401k Plan data: CAMPSPOT HEALTH AND WELFARE PLAN plan

CAMPSPOT HEALTH AND WELFARE PLAN 401k Plan overview

Plan Name	CAMPSPOT HEALTH AND WELFARE PLAN
Plan identification number	501

CAMPSPOT HEALTH AND WELFARE 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

REZPLOT SYSTEMS LLC has sponsored the creation of one or more 401k plans.

Company Name: REZPLOT SYSTEMS LLC

Employer identification number (EIN): 611751996

NAIC Classification: 541512
NAIC Description: Computer Systems Design Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CAMPSPOT HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-01-01 KIRSTEN LICKEL 2024-07-18

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2023-01-01	KIRSTEN LICKEL	2024-07-18

Form 5500 Responses for CAMPSPOT HEALTH AND WELFARE PLAN

2023: CAMPSPOT HEALTH AND WELFARE PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	First time form 5500 has been submitted	Yes
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 )

Policy contract number

10305

Policy instance

Insurance contract or identification number	10305
Number of Individuals Covered	121
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $4,851
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30102930

Policy instance

Insurance contract or identification number	30102930
Number of Individuals Covered	70
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $937
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $9,388
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )

Policy contract number

284259

Policy instance

Insurance contract or identification number	284259
Number of Individuals Covered	92
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $11,740
Total amount of fees paid to insurance company	USD $775
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 )

Policy contract number

284259

Policy instance

Insurance contract or identification number	284259
Number of Individuals Covered	60
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-01
Total amount of commissions paid to insurance broker	USD $7,080
Total amount of fees paid to insurance company	USD $546
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )

Policy contract number

896209G

Policy instance

Insurance contract or identification number	896209G
Number of Individuals Covered	104
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $4,244
Total amount of fees paid to insurance company	USD $1,049
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $42,440
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	REZPLOT SYSTEMS LLC
Employer identification number (EIN):	611751996
NAIC Classification:	541512
NAIC Description:	Computer Systems Design Services