401k Plan data: SOFTWARE INFORMATION SYSTEMS, LLC HEALTH AND WELFARE BENEFITS PLAN plan

SOFTWARE INFORMATION SYSTEMS, LLC HEALTH AND WELFARE BENEFITS PLAN 401k Plan overview

Plan Name	SOFTWARE INFORMATION SYSTEMS, LLC HEALTH AND WELFARE BENEFITS PLAN
Plan identification number	505

SOFTWARE INFORMATION SYSTEMS, LLC 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

401k Sponsoring company profile

SOFTWARE INFORMATION SYSTEMS, LLC has sponsored the creation of one or more 401k plans.

Company Name: SOFTWARE INFORMATION SYSTEMS, LLC

Employer identification number (EIN): 611371685

NAIC Classification: 541519
NAIC Description: Other Computer Related Services

Additional information about SOFTWARE INFORMATION SYSTEMS, LLC

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 2012-11-30

Company Identification Number: 0801691509

Legal Registered Office Address: 165 BARR ST

LEXINGTON
United States of America (USA)
40507

More information about SOFTWARE INFORMATION SYSTEMS, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SOFTWARE INFORMATION SYSTEMS, LLC HEALTH AND WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
505 2019-06-01

Plan Statistics for SOFTWARE INFORMATION SYSTEMS, LLC HEALTH AND WELFARE BENEFITS PLAN

401k plan membership statisitcs for SOFTWARE INFORMATION SYSTEMS, LLC HEALTH AND WELFARE BENEFITS PLAN

Measure Date Value
2019: SOFTWARE INFORMATION SYSTEMS, LLC HEALTH AND WELFARE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-06-01 116
Total number of active participants reported on line 7a of the Form 5500 2019-06-01 0
Number of retired or separated participants receiving benefits 2019-06-01 0
Number of other retired or separated participants entitled to future benefits 2019-06-01 0
Total of all active and inactive participants 2019-06-01 0

Measure	Date	Value
2019: SOFTWARE INFORMATION SYSTEMS, LLC HEALTH AND WELFARE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-06-01	116
Total number of active participants reported on line 7a of the Form 5500	2019-06-01	0
Number of retired or separated participants receiving benefits	2019-06-01	0
Number of other retired or separated participants entitled to future benefits	2019-06-01	0
Total of all active and inactive participants	2019-06-01	0

Form 5500 Responses for SOFTWARE INFORMATION SYSTEMS, LLC HEALTH AND WELFARE BENEFITS PLAN

2019: SOFTWARE INFORMATION SYSTEMS, LLC HEALTH AND WELFARE BENEFITS PLAN 2019 form 5500 responses
2019-06-01	Type of plan entity	Single employer plan
2019-06-01	First time form 5500 has been submitted	Yes
2019-06-01	Submission has been amended	No
2019-06-01	This submission is the final filing	Yes
2019-06-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2019-06-01	Plan is a collectively bargained plan	No
2019-06-01	Plan funding arrangement – Insurance	Yes
2019-06-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 )

Policy contract number

00247624

Policy instance

Insurance contract or identification number	00247624
Number of Individuals Covered	277
Insurance policy start date	2019-06-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $12,909
Total amount of fees paid to insurance company	USD $1,460
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
Welfare Benefit Premiums Paid to Carrier	USD $645,090
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $8,020
Amount paid for insurance broker fees	1460
Additional information about fees paid to insurance broker	FEES PAID
Insurance broker organization code?	3

DELTA DENTAL OF KENTUCKY (National Association of Insurance Commissioners NAIC id number: 54674 )

Policy contract number

0691200

Policy instance

Insurance contract or identification number	0691200
Number of Individuals Covered	268
Insurance policy start date	2019-06-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $3,226
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	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?	No
Commission paid to Insurance Broker	USD $1,814
Insurance broker organization code?	3

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

Policy contract number

G000BCK7

Policy instance

Insurance contract or identification number	G000BCK7
Number of Individuals Covered	107
Insurance policy start date	2019-06-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $5,996
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	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, CRITICAL ILLNESS, ACCIDENT, VOLUNTARY LIFE, VOLUNTARY 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 $58,153
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,192
Insurance broker organization code?	3

Potentially related plans

SOFTWARE INFORMATION RESOURCE CORP 401(K) PLAN [EIN = 541727076]

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Company Name:	SOFTWARE INFORMATION SYSTEMS, LLC
Employer identification number (EIN):	611371685
NAIC Classification:	541519
NAIC Description:	Other Computer Related Services

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	2012-11-30
Company Identification Number:	0801691509
Legal Registered Office Address:	165 BARR ST LEXINGTON United States of America (USA) 40507