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SCREEN-IT GRAPHICS OF LAWRENCE, INC. LIFE AND AD&D INSURANCE PLAN 401k Plan overview

Plan NameSCREEN-IT GRAPHICS OF LAWRENCE, INC. LIFE AND AD&D INSURANCE PLAN
Plan identification number 503

SCREEN-IT GRAPHICS OF LAWRENCE, INC. LIFE AND AD&D INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Other welfare benefit cover

401k Sponsoring company profile

SCREEN-IT GRAPHICS OF LAWRENCE, has sponsored the creation of one or more 401k plans.

Company Name:SCREEN-IT GRAPHICS OF LAWRENCE,
Employer identification number (EIN):481053811
NAIC Classification:323100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SCREEN-IT GRAPHICS OF LAWRENCE, INC. LIFE AND AD&D INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032017-03-01BRANDON PETZ

Plan Statistics for SCREEN-IT GRAPHICS OF LAWRENCE, INC. LIFE AND AD&D INSURANCE PLAN

401k plan membership statisitcs for SCREEN-IT GRAPHICS OF LAWRENCE, INC. LIFE AND AD&D INSURANCE PLAN

Measure Date Value
2017: SCREEN-IT GRAPHICS OF LAWRENCE, INC. LIFE AND AD&D INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-03-01195
Total number of active participants reported on line 7a of the Form 55002017-03-01203
Number of retired or separated participants receiving benefits2017-03-010
Number of other retired or separated participants entitled to future benefits2017-03-010
Total of all active and inactive participants2017-03-01203

Form 5500 Responses for SCREEN-IT GRAPHICS OF LAWRENCE, INC. LIFE AND AD&D INSURANCE PLAN

2017: SCREEN-IT GRAPHICS OF LAWRENCE, INC. LIFE AND AD&D INSURANCE PLAN 2017 form 5500 responses
2017-03-01Type of plan entitySingle employer plan
2017-03-01First time form 5500 has been submittedYes
2017-03-01Plan funding arrangement – InsuranceYes
2017-03-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number648825
Policy instance 1
Insurance contract or identification number648825
Number of Individuals Covered213
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
Total amount of commissions paid to insurance brokerUSD $1,188
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $9,884
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,188
Insurance broker organization code?3
Insurance broker nameINTEGRITY MIDWEST INSURANCE

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