401k Plan data: SSI LIFE AND AD&D PLAN plan

SSI LIFE AND AD&D PLAN 401k Plan overview

Plan Name	SSI LIFE AND AD&D PLAN
Plan identification number	502

SSI LIFE AND AD&D PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

SATELLITE SERVICES INC has sponsored the creation of one or more 401k plans.

Company Name: SATELLITE SERVICES INC

Employer identification number (EIN): 382380703

NAIC Classification: 561210
NAIC Description: Facilities Support Services

Additional information about SATELLITE SERVICES INC

Jurisdiction of Incorporation: Nevada Department of State

Incorporation Date: 2001-11-28

Company Identification Number: 20011488500

Legal Registered Office Address: 5605 RIGGINS CT STE 200

RENO
United States of America (USA)
89502

More information about SATELLITE SERVICES INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SSI LIFE AND AD&D PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2016-10-01
502 2016-10-01 JULI A. DUPRAS 2019-01-10
502 2015-10-01 JULI DUPRAS
502 2014-10-01 JULI DUPRAS
502 2013-10-01 JULI DUPRAS JULI DUPRAS 2015-02-18
502 2012-10-01 JULI DUPRAS JULI DUPRAS 2014-03-21

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
502	2016-10-01
502	2016-10-01	JULI A. DUPRAS	2019-01-10
502	2015-10-01	JULI DUPRAS
502	2014-10-01	JULI DUPRAS
502	2013-10-01	JULI DUPRAS		JULI DUPRAS	2015-02-18
502	2012-10-01	JULI DUPRAS		JULI DUPRAS	2014-03-21

Plan Statistics for SSI LIFE AND AD&D PLAN

401k plan membership statisitcs for SSI LIFE AND AD&D PLAN

Measure Date Value
2016: SSI LIFE AND AD&D PLAN 2016 401k membership
Total participants, beginning-of-year 2016-10-01 129
Total number of active participants reported on line 7a of the Form 5500 2016-10-01 125
Number of retired or separated participants receiving benefits 2016-10-01 0
Number of other retired or separated participants entitled to future benefits 2016-10-01 0
Total of all active and inactive participants 2016-10-01 125
2015: SSI LIFE AND AD&D PLAN 2015 401k membership
Total participants, beginning-of-year 2015-10-01 137
Total number of active participants reported on line 7a of the Form 5500 2015-10-01 129
Number of retired or separated participants receiving benefits 2015-10-01 0
Number of other retired or separated participants entitled to future benefits 2015-10-01 0
Total of all active and inactive participants 2015-10-01 129
Total participants 2015-10-01 129
2014: SSI LIFE AND AD&D PLAN 2014 401k membership
Total participants, beginning-of-year 2014-10-01 168
Total number of active participants reported on line 7a of the Form 5500 2014-10-01 137
Total of all active and inactive participants 2014-10-01 137
Total participants 2014-10-01 137
2013: SSI LIFE AND AD&D PLAN 2013 401k membership
Total participants, beginning-of-year 2013-10-01 154
Total number of active participants reported on line 7a of the Form 5500 2013-10-01 168
Total of all active and inactive participants 2013-10-01 168
Total participants 2013-10-01 168
2012: SSI LIFE AND AD&D PLAN 2012 401k membership
Total participants, beginning-of-year 2012-10-01 135
Total number of active participants reported on line 7a of the Form 5500 2012-10-01 154
Total of all active and inactive participants 2012-10-01 154
Total participants 2012-10-01 154

Measure	Date	Value
2016: SSI LIFE AND AD&D PLAN 2016 401k membership
Total participants, beginning-of-year	2016-10-01	129
Total number of active participants reported on line 7a of the Form 5500	2016-10-01	125
Number of retired or separated participants receiving benefits	2016-10-01	0
Number of other retired or separated participants entitled to future benefits	2016-10-01	0
Total of all active and inactive participants	2016-10-01	125
2015: SSI LIFE AND AD&D PLAN 2015 401k membership
Total participants, beginning-of-year	2015-10-01	137
Total number of active participants reported on line 7a of the Form 5500	2015-10-01	129
Number of retired or separated participants receiving benefits	2015-10-01	0
Number of other retired or separated participants entitled to future benefits	2015-10-01	0
Total of all active and inactive participants	2015-10-01	129
Total participants	2015-10-01	129
2014: SSI LIFE AND AD&D PLAN 2014 401k membership
Total participants, beginning-of-year	2014-10-01	168
Total number of active participants reported on line 7a of the Form 5500	2014-10-01	137
Total of all active and inactive participants	2014-10-01	137
Total participants	2014-10-01	137
2013: SSI LIFE AND AD&D PLAN 2013 401k membership
Total participants, beginning-of-year	2013-10-01	154
Total number of active participants reported on line 7a of the Form 5500	2013-10-01	168
Total of all active and inactive participants	2013-10-01	168
Total participants	2013-10-01	168
2012: SSI LIFE AND AD&D PLAN 2012 401k membership
Total participants, beginning-of-year	2012-10-01	135
Total number of active participants reported on line 7a of the Form 5500	2012-10-01	154
Total of all active and inactive participants	2012-10-01	154
Total participants	2012-10-01	154

Form 5500 Responses for SSI LIFE AND AD&D PLAN

2016: SSI LIFE AND AD&D PLAN 2016 form 5500 responses
2016-10-01	Type of plan entity	Single employer plan
2016-10-01	Submission has been amended	No
2016-10-01	This submission is the final filing	No
2016-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-10-01	Plan is a collectively bargained plan	No
2016-10-01	Plan funding arrangement – Insurance	Yes
2016-10-01	Plan benefit arrangement – Insurance	Yes
2015: SSI LIFE AND AD&D PLAN 2015 form 5500 responses
2015-10-01	Type of plan entity	Single employer plan
2015-10-01	Submission has been amended	No
2015-10-01	This submission is the final filing	No
2015-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-10-01	Plan is a collectively bargained plan	No
2015-10-01	Plan funding arrangement – Insurance	Yes
2015-10-01	Plan benefit arrangement – Insurance	Yes
2014: SSI LIFE AND AD&D PLAN 2014 form 5500 responses
2014-10-01	Type of plan entity	Single employer plan
2014-10-01	Submission has been amended	No
2014-10-01	This submission is the final filing	No
2014-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-10-01	Plan is a collectively bargained plan	No
2014-10-01	Plan funding arrangement – Insurance	Yes
2014-10-01	Plan benefit arrangement – Insurance	Yes
2013: SSI LIFE AND AD&D PLAN 2013 form 5500 responses
2013-10-01	Type of plan entity	Single employer plan
2013-10-01	Submission has been amended	No
2013-10-01	This submission is the final filing	No
2013-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-10-01	Plan is a collectively bargained plan	No
2013-10-01	Plan funding arrangement – Insurance	Yes
2013-10-01	Plan benefit arrangement – Insurance	Yes
2012: SSI LIFE AND AD&D PLAN 2012 form 5500 responses
2012-10-01	Type of plan entity	Single employer plan
2012-10-01	First time form 5500 has been submitted	Yes
2012-10-01	Submission has been amended	No
2012-10-01	This submission is the final filing	No
2012-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-10-01	Plan is a collectively bargained plan	No
2012-10-01	Plan funding arrangement – Insurance	Yes
2012-10-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

MADISON NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65781 )

Policy contract number

6833 MNL

Policy instance

Insurance contract or identification number	6833 MNL
Number of Individuals Covered	129
Insurance policy start date	2015-10-01
Insurance policy end date	2016-09-30
Total amount of commissions paid to insurance broker	USD $359
Total amount of fees paid to insurance company	USD $557
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	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
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 $3,594
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $359
Amount paid for insurance broker fees	557
Additional information about fees paid to insurance broker	PREFERRED BROKER COMPENSATION
Insurance broker organization code?	3
Insurance broker name	CRAFORD BENEFIT CONSULTANTS

MADISON NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65781 )

Policy contract number

6833 MNL

Policy instance

Insurance contract or identification number	6833 MNL
Number of Individuals Covered	137
Insurance policy start date	2014-10-01
Insurance policy end date	2015-09-30
Total amount of commissions paid to insurance broker	USD $425
Total amount of fees paid to insurance company	USD $658
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	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL & 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 $4,247
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $425
Amount paid for insurance broker fees	658
Additional information about fees paid to insurance broker	PREFERRED BROKER COMPENSATION
Insurance broker organization code?	3
Insurance broker name	CRAFORD BENEFIT CONSULTANTS

FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 )

Policy contract number

6833-4EL

Policy instance

Insurance contract or identification number	6833-4EL
Number of Individuals Covered	168
Insurance policy start date	2013-10-01
Insurance policy end date	2014-09-30
Total amount of commissions paid to insurance broker	USD $340
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	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
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 $3,395
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $340
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	CRAFORD BENEFIT CONSULTANTS

FOUR EVER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80985 )

Policy contract number

6833-4EL

Policy instance

Insurance contract or identification number	6833-4EL
Number of Individuals Covered	154
Insurance policy start date	2012-10-01
Insurance policy end date	2013-09-30
Total amount of commissions paid to insurance broker	USD $307
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	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
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 $3,073
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $307
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	CRAFORD BENEFIT CONSULTANTS

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Company Name:	SATELLITE SERVICES INC
Employer identification number (EIN):	382380703
NAIC Classification:	561210
NAIC Description:	Facilities Support Services

Jurisdiction of Incorporation:	Nevada Department of State
Incorporation Date:	2001-11-28
Company Identification Number:	20011488500
Legal Registered Office Address:	5605 RIGGINS CT STE 200 RENO United States of America (USA) 89502