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EVERIS USA, INC. HEALTH & WELFARE PLANS 401k Plan overview

Plan NameEVERIS USA, INC. HEALTH & WELFARE PLANS
Plan identification number 501

EVERIS USA, INC. HEALTH & WELFARE PLANS Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Vision
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

NTT DATA EUROPE & LATAM, BRANCH IN USA, INC. has sponsored the creation of one or more 401k plans.

Company Name:NTT DATA EUROPE & LATAM, BRANCH IN USA, INC.
Employer identification number (EIN):272702152
NAIC Classification:541600

Additional information about NTT DATA EUROPE & LATAM, BRANCH IN USA, INC.

Jurisdiction of Incorporation: Virginia Secretary of State
Incorporation Date: 2010-11-10
Company Identification Number: F184175
Legal Registered Office Address: 4100 NORTH FAIRFAX DRIVE
SUITE 810
ARLINGTON
United States of America (USA)
22203

More information about NTT DATA EUROPE & LATAM, BRANCH IN USA, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EVERIS USA, INC. HEALTH & WELFARE PLANS

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012020-06-01JOSEPH GREGORY2022-02-24
5012019-06-01JOSEPH GREGORY2020-12-08
5012018-06-01JOSEPH GREGORY2019-11-15
5012017-06-01

Plan Statistics for EVERIS USA, INC. HEALTH & WELFARE PLANS

401k plan membership statisitcs for EVERIS USA, INC. HEALTH & WELFARE PLANS

Measure Date Value
2020: EVERIS USA, INC. HEALTH & WELFARE PLANS 2020 401k membership
Total participants, beginning-of-year2020-06-01129
Total number of active participants reported on line 7a of the Form 55002020-06-0173
Number of retired or separated participants receiving benefits2020-06-010
Number of other retired or separated participants entitled to future benefits2020-06-010
Total of all active and inactive participants2020-06-0173
Number of employers contributing to the scheme2020-06-010
2019: EVERIS USA, INC. HEALTH & WELFARE PLANS 2019 401k membership
Total participants, beginning-of-year2019-06-01126
Total number of active participants reported on line 7a of the Form 55002019-06-01129
Number of retired or separated participants receiving benefits2019-06-010
Number of other retired or separated participants entitled to future benefits2019-06-010
Total of all active and inactive participants2019-06-01129
Number of employers contributing to the scheme2019-06-010
2018: EVERIS USA, INC. HEALTH & WELFARE PLANS 2018 401k membership
Total participants, beginning-of-year2018-06-01111
Total number of active participants reported on line 7a of the Form 55002018-06-01126
Number of retired or separated participants receiving benefits2018-06-010
Number of other retired or separated participants entitled to future benefits2018-06-010
Total of all active and inactive participants2018-06-01126
Number of employers contributing to the scheme2018-06-010
2017: EVERIS USA, INC. HEALTH & WELFARE PLANS 2017 401k membership
Total participants, beginning-of-year2017-06-01111
Total number of active participants reported on line 7a of the Form 55002017-06-01111
Number of retired or separated participants receiving benefits2017-06-010
Number of other retired or separated participants entitled to future benefits2017-06-010
Total of all active and inactive participants2017-06-01111
Number of employers contributing to the scheme2017-06-010

Form 5500 Responses for EVERIS USA, INC. HEALTH & WELFARE PLANS

2020: EVERIS USA, INC. HEALTH & WELFARE PLANS 2020 form 5500 responses
2020-06-01Type of plan entitySingle employer plan
2020-06-01Plan funding arrangement – InsuranceYes
2020-06-01Plan benefit arrangement – InsuranceYes
2019: EVERIS USA, INC. HEALTH & WELFARE PLANS 2019 form 5500 responses
2019-06-01Type of plan entitySingle employer plan
2019-06-01Plan funding arrangement – InsuranceYes
2019-06-01Plan benefit arrangement – InsuranceYes
2018: EVERIS USA, INC. HEALTH & WELFARE PLANS 2018 form 5500 responses
2018-06-01Type of plan entitySingle employer plan
2018-06-01Plan funding arrangement – InsuranceYes
2018-06-01Plan benefit arrangement – InsuranceYes
2017: EVERIS USA, INC. HEALTH & WELFARE PLANS 2017 form 5500 responses
2017-06-01Type of plan entitySingle employer plan
2017-06-01First time form 5500 has been submittedYes
2017-06-01Plan funding arrangement – InsuranceYes
2017-06-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3339879
Policy instance 1
Insurance contract or identification number3339879
Number of Individuals Covered73
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $6,214
Total amount of fees paid to insurance companyUSD $78,647
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,356,465
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,214
Amount paid for insurance broker fees49209
Additional information about fees paid to insurance brokerBENEFIT ADVISOR PAYMENTS
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3339879
Policy instance 1
Insurance contract or identification number3339879
Number of Individuals Covered129
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $7,601
Total amount of fees paid to insurance companyUSD $95,455
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,662,925
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,601
Amount paid for insurance broker fees60055
Additional information about fees paid to insurance brokerBENEFIT ADVISOR PAYMENTS
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3339879
Policy instance 1
Insurance contract or identification number3339879
Number of Individuals Covered126
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $7,283
Total amount of fees paid to insurance companyUSD $85,663
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,493,522
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,283
Amount paid for insurance broker fees53688
Additional information about fees paid to insurance brokerBENEFIT ADVISOR PAYMENTS
Insurance broker organization code?3
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number3339879
Policy instance 1
Insurance contract or identification number3339879
Number of Individuals Covered111
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $6,284
Total amount of fees paid to insurance companyUSD $75,697
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,206,089
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,284
Amount paid for insurance broker fees49814
Additional information about fees paid to insurance brokerBENEFIT ADVISOR PAYMENTS GENERAL AGENT PAYMENTS
Insurance broker organization code?3
Insurance broker nameKELLY AND ASSOCIATES INS GROUP, INC

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