401k Plan data: WORKBOX STAFFING, LLC ESSENTIAL STAFFCARE plan

WORKBOX STAFFING, LLC ESSENTIAL STAFFCARE 401k Plan overview

Plan Name	WORKBOX STAFFING, LLC ESSENTIAL STAFFCARE
Plan identification number	510

WORKBOX STAFFING, LLC ESSENTIAL STAFFCARE Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision

401k Sponsoring company profile

WORKBOX STAFFING, LLC has sponsored the creation of one or more 401k plans.

Company Name: WORKBOX STAFFING, LLC

Employer identification number (EIN): 270688056

NAIC Classification: 561300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WORKBOX STAFFING, LLC ESSENTIAL STAFFCARE

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
510 2021-12-01
510 2020-12-01

Plan Statistics for WORKBOX STAFFING, LLC ESSENTIAL STAFFCARE

401k plan membership statisitcs for WORKBOX STAFFING, LLC ESSENTIAL STAFFCARE

Measure Date Value
2021: WORKBOX STAFFING, LLC ESSENTIAL STAFFCARE 2021 401k membership
Total participants, beginning-of-year 2021-12-01 227
Total number of active participants reported on line 7a of the Form 5500 2021-12-01 834
Total of all active and inactive participants 2021-12-01 834
Total participants 2021-12-01 834
2020: WORKBOX STAFFING, LLC ESSENTIAL STAFFCARE 2020 401k membership
Total participants, beginning-of-year 2020-12-01 2,200
Total number of active participants reported on line 7a of the Form 5500 2020-12-01 227
Total of all active and inactive participants 2020-12-01 227
Total participants 2020-12-01 227

Measure	Date	Value
2021: WORKBOX STAFFING, LLC ESSENTIAL STAFFCARE 2021 401k membership
Total participants, beginning-of-year	2021-12-01	227
Total number of active participants reported on line 7a of the Form 5500	2021-12-01	834
Total of all active and inactive participants	2021-12-01	834
Total participants	2021-12-01	834
2020: WORKBOX STAFFING, LLC ESSENTIAL STAFFCARE 2020 401k membership
Total participants, beginning-of-year	2020-12-01	2,200
Total number of active participants reported on line 7a of the Form 5500	2020-12-01	227
Total of all active and inactive participants	2020-12-01	227
Total participants	2020-12-01	227

Form 5500 Responses for WORKBOX STAFFING, LLC ESSENTIAL STAFFCARE

2021: WORKBOX STAFFING, LLC ESSENTIAL STAFFCARE 2021 form 5500 responses
2021-12-01	Type of plan entity	Single employer plan
2021-12-01	Submission has been amended	No
2021-12-01	This submission is the final filing	No
2021-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-12-01	Plan is a collectively bargained plan	No
2021-12-01	Plan funding arrangement – Insurance	Yes
2021-12-01	Plan benefit arrangement – Insurance	Yes
2020: WORKBOX STAFFING, LLC ESSENTIAL STAFFCARE 2020 form 5500 responses
2020-12-01	Type of plan entity	Single employer plan
2020-12-01	First time form 5500 has been submitted	Yes
2020-12-01	Submission has been amended	No
2020-12-01	This submission is the final filing	No
2020-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-12-01	Plan is a collectively bargained plan	No
2020-12-01	Plan funding arrangement – Insurance	Yes
2020-12-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

BCS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 38245 )

Policy contract number

2933100

Policy instance

Insurance contract or identification number	2933100
Number of Individuals Covered	599
Insurance policy start date	2021-11-16
Insurance policy end date	2022-11-15
Total amount of commissions paid to insurance broker	USD $49,778
Total amount of fees paid to insurance company	USD $36,093
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $248,914
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	36093
Additional information about fees paid to insurance broker	FEES PAID

FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 )

Policy contract number

2933100

Policy instance

Insurance contract or identification number	2933100
Number of Individuals Covered	235
Insurance policy start date	2021-11-16
Insurance policy end date	2022-11-15
Total amount of commissions paid to insurance broker	USD $1,829
Total amount of fees paid to insurance company	USD $1,154
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
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	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $7,958
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	1154
Additional information about fees paid to insurance broker	FEES PAID

BCS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 38245 )

Policy contract number

2933100

Policy instance

Insurance contract or identification number	2933100
Number of Individuals Covered	227
Insurance policy start date	2020-11-16
Insurance policy end date	2021-11-15
Total amount of commissions paid to insurance broker	USD $34,854
Total amount of fees paid to insurance company	USD $25,290
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $174,417
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	25290
Additional information about fees paid to insurance broker	FEES

FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 )

Policy contract number

2933100

Policy instance

Insurance contract or identification number	2933100
Number of Individuals Covered	120
Insurance policy start date	2020-11-16
Insurance policy end date	2021-11-15
Total amount of commissions paid to insurance broker	USD $1,005
Total amount of fees paid to insurance company	USD $646
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
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	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $4,458
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	646
Additional information about fees paid to insurance broker	FEES

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Company Name:	WORKBOX STAFFING, LLC
Employer identification number (EIN):	270688056
NAIC Classification:	561300