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EVERIS USA, INC. LIFE & DISABILITY PLANS 401k Plan overview

Plan NameEVERIS USA, INC. LIFE & DISABILITY PLANS
Plan identification number 502

EVERIS USA, INC. LIFE & DISABILITY PLANS Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • 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. LIFE & DISABILITY PLANS

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022020-06-01JOSEPH GREGORY2022-02-24
5022019-06-01JOSEPH GREGORY2020-12-08
5022018-06-01JOSEPH GREGORY2019-11-15
5022017-06-01

Plan Statistics for EVERIS USA, INC. LIFE & DISABILITY PLANS

401k plan membership statisitcs for EVERIS USA, INC. LIFE & DISABILITY PLANS

Measure Date Value
2020: EVERIS USA, INC. LIFE & DISABILITY PLANS 2020 401k membership
Total participants, beginning-of-year2020-06-01120
Total number of active participants reported on line 7a of the Form 55002020-06-0175
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 participants2020-06-0175
Number of employers contributing to the scheme2020-06-010
2019: EVERIS USA, INC. LIFE & DISABILITY PLANS 2019 401k membership
Total participants, beginning-of-year2019-06-01120
Total number of active participants reported on line 7a of the Form 55002019-06-01120
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 participants2019-06-01120
Number of employers contributing to the scheme2019-06-010
2018: EVERIS USA, INC. LIFE & DISABILITY PLANS 2018 401k membership
Total participants, beginning-of-year2018-06-01120
Total number of active participants reported on line 7a of the Form 55002018-06-01120
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 participants2018-06-01120
Number of employers contributing to the scheme2018-06-010
2017: EVERIS USA, INC. LIFE & DISABILITY PLANS 2017 401k membership
Total participants, beginning-of-year2017-06-01120
Total number of active participants reported on line 7a of the Form 55002017-06-01120
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 participants2017-06-01120
Number of employers contributing to the scheme2017-06-010

Form 5500 Responses for EVERIS USA, INC. LIFE & DISABILITY PLANS

2020: EVERIS USA, INC. LIFE & DISABILITY 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. LIFE & DISABILITY 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. LIFE & DISABILITY 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. LIFE & DISABILITY 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

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM607545
Policy instance 1
Insurance contract or identification numberSGM607545
Number of Individuals Covered120
Insurance policy start date2020-06-01
Insurance policy end date2021-05-31
Total amount of commissions paid to insurance brokerUSD $5,880
Total amount of fees paid to insurance companyUSD $3,729
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $59,186
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $5,880
Amount paid for insurance broker fees2959
Additional information about fees paid to insurance brokerSALES AND SERVICE
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM607545
Policy instance 1
Insurance contract or identification numberSGM607545
Number of Individuals Covered120
Insurance policy start date2019-06-01
Insurance policy end date2020-05-31
Total amount of commissions paid to insurance brokerUSD $8,134
Total amount of fees paid to insurance companyUSD $4,067
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $81,337
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $8,134
Amount paid for insurance broker fees4067
Additional information about fees paid to insurance brokerSALES AND SERVICE
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM607545
Policy instance 1
Insurance contract or identification numberSGM607545
Number of Individuals Covered120
Insurance policy start date2018-06-01
Insurance policy end date2019-05-31
Total amount of commissions paid to insurance brokerUSD $7,020
Total amount of fees paid to insurance companyUSD $3,552
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $71,041
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $7,020
Amount paid for insurance broker fees3552
Additional information about fees paid to insurance brokerSALES AND SERVICE
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM607545
Policy instance 1
Insurance contract or identification numberSGM607545
Number of Individuals Covered120
Insurance policy start date2017-06-01
Insurance policy end date2018-05-31
Total amount of commissions paid to insurance brokerUSD $6,220
Total amount of fees paid to insurance companyUSD $4,409
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $62,200
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $6,220
Amount paid for insurance broker fees4409
Additional information about fees paid to insurance brokerSALES AND SERVICE OVERRIDES
Insurance broker organization code?3
Insurance broker nameKELLY AND ASSOCIATES INS GROUP, INC

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