401k Plan data: ELATION HEALTH INC. WELFARE BENEFIT PLAN plan

ELATION HEALTH INC. WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	ELATION HEALTH INC. WELFARE BENEFIT PLAN
Plan identification number	503

ELATION HEALTH INC. 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 Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

ELATION HEALTH, INC. has sponsored the creation of one or more 401k plans.

Company Name: ELATION HEALTH, INC.

Employer identification number (EIN): 263415697

NAIC Classification: 511210
NAIC Description: Software Publishers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ELATION HEALTH INC. WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2023-01-01 KYNA FONG 2024-06-05

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
503	2023-01-01	KYNA FONG	2024-06-05

Plan Statistics for ELATION HEALTH INC. WELFARE BENEFIT PLAN

401k plan membership statisitcs for ELATION HEALTH INC. WELFARE BENEFIT PLAN

Measure Date Value
2023: ELATION HEALTH INC. WELFARE BENEFIT PLAN 2023 401k membership
Total participants, beginning-of-year 2023-01-01 393
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 427
Number of retired or separated participants receiving benefits 2023-01-01 0
Number of other retired or separated participants entitled to future benefits 2023-01-01 0
Total of all active and inactive participants 2023-01-01 427
Number of employers contributing to the scheme 2023-01-01 0

Measure	Date	Value
2023: ELATION HEALTH INC. WELFARE BENEFIT PLAN 2023 401k membership
Total participants, beginning-of-year	2023-01-01	393
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	427
Number of retired or separated participants receiving benefits	2023-01-01	0
Number of other retired or separated participants entitled to future benefits	2023-01-01	0
Total of all active and inactive participants	2023-01-01	427
Number of employers contributing to the scheme	2023-01-01	0

Form 5500 Responses for ELATION HEALTH INC. WELFARE BENEFIT PLAN

2023: ELATION HEALTH INC. WELFARE BENEFIT PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	First time form 5500 has been submitted	Yes
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

Insurance Providers Used on plan

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

Policy contract number

1102103

Policy instance

Insurance contract or identification number	1102103
Number of Individuals Covered	427
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $43,625
Total amount of fees paid to insurance company	USD $4,816
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to Carrier	USD $328,690
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: )

Policy contract number

30087802

Policy instance

Insurance contract or identification number	30087802
Number of Individuals Covered	236
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $4,698
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $46,570
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )

Policy contract number

11906-1

Policy instance

Insurance contract or identification number	11906-1
Number of Individuals Covered	19
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $143,397
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

607710

Policy instance

Insurance contract or identification number	607710
Number of Individuals Covered	23
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $6,837
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $128,939
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	ELATION HEALTH, INC.
Employer identification number (EIN):	263415697
NAIC Classification:	511210
NAIC Description:	Software Publishers