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| Plan Name | TRIVIUM LIFE SERVICES VISION BENEFIT PLAN |
| Plan identification number | 503 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | TRIVIUM LIFE SERVICES |
| Employer identification number (EIN): | 421041046 |
| NAIC Classification: | 624100 |
| NAIC Description: | Individual and Family Services |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 503 | 2022-07-01 | ||||
| 503 | 2022-07-01 | ||||
| 503 | 2012-07-01 | ||||
| 503 | 2011-07-01 |
| Measure | Date | Value |
|---|---|---|
| 2022: TRIVIUM LIFE SERVICES VISION BENEFIT PLAN 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-07-01 | 138 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-07-01 | 0 |
| Number of retired or separated participants receiving benefits | 2022-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-07-01 | 0 |
| Total of all active and inactive participants | 2022-07-01 | 0 |
| 2012: TRIVIUM LIFE SERVICES VISION BENEFIT PLAN 2012 401k membership | ||
| Total participants, beginning-of-year | 2012-07-01 | 119 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-07-01 | 0 |
| Number of retired or separated participants receiving benefits | 2012-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2012-07-01 | 0 |
| Total of all active and inactive participants | 2012-07-01 | 0 |
| 2011: TRIVIUM LIFE SERVICES VISION BENEFIT PLAN 2011 401k membership | ||
| Total participants, beginning-of-year | 2011-07-01 | 119 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-07-01 | 119 |
| Number of retired or separated participants receiving benefits | 2011-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2011-07-01 | 0 |
| Total of all active and inactive participants | 2011-07-01 | 119 |
| 2022: TRIVIUM LIFE SERVICES VISION BENEFIT PLAN 2022 form 5500 responses | ||
|---|---|---|
| 2022-07-01 | Type of plan entity | Single employer plan |
| 2022-07-01 | First time form 5500 has been submitted | Yes |
| 2022-07-01 | Submission has been amended | No |
| 2022-07-01 | This submission is the final filing | Yes |
| 2022-07-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2022-07-01 | Plan is a collectively bargained plan | No |
| 2022-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: TRIVIUM LIFE SERVICES VISION BENEFIT PLAN 2012 form 5500 responses | ||
| 2012-07-01 | Type of plan entity | Single employer plan |
| 2012-07-01 | Submission has been amended | No |
| 2012-07-01 | This submission is the final filing | Yes |
| 2012-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-07-01 | Plan is a collectively bargained plan | No |
| 2012-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: TRIVIUM LIFE SERVICES VISION BENEFIT PLAN 2011 form 5500 responses | ||
| 2011-07-01 | Type of plan entity | Single employer plan |
| 2011-07-01 | First time form 5500 has been submitted | Yes |
| 2011-07-01 | Submission has been amended | No |
| 2011-07-01 | This submission is the final filing | No |
| 2011-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-07-01 | Plan is a collectively bargained plan | No |
| 2011-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-07-01 | Plan benefit arrangement – Insurance | Yes |
| VERATRUS BUSINESS SOLUTIONS (National Association of Insurance Commissioners NAIC id number: 13742 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 35025 | ||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||
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| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 10130991 | ||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||
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| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 10130992 | ||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||
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| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 10130991 | ||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||
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