401k Plan data: DMS HEALTH TECHNOLOGIES WELFARE BENEFIT PLAN plan

DMS HEALTH TECHNOLOGIES WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	DMS HEALTH TECHNOLOGIES WELFARE BENEFIT PLAN
Plan identification number	504

DMS HEALTH TECHNOLOGIES WELFARE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Dental

401k Sponsoring company profile

DMS HEALTH TECHNOLOGIES has sponsored the creation of one or more 401k plans.

Company Name: DMS HEALTH TECHNOLOGIES

Employer identification number (EIN): 450314852

NAIC Classification: 339110

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DMS HEALTH TECHNOLOGIES WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
504 2013-01-01 LAURIE MEYER
504 2012-01-01 TANYA KNUTSON TANYA KNUTSON 2013-07-30

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
504	2013-01-01	LAURIE MEYER
504	2012-01-01	TANYA KNUTSON		TANYA KNUTSON	2013-07-30

Plan Statistics for DMS HEALTH TECHNOLOGIES WELFARE BENEFIT PLAN

401k plan membership statisitcs for DMS HEALTH TECHNOLOGIES WELFARE BENEFIT PLAN

Measure Date Value
2013: DMS HEALTH TECHNOLOGIES WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 140
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 0
Total of all active and inactive participants 2013-01-01 0
2012: DMS HEALTH TECHNOLOGIES WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 165
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 140
Total of all active and inactive participants 2012-01-01 140

Measure	Date	Value
2013: DMS HEALTH TECHNOLOGIES WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	140
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	0
Total of all active and inactive participants	2013-01-01	0
2012: DMS HEALTH TECHNOLOGIES WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	165
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	140
Total of all active and inactive participants	2012-01-01	140

Form 5500 Responses for DMS HEALTH TECHNOLOGIES WELFARE BENEFIT PLAN

2013: DMS HEALTH TECHNOLOGIES WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	Yes
2013-01-01	This submission is the final filing	Yes
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: DMS HEALTH TECHNOLOGIES WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	First time form 5500 has been submitted	Yes
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

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

Policy contract number

KM05988345

Policy instance

Insurance contract or identification number	KM05988345
Number of Individuals Covered	358
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $36
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	Yes
Vision Insurance Welfare Benefit	No
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 $132,818
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	36
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3
Insurance broker name	HAYS BENEFIT GORUP LLC

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

Policy contract number

KM05988345

Policy instance

Insurance contract or identification number	KM05988345
Number of Individuals Covered	407
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $1,902
Total amount of fees paid to insurance company	USD $5,869
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	Yes
Vision Insurance Welfare Benefit	No
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 $144,460
Commission paid to Insurance Broker	USD $1,902
Amount paid for insurance broker fees	5833
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	3
Insurance broker name	HAYS BENEFITS GROUP LLC

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Company Name:	DMS HEALTH TECHNOLOGIES
Employer identification number (EIN):	450314852
NAIC Classification:	339110