401k Plan data: INFINITY COMMUNICATIONS GROUP HEALTH AND WELFARE BENEFITS PLAN plan

INFINITY COMMUNICATIONS GROUP HEALTH AND WELFARE BENEFITS PLAN 401k Plan overview

Plan Name	INFINITY COMMUNICATIONS GROUP HEALTH AND WELFARE BENEFITS PLAN
Plan identification number	501

INFINITY COMMUNICATIONS GROUP HEALTH AND WELFARE BENEFITS 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

INFINITY COMMUNICATIONS, LLC has sponsored the creation of one or more 401k plans.

Company Name: INFINITY COMMUNICATIONS, LLC

Employer identification number (EIN): 455449078

NAIC Classification: 811210
NAIC Description: Electronic and Precision Equipment Repair and Maintenance

Form 5500 Filing Information

Submission information for form 5500 for 401k plan INFINITY COMMUNICATIONS GROUP HEALTH AND WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-12-01 JEFFREY COFFEY 2024-04-23

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2022-12-01	JEFFREY COFFEY	2024-04-23

Plan Statistics for INFINITY COMMUNICATIONS GROUP HEALTH AND WELFARE BENEFITS PLAN

401k plan membership statisitcs for INFINITY COMMUNICATIONS GROUP HEALTH AND WELFARE BENEFITS PLAN

Measure Date Value
2022: INFINITY COMMUNICATIONS GROUP HEALTH AND WELFARE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year 2022-12-01 126
Total number of active participants reported on line 7a of the Form 5500 2022-12-01 117
Number of retired or separated participants receiving benefits 2022-12-01 1
Number of other retired or separated participants entitled to future benefits 2022-12-01 0
Total of all active and inactive participants 2022-12-01 118
Number of employers contributing to the scheme 2022-12-01 0

Measure	Date	Value
2022: INFINITY COMMUNICATIONS GROUP HEALTH AND WELFARE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year	2022-12-01	126
Total number of active participants reported on line 7a of the Form 5500	2022-12-01	117
Number of retired or separated participants receiving benefits	2022-12-01	1
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	118
Number of employers contributing to the scheme	2022-12-01	0

Form 5500 Responses for INFINITY COMMUNICATIONS GROUP HEALTH AND WELFARE BENEFITS PLAN

2022: INFINITY COMMUNICATIONS GROUP HEALTH AND WELFARE BENEFITS PLAN 2022 form 5500 responses
2022-12-01	Type of plan entity	Single employer plan
2022-12-01	First time form 5500 has been submitted	Yes
2022-12-01	Plan funding arrangement – Insurance	Yes
2022-12-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

1101966

Policy instance

Insurance contract or identification number	1101966
Number of Individuals Covered	147
Insurance policy start date	2022-12-01
Insurance policy end date	2023-11-30
Total amount of commissions paid to insurance broker	USD $16,101
Total amount of fees paid to insurance company	USD $2,175
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT, ACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to Carrier	USD $75,123
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,384
Amount paid for insurance broker fees	580
Additional information about fees paid to insurance broker	BONUS
Insurance broker organization code?	3

BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )

Policy contract number

141672931001

Policy instance

Insurance contract or identification number	141672931001
Number of Individuals Covered	90
Insurance policy start date	2022-12-01
Insurance policy end date	2023-11-30
Total amount of commissions paid to insurance broker	USD $18,236
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $647,277
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $18,236
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

MONY (National Association of Insurance Commissioners NAIC id number: 78077 )

Policy contract number

1192

Policy instance

Insurance contract or identification number	1192
Number of Individuals Covered	32
Insurance policy start date	2022-12-01
Insurance policy end date	2023-11-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $560
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $12,314
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	560
Additional information about fees paid to insurance broker	BONUS
Insurance broker organization code?	3

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Company Name:	INFINITY COMMUNICATIONS, LLC
Employer identification number (EIN):	455449078
NAIC Classification:	811210
NAIC Description:	Electronic and Precision Equipment Repair and Maintenance