401k Plan data: COLLABORATIVE SOLUTIONS, LLC VISION PLAN plan

COLLABORATIVE SOLUTIONS, LLC VISION PLAN 401k Plan overview

Plan Name	COLLABORATIVE SOLUTIONS, LLC VISION PLAN
Plan identification number	504

COLLABORATIVE SOLUTIONS, LLC VISION PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Vision

401k Sponsoring company profile

COLLABORATIVE SOLUTIONS, LLC has sponsored the creation of one or more 401k plans.

Company Name: COLLABORATIVE SOLUTIONS, LLC

Employer identification number (EIN): 320073742

NAIC Classification: 541600

Additional information about COLLABORATIVE SOLUTIONS, LLC

Jurisdiction of Incorporation: California Department of State

Incorporation Date:

Company Identification Number: 201306310185

More information about COLLABORATIVE SOLUTIONS, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COLLABORATIVE SOLUTIONS, LLC VISION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
504 2017-01-01
504 2016-01-01 BONNIE DOWLER
504 2015-01-01 BONNIE DOWLER
504 2014-01-01 BONNIE DOWLER BONNIE DOWLER 2015-10-14

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
504	2017-01-01
504	2016-01-01	BONNIE DOWLER
504	2015-01-01	BONNIE DOWLER
504	2014-01-01	BONNIE DOWLER	BONNIE DOWLER	2015-10-14

Plan Statistics for COLLABORATIVE SOLUTIONS, LLC VISION PLAN

401k plan membership statisitcs for COLLABORATIVE SOLUTIONS, LLC VISION PLAN

Measure Date Value
2017: COLLABORATIVE SOLUTIONS, LLC VISION PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 323
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 0
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 0
2016: COLLABORATIVE SOLUTIONS, LLC VISION PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 246
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 148
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 148
2015: COLLABORATIVE SOLUTIONS, LLC VISION PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 149
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 246
Total of all active and inactive participants 2015-01-01 246
2014: COLLABORATIVE SOLUTIONS, LLC VISION PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 111
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 149
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 149

Measure	Date	Value
2017: COLLABORATIVE SOLUTIONS, LLC VISION PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	323
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	0
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	0
2016: COLLABORATIVE SOLUTIONS, LLC VISION PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	246
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	148
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	148
2015: COLLABORATIVE SOLUTIONS, LLC VISION PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	149
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	246
Total of all active and inactive participants	2015-01-01	246
2014: COLLABORATIVE SOLUTIONS, LLC VISION PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	111
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	149
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	149

Form 5500 Responses for COLLABORATIVE SOLUTIONS, LLC VISION PLAN

2017: COLLABORATIVE SOLUTIONS, LLC VISION PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	This submission is the final filing	Yes
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: COLLABORATIVE SOLUTIONS, LLC VISION PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: COLLABORATIVE SOLUTIONS, LLC VISION PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: COLLABORATIVE SOLUTIONS, LLC VISION PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	First time form 5500 has been submitted	Yes
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )

Policy contract number

30032303

Policy instance

Insurance contract or identification number	30032303
Number of Individuals Covered	344
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $3,988
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $45,461
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,240
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	ALLIANT INSURANCE SERVICES, INC.

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )

Policy contract number

30032303

Policy instance

Insurance contract or identification number	30032303
Number of Individuals Covered	246
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $2,594
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $25,722
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $950
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	ALLIANT INSURANCE SERVICES, INC

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )

Policy contract number

30032303

Policy instance

Insurance contract or identification number	30032303
Number of Individuals Covered	149
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $184
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 $18,637
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $184
Insurance broker organization code?	3
Insurance broker name	CORPORATE SYNERGIES GROUP LLC

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Company Name:	COLLABORATIVE SOLUTIONS, LLC
Employer identification number (EIN):	320073742
NAIC Classification:	541600

Jurisdiction of Incorporation:	California Department of State
Incorporation Date:
Company Identification Number:	201306310185