401k Plan data: PROLINK STAFFING SERVICES HAWAII MEDICAL BENEFIT PLAN plan

PROLINK STAFFING SERVICES HAWAII MEDICAL BENEFIT PLAN 401k Plan overview

Plan Name	PROLINK STAFFING SERVICES HAWAII MEDICAL BENEFIT PLAN
Plan identification number	502

PROLINK STAFFING SERVICES HAWAII MEDICAL BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision)

401k Sponsoring company profile

PROLINK STAFFING SERVICES, LLC has sponsored the creation of one or more 401k plans.

Company Name: PROLINK STAFFING SERVICES, LLC

Employer identification number (EIN): 452262555

NAIC Classification: 561300

Additional information about PROLINK STAFFING SERVICES, LLC

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division

Incorporation Date: 2011-05-02

Company Identification Number: 2018167

Legal Registered Office Address: 3300 GREAT AMERICAN TOWER
301 EAST FOURTH STREET
CINCINNATI
United States of America (USA)
45202

More information about PROLINK STAFFING SERVICES, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PROLINK STAFFING SERVICES HAWAII MEDICAL BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2022-02-01 SARAH FARNEY 2023-09-28

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
502	2022-02-01	SARAH FARNEY	2023-09-28

Plan Statistics for PROLINK STAFFING SERVICES HAWAII MEDICAL BENEFIT PLAN

401k plan membership statisitcs for PROLINK STAFFING SERVICES HAWAII MEDICAL BENEFIT PLAN

Measure Date Value
2022: PROLINK STAFFING SERVICES HAWAII MEDICAL BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-02-01 0
Total number of active participants reported on line 7a of the Form 5500 2022-02-01 229
Number of retired or separated participants receiving benefits 2022-02-01 4
Number of other retired or separated participants entitled to future benefits 2022-02-01 0
Total of all active and inactive participants 2022-02-01 233

Measure	Date	Value
2022: PROLINK STAFFING SERVICES HAWAII MEDICAL BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-02-01	0
Total number of active participants reported on line 7a of the Form 5500	2022-02-01	229
Number of retired or separated participants receiving benefits	2022-02-01	4
Number of other retired or separated participants entitled to future benefits	2022-02-01	0
Total of all active and inactive participants	2022-02-01	233

Form 5500 Responses for PROLINK STAFFING SERVICES HAWAII MEDICAL BENEFIT PLAN

2022: PROLINK STAFFING SERVICES HAWAII MEDICAL BENEFIT PLAN 2022 form 5500 responses
2022-02-01	Type of plan entity	Single employer plan
2022-02-01	First time form 5500 has been submitted	Yes
2022-02-01	Submission has been amended	No
2022-02-01	This submission is the final filing	Yes
2022-02-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2022-02-01	Plan is a collectively bargained plan	No
2022-02-01	Plan funding arrangement – Insurance	Yes
2022-02-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

HAWAII MEDICAL SERVICE ASSOCIATION (National Association of Insurance Commissioners NAIC id number: 95804 )

Policy contract number

120024

Policy instance

Insurance contract or identification number	120024
Number of Individuals Covered	8
Insurance policy start date	2022-02-01
Insurance policy end date	2022-12-31
Are there contracts with allocated funds for individual policies?	0
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	Yes
Dental Insurance Welfare Benefit	No
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 $36,653
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HAWAII MEDICAL SERVICE ASSOCIATION (National Association of Insurance Commissioners NAIC id number: 95804 )

Policy contract number

120188

Policy instance

Insurance contract or identification number	120188
Number of Individuals Covered	239
Insurance policy start date	2022-02-01
Insurance policy end date	2022-12-31
Are there contracts with allocated funds for individual policies?	0
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	Yes
Dental Insurance Welfare Benefit	No
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 $1,167,579
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	PROLINK STAFFING SERVICES, LLC
Employer identification number (EIN):	452262555
NAIC Classification:	561300

Jurisdiction of Incorporation:	Ohio Secretary of State Business Services Division
Incorporation Date:	2011-05-02
Company Identification Number:	2018167
Legal Registered Office Address:	3300 GREAT AMERICAN TOWER 301 EAST FOURTH STREET CINCINNATI United States of America (USA) 45202