401k Plan data: plan

Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

NTI CONNECT, LLC has sponsored the creation of one or more 401k plans.

Company Name: NTI CONNECT, LLC

Employer identification number (EIN): 364816010

NAIC Classification: 237100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-01-01 LAYNA HEUBEL 2024-07-24
501 2022-12-01 CRISTINA VILLAZAN 2023-06-27
501 2021-12-01 CRISTY VILLAZAN 2023-06-30
501 2020-12-01 EILEEN SNICK 2022-05-12
501 2019-12-01 EILEEN SNICK 2021-09-12

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2023-01-01	LAYNA HEUBEL	2024-07-24
501	2022-12-01	CRISTINA VILLAZAN	2023-06-27
501	2021-12-01	CRISTY VILLAZAN	2023-06-30
501	2020-12-01	EILEEN SNICK	2022-05-12
501	2019-12-01	EILEEN SNICK	2021-09-12

Plan Statistics for

401k plan membership statisitcs for

Measure Date Value
2023: 2023 401k membership
Total participants, beginning-of-year 2023-01-01 753
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 700
Number of retired or separated participants receiving benefits 2023-01-01 11
Number of other retired or separated participants entitled to future benefits 2023-01-01 0
Total of all active and inactive participants 2023-01-01 711
Number of employers contributing to the scheme 2023-01-01 0
2022: 2022 401k membership
Total participants, beginning-of-year 2022-12-01 339
Total number of active participants reported on line 7a of the Form 5500 2022-12-01 743
Number of retired or separated participants receiving benefits 2022-12-01 10
Number of other retired or separated participants entitled to future benefits 2022-12-01 0
Total of all active and inactive participants 2022-12-01 753
Number of employers contributing to the scheme 2022-12-01 0
2021: 2021 401k membership
Total participants, beginning-of-year 2021-12-01 331
Total number of active participants reported on line 7a of the Form 5500 2021-12-01 337
Number of retired or separated participants receiving benefits 2021-12-01 2
Number of other retired or separated participants entitled to future benefits 2021-12-01 0
Total of all active and inactive participants 2021-12-01 339
Number of employers contributing to the scheme 2021-12-01 0
2020: 2020 401k membership
Total participants, beginning-of-year 2020-12-01 162
Total number of active participants reported on line 7a of the Form 5500 2020-12-01 329
Number of retired or separated participants receiving benefits 2020-12-01 0
Number of other retired or separated participants entitled to future benefits 2020-12-01 0
Total of all active and inactive participants 2020-12-01 329
Number of employers contributing to the scheme 2020-12-01 0
2019: 2019 401k membership
Total participants, beginning-of-year 2019-12-01 150
Total number of active participants reported on line 7a of the Form 5500 2019-12-01 162
Number of retired or separated participants receiving benefits 2019-12-01 0
Number of other retired or separated participants entitled to future benefits 2019-12-01 0
Total of all active and inactive participants 2019-12-01 162
Number of employers contributing to the scheme 2019-12-01 0

Measure	Date	Value
2023: 2023 401k membership
Total participants, beginning-of-year	2023-01-01	753
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	700
Number of retired or separated participants receiving benefits	2023-01-01	11
Number of other retired or separated participants entitled to future benefits	2023-01-01	0
Total of all active and inactive participants	2023-01-01	711
Number of employers contributing to the scheme	2023-01-01	0
2022: 2022 401k membership
Total participants, beginning-of-year	2022-12-01	339
Total number of active participants reported on line 7a of the Form 5500	2022-12-01	743
Number of retired or separated participants receiving benefits	2022-12-01	10
Number of other retired or separated participants entitled to future benefits	2022-12-01	0
Total of all active and inactive participants	2022-12-01	753
Number of employers contributing to the scheme	2022-12-01	0
2021: 2021 401k membership
Total participants, beginning-of-year	2021-12-01	331
Total number of active participants reported on line 7a of the Form 5500	2021-12-01	337
Number of retired or separated participants receiving benefits	2021-12-01	2
Number of other retired or separated participants entitled to future benefits	2021-12-01	0
Total of all active and inactive participants	2021-12-01	339
Number of employers contributing to the scheme	2021-12-01	0
2020: 2020 401k membership
Total participants, beginning-of-year	2020-12-01	162
Total number of active participants reported on line 7a of the Form 5500	2020-12-01	329
Number of retired or separated participants receiving benefits	2020-12-01	0
Number of other retired or separated participants entitled to future benefits	2020-12-01	0
Total of all active and inactive participants	2020-12-01	329
Number of employers contributing to the scheme	2020-12-01	0
2019: 2019 401k membership
Total participants, beginning-of-year	2019-12-01	150
Total number of active participants reported on line 7a of the Form 5500	2019-12-01	162
Number of retired or separated participants receiving benefits	2019-12-01	0
Number of other retired or separated participants entitled to future benefits	2019-12-01	0
Total of all active and inactive participants	2019-12-01	162
Number of employers contributing to the scheme	2019-12-01	0

Form 5500 Responses for

2023: 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2022: 2022 form 5500 responses
2022-12-01	Type of plan entity	Single employer plan
2022-12-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2022-12-01	Plan funding arrangement – Insurance	Yes
2022-12-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-12-01	Plan benefit arrangement – Insurance	Yes
2022-12-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: 2021 form 5500 responses
2021-12-01	Type of plan entity	Single employer plan
2021-12-01	Plan funding arrangement – Insurance	Yes
2021-12-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-12-01	Plan benefit arrangement – Insurance	Yes
2021-12-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: 2020 form 5500 responses
2020-12-01	Type of plan entity	Single employer plan
2020-12-01	Plan funding arrangement – Insurance	Yes
2020-12-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-12-01	Plan benefit arrangement – Insurance	Yes
2020-12-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: 2019 form 5500 responses
2019-12-01	Type of plan entity	Single employer plan
2019-12-01	Plan funding arrangement – Insurance	Yes
2019-12-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-12-01	Plan benefit arrangement – Insurance	Yes
2019-12-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

169575

Policy instance

Insurance contract or identification number	169575
Number of Individuals Covered	712
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $36,374
Total amount of fees paid to insurance company	USD $12,356
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	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

892404G

Policy instance

Insurance contract or identification number	892404G
Number of Individuals Covered	304
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $41,877
Total amount of fees paid to insurance company	USD $4,272
Other welfare benefits provided	ACCIDENT, CRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to Carrier	USD $209,386
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

299508

Policy instance

Insurance contract or identification number	299508
Number of Individuals Covered	1042
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $152,613
Total amount of fees paid to insurance company	USD $50,036
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $5,093,731
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

10347521001

Policy instance

Insurance contract or identification number	10347521001
Number of Individuals Covered	990
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $6,962
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $69,506
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5392283

Policy instance

Insurance contract or identification number	5392283
Number of Individuals Covered	1052
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $37,423
Total amount of fees paid to insurance company	USD $7,660
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $369,701
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

10347521001

Policy instance

Insurance contract or identification number	10347521001
Number of Individuals Covered	1032
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $6,349
Total amount of fees paid to insurance company	USD $0
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
Welfare Benefit Premiums Paid to Carrier	USD $69,232
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

169575

Policy instance

Insurance contract or identification number	169575
Number of Individuals Covered	732
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $67,302
Total amount of fees paid to insurance company	USD $15,704
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	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

3344726

Policy instance

Insurance contract or identification number	3344726
Number of Individuals Covered	563
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $257,823
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $4,707,622
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5392283

Policy instance

Insurance contract or identification number	5392283
Number of Individuals Covered	1114
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $33,924
Total amount of fees paid to insurance company	USD $4,354
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $377,910
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

239631

Policy instance

DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )

Policy contract number

F025073

Policy instance

DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )

Policy contract number

F025073

Policy instance

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

239631

Policy instance

NEW BENEFITS LTD TELADOC HEALTH ADVOCATE AND UNITED HEALTHCARE GLO (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

6008BG

Policy instance

DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )

Policy contract number

F025073

Policy instance

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

5374714

Policy instance

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

239631

Policy instance

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Company Name:	NTI CONNECT, LLC
Employer identification number (EIN):	364816010
NAIC Classification:	237100