401k Plan data: DORAN MANAGEMENT, LLC LIFE AND DISABILITY PLAN plan

DORAN MANAGEMENT, LLC LIFE AND DISABILITY PLAN 401k Plan overview

Plan Name	DORAN MANAGEMENT, LLC LIFE AND DISABILITY PLAN
Plan identification number	502

DORAN MANAGEMENT, LLC LIFE AND DISABILITY PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

DORAN MANAGEMENT, LLC has sponsored the creation of one or more 401k plans.

Company Name: DORAN MANAGEMENT, LLC

Employer identification number (EIN): 274347581

NAIC Classification: 531310

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DORAN MANAGEMENT, LLC LIFE AND DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2020-07-01 JEANNINE EDGREN 2022-07-13

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
502	2020-07-01	JEANNINE EDGREN	2022-07-13

Plan Statistics for DORAN MANAGEMENT, LLC LIFE AND DISABILITY PLAN

401k plan membership statisitcs for DORAN MANAGEMENT, LLC LIFE AND DISABILITY PLAN

Measure Date Value
2020: DORAN MANAGEMENT, LLC LIFE AND DISABILITY PLAN 2020 401k membership
Total participants, beginning-of-year 2020-07-01 101
Total number of active participants reported on line 7a of the Form 5500 2020-07-01 0
Number of retired or separated participants receiving benefits 2020-07-01 0
Number of other retired or separated participants entitled to future benefits 2020-07-01 0
Total of all active and inactive participants 2020-07-01 0

Measure	Date	Value
2020: DORAN MANAGEMENT, LLC LIFE AND DISABILITY PLAN 2020 401k membership
Total participants, beginning-of-year	2020-07-01	101
Total number of active participants reported on line 7a of the Form 5500	2020-07-01	0
Number of retired or separated participants receiving benefits	2020-07-01	0
Number of other retired or separated participants entitled to future benefits	2020-07-01	0
Total of all active and inactive participants	2020-07-01	0

Form 5500 Responses for DORAN MANAGEMENT, LLC LIFE AND DISABILITY PLAN

2020: DORAN MANAGEMENT, LLC LIFE AND DISABILITY PLAN 2020 form 5500 responses
2020-07-01	Type of plan entity	Single employer plan
2020-07-01	First time form 5500 has been submitted	Yes
2020-07-01	Submission has been amended	No
2020-07-01	This submission is the final filing	Yes
2020-07-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2020-07-01	Plan is a collectively bargained plan	No
2020-07-01	Plan funding arrangement – Insurance	Yes
2020-07-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-07-01	Plan benefit arrangement – Insurance	Yes
2020-07-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

G000BR87

Policy instance

Insurance contract or identification number	G000BR87
Number of Individuals Covered	112
Insurance policy start date	2020-07-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $2,213
Total amount of fees paid to insurance company	USD $0
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	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
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 $15,379
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,213
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3

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Company Name:	DORAN MANAGEMENT, LLC
Employer identification number (EIN):	274347581
NAIC Classification:	531310