401k Plan data: ATLANTIC BUSINESS TECHNOLOGIES AND AFFILIATES HEALTH AND WELFARE PLAN plan

ATLANTIC BUSINESS TECHNOLOGIES AND AFFILIATES HEALTH AND WELFARE PLAN 401k Plan overview

Plan Name	ATLANTIC BUSINESS TECHNOLOGIES AND AFFILIATES HEALTH AND WELFARE PLAN
Plan identification number	501

ATLANTIC BUSINESS TECHNOLOGIES AND AFFILIATES HEALTH AND WELFARE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Temporary disability (accident and sickness) Long-term disability cover Other welfare benefit cover

401k Sponsoring company profile

ATLANTIC BUSINESS TECHNOLOGIES, INC. has sponsored the creation of one or more 401k plans.

Company Name: ATLANTIC BUSINESS TECHNOLOGIES, INC.

Employer identification number (EIN): 562109067

NAIC Classification: 541511
NAIC Description: Custom Computer Programming Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ATLANTIC BUSINESS TECHNOLOGIES AND AFFILIATES HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2017-07-01 JENNIFER HERNDON
501 2016-07-01 JENNIFER HERNDON

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2017-07-01	JENNIFER HERNDON
501	2016-07-01	JENNIFER HERNDON

Plan Statistics for ATLANTIC BUSINESS TECHNOLOGIES AND AFFILIATES HEALTH AND WELFARE PLAN

401k plan membership statisitcs for ATLANTIC BUSINESS TECHNOLOGIES AND AFFILIATES HEALTH AND WELFARE PLAN

Measure Date Value
2017: ATLANTIC BUSINESS TECHNOLOGIES AND AFFILIATES HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year 2017-07-01 106
Total number of active participants reported on line 7a of the Form 5500 2017-07-01 104
Number of retired or separated participants receiving benefits 2017-07-01 0
Number of other retired or separated participants entitled to future benefits 2017-07-01 0
Total of all active and inactive participants 2017-07-01 104
2016: ATLANTIC BUSINESS TECHNOLOGIES AND AFFILIATES HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year 2016-07-01 102
Total number of active participants reported on line 7a of the Form 5500 2016-07-01 102
Number of retired or separated participants receiving benefits 2016-07-01 0
Number of other retired or separated participants entitled to future benefits 2016-07-01 0
Total of all active and inactive participants 2016-07-01 102

Measure	Date	Value
2017: ATLANTIC BUSINESS TECHNOLOGIES AND AFFILIATES HEALTH AND WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year	2017-07-01	106
Total number of active participants reported on line 7a of the Form 5500	2017-07-01	104
Number of retired or separated participants receiving benefits	2017-07-01	0
Number of other retired or separated participants entitled to future benefits	2017-07-01	0
Total of all active and inactive participants	2017-07-01	104
2016: ATLANTIC BUSINESS TECHNOLOGIES AND AFFILIATES HEALTH AND WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year	2016-07-01	102
Total number of active participants reported on line 7a of the Form 5500	2016-07-01	102
Number of retired or separated participants receiving benefits	2016-07-01	0
Number of other retired or separated participants entitled to future benefits	2016-07-01	0
Total of all active and inactive participants	2016-07-01	102

Form 5500 Responses for ATLANTIC BUSINESS TECHNOLOGIES AND AFFILIATES HEALTH AND WELFARE PLAN

2017: ATLANTIC BUSINESS TECHNOLOGIES AND AFFILIATES HEALTH AND WELFARE PLAN 2017 form 5500 responses
2017-07-01	Type of plan entity	Single employer plan
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
2016: ATLANTIC BUSINESS TECHNOLOGIES AND AFFILIATES HEALTH AND WELFARE PLAN 2016 form 5500 responses
2016-07-01	Type of plan entity	Single employer plan
2016-07-01	First time form 5500 has been submitted	Yes
2016-07-01	Submission has been amended	No
2016-07-01	This submission is the final filing	No
2016-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-07-01	Plan is a collectively bargained plan	No
2016-07-01	Plan funding arrangement – Insurance	Yes
2016-07-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

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

Policy contract number

076515

Policy instance

Insurance contract or identification number	076515
Number of Individuals Covered	180
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $41,022
Total amount of fees paid to insurance company	USD $500
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	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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $41,022
Amount paid for insurance broker fees	500
Additional information about fees paid to insurance broker	ADDITIONAL BROKER COMPENSATION
Insurance broker organization code?	3
Insurance broker name	GRUBER JR, ROBERT P

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

LUG0B6RK

Policy instance

Insurance contract or identification number	LUG0B6RK
Number of Individuals Covered	99
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
Total amount of commissions paid to insurance broker	USD $19,054
Total amount of fees paid to insurance company	USD $8,471
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	AD&D, ACCIDENT, CRITICAL ILLNESS
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 $130,709
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $19,054
Amount paid for insurance broker fees	8471
Additional information about fees paid to insurance broker	OTHER COMPENSATION
Insurance broker organization code?	3
Insurance broker name	HUB INTERNATIONAL MIDWEST LIMITED

TELADOC, INC. (National Association of Insurance Commissioners NAIC id number: 62199 )

Policy contract number

ATLANTICBUS

Policy instance

Insurance contract or identification number	ATLANTICBUS
Number of Individuals Covered	25
Insurance policy start date	2017-07-01
Insurance policy end date	2018-06-30
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 $4,530
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	ATLANTIC BUSINESS TECHNOLOGIES, INC.
Employer identification number (EIN):	562109067
NAIC Classification:	541511
NAIC Description:	Custom Computer Programming Services