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| Plan Name | SIERRA7, INC. MEDICAL, DENTAL & VISION PLAN |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | SIERRA7, INC. |
| Employer identification number (EIN): | 271269572 |
| NAIC Classification: | 541519 |
| NAIC Description: | Other Computer Related Services |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2021-01-01 | FRANK RENDON | 2022-05-23 | ||
| 502 | 2020-04-01 | FRANK RENDON | 2021-06-18 |
| Measure | Date | Value |
|---|---|---|
| 2021: SIERRA7, INC. MEDICAL, DENTAL & VISION PLAN 2021 401k membership | ||
| Total participants, beginning-of-year | 2021-01-01 | 297 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 163 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
| Total of all active and inactive participants | 2021-01-01 | 165 |
| Number of employers contributing to the scheme | 2021-01-01 | 0 |
| 2020: SIERRA7, INC. MEDICAL, DENTAL & VISION PLAN 2020 401k membership | ||
| Total participants, beginning-of-year | 2020-04-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-04-01 | 297 |
| Number of retired or separated participants receiving benefits | 2020-04-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-04-01 | 0 |
| Total of all active and inactive participants | 2020-04-01 | 297 |
| Number of employers contributing to the scheme | 2020-04-01 | 0 |
| 2021: SIERRA7, INC. MEDICAL, DENTAL & VISION PLAN 2021 form 5500 responses | ||
|---|---|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: SIERRA7, INC. MEDICAL, DENTAL & VISION PLAN 2020 form 5500 responses | ||
| 2020-04-01 | Type of plan entity | Single employer plan |
| 2020-04-01 | First time form 5500 has been submitted | Yes |
| 2020-04-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2020-04-01 | Plan funding arrangement – Insurance | Yes |
| 2020-04-01 | Plan benefit arrangement – Insurance | Yes |
| GHMSI (National Association of Insurance Commissioners NAIC id number: 53007 ) | |||||||||||||||||||||||||||||||
| Policy contract number | 2KA7 | ||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||
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| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |||||||||||||||||||||||||||||||
| Policy contract number | 5F3091 | ||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||
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