employer plan |
| 2016-12-01 | First time form 5500 has been submitted | Yes |
| 2016-12-01 | Plan funding arrangement – Insurance | Yes |
| 2016-12-01 | Plan benefit arrangement – Insurance | Yes |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |||||||||||||||||||||
| Policy contract number | GLUG0ASYG | ||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||
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