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VERACITY WORKSITE WELFARE BENEFIT PLAN 401k Plan overview

Plan NameVERACITY WORKSITE WELFARE BENEFIT PLAN
Plan identification number 504

VERACITY WORKSITE WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare 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)

401k Sponsoring company profile

VERACITY NETWORKS has sponsored the creation of one or more 401k plans.

Company Name:VERACITY NETWORKS
Employer identification number (EIN):271137395
NAIC Classification:517000

Additional information about VERACITY NETWORKS

Jurisdiction of Incorporation: Colorado Department of State
Incorporation Date: 2009-05-26
Company Identification Number: 20091286981
Legal Registered Office Address: 2298 East 109th Pl

Northglenn
United States of America (USA)
80233

More information about VERACITY NETWORKS

Form 5500 Filing Information

Submission information for form 5500 for 401k plan VERACITY WORKSITE WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042018-01-01CHRISTINA JACKSON2019-09-17
5042017-01-01
5042016-01-01

Plan Statistics for VERACITY WORKSITE WELFARE BENEFIT PLAN

401k plan membership statisitcs for VERACITY WORKSITE WELFARE BENEFIT PLAN

Measure Date Value
2018: VERACITY WORKSITE WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01126
Total number of active participants reported on line 7a of the Form 55002018-01-01115
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01115
Number of employers contributing to the scheme2018-01-010
2017: VERACITY WORKSITE WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01126
Total number of active participants reported on line 7a of the Form 55002017-01-01126
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01126
2016: VERACITY WORKSITE WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01114
Total number of active participants reported on line 7a of the Form 55002016-01-01126
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01126

Form 5500 Responses for VERACITY WORKSITE WELFARE BENEFIT PLAN

2018: VERACITY WORKSITE WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: VERACITY WORKSITE WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: VERACITY WORKSITE WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01First time form 5500 has been submittedYes
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )
Policy contract number12007391
Policy instance 2
Insurance contract or identification number12007391
Number of Individuals Covered81
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $503
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,647
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $503
Amount paid for insurance broker fees0
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3484722
Policy instance 3
Insurance contract or identification numberE3484722
Number of Individuals Covered20
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $4,778
Total amount of fees paid to insurance companyUSD $206
Other welfare benefits providedACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $26,584
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,539
Amount paid for insurance broker fees128
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGD608445
Policy instance 4
Insurance contract or identification numberSGD608445
Number of Individuals Covered115
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $4,029
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $40,293
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $4,029
Amount paid for insurance broker fees0
Insurance broker organization code?3
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 )
Policy contract numberE3484722
Policy instance 1
Insurance contract or identification numberE3484722
Number of Individuals Covered23
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $6,584
Total amount of fees paid to insurance companyUSD $1,279
Other welfare benefits providedCRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $25,953
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,466
Amount paid for insurance broker fees1157
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameDESIREE ROBERTSON
ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 )
Policy contract number12007391
Policy instance 3
Insurance contract or identification number12007391
Number of Individuals Covered85
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,322
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGD608445
Policy instance 4
Insurance contract or identification numberSGD608445
Number of Individuals Covered126
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $3,799
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $37,991
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $3,799
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameSPECTRA MANAGEMENT, LLC

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