401k Plan data: MYELIN HEALTH COMMUNICATIONS WELFARE BENEFIT PLAN plan

MYELIN HEALTH COMMUNICATIONS WELFARE BENEFIT PLAN 401k Plan overview

Plan Name	MYELIN HEALTH COMMUNICATIONS WELFARE BENEFIT PLAN
Plan identification number	501

MYELIN HEALTH COMMUNICATIONS WELFARE BENEFIT 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 Other welfare benefit cover

401k Sponsoring company profile

MYELIN HEALTH COMMUNICATIONS LLC has sponsored the creation of one or more 401k plans.

Company Name: MYELIN HEALTH COMMUNICATIONS LLC

Employer identification number (EIN): 461370029

NAIC Classification: 541800

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MYELIN HEALTH COMMUNICATIONS WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2017-07-01 KERRY GRIFFIN

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2017-07-01	KERRY GRIFFIN

Plan Statistics for MYELIN HEALTH COMMUNICATIONS WELFARE BENEFIT PLAN

401k plan membership statisitcs for MYELIN HEALTH COMMUNICATIONS WELFARE BENEFIT PLAN

Measure Date Value
2017: MYELIN HEALTH COMMUNICATIONS WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-07-01 255
Total number of active participants reported on line 7a of the Form 5500 2017-07-01 255
Total of all active and inactive participants 2017-07-01 255

Measure	Date	Value
2017: MYELIN HEALTH COMMUNICATIONS WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-07-01	255
Total number of active participants reported on line 7a of the Form 5500	2017-07-01	255
Total of all active and inactive participants	2017-07-01	255

Form 5500 Responses for MYELIN HEALTH COMMUNICATIONS WELFARE BENEFIT PLAN

2017: MYELIN HEALTH COMMUNICATIONS WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-07-01	Type of plan entity	Single employer plan
2017-07-01	First time form 5500 has been submitted	Yes
2017-07-01	Submission has been amended	No
2017-07-01	This submission is the final filing	No
2017-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-07-01	Plan is a collectively bargained plan	No
2017-07-01	Plan funding arrangement – Insurance	Yes
2017-07-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )

Policy contract number

10000581001

Policy instance

Insurance contract or identification number	10000581001
Number of Individuals Covered	380
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $1,674
Total amount of fees paid to insurance company	USD $0
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	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
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 $19,309
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )

Policy contract number

248586

Policy instance

Insurance contract or identification number	248586
Number of Individuals Covered	255
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $16,226
Total amount of fees paid to insurance company	USD $0
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	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENT, CRITICAL ILLNESS, AND AD&D
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 $171,580
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

911381

Policy instance

Insurance contract or identification number	911381
Number of Individuals Covered	402
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $52,701
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 $1,705,609
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

Potentially related plans

MYELIN HEALTH COMMUNICATIONS INC PROFIT SHARING TRUST [EIN = 800938405]

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Company Name:	MYELIN HEALTH COMMUNICATIONS LLC
Employer identification number (EIN):	461370029
NAIC Classification:	541800