401k Plan data: GENERAL INFORMATICS, LLC HEALTH AND WELFARE PLAN plan

GENERAL INFORMATICS, LLC HEALTH AND WELFARE PLAN 401k Plan overview

Plan Name	GENERAL INFORMATICS, LLC HEALTH AND WELFARE PLAN
Plan identification number	501

GENERAL INFORMATICS, LLC 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

401k Sponsoring company profile

GENERAL INFORMATICS, LLC has sponsored the creation of one or more 401k plans.

Company Name: GENERAL INFORMATICS, LLC

Employer identification number (EIN): 721511032

NAIC Classification: 541519
NAIC Description: Other Computer Related Services

Additional information about GENERAL INFORMATICS, LLC

Jurisdiction of Incorporation: Nevada Department of State

Incorporation Date: 2007-04-25

Company Identification Number: 20071678335

Legal Registered Office Address: 601 E CHARLESTON BLVD STE 100

LAS VEGAS
United States of America (USA)
89104

More information about GENERAL INFORMATICS, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GENERAL INFORMATICS, LLC HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-02-01

Plan Statistics for GENERAL INFORMATICS, LLC HEALTH AND WELFARE PLAN

401k plan membership statisitcs for GENERAL INFORMATICS, LLC HEALTH AND WELFARE PLAN

Measure Date Value
2022: GENERAL INFORMATICS, LLC HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year 2022-02-01 176
Total number of active participants reported on line 7a of the Form 5500 2022-02-01 167
Total of all active and inactive participants 2022-02-01 167
Total participants 2022-02-01 167
Number of employers contributing to the scheme 2022-02-01 167

Measure	Date	Value
2022: GENERAL INFORMATICS, LLC HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year	2022-02-01	176
Total number of active participants reported on line 7a of the Form 5500	2022-02-01	167
Total of all active and inactive participants	2022-02-01	167
Total participants	2022-02-01	167
Number of employers contributing to the scheme	2022-02-01	167

Form 5500 Responses for GENERAL INFORMATICS, LLC HEALTH AND WELFARE PLAN

2022: GENERAL INFORMATICS, LLC HEALTH AND WELFARE PLAN 2022 form 5500 responses
2022-02-01	Type of plan entity	Single employer plan
2022-02-01	First time form 5500 has been submitted	Yes
2022-02-01	Submission has been amended	No
2022-02-01	This submission is the final filing	No
2022-02-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-02-01	Plan is a collectively bargained plan	No
2022-02-01	Plan funding arrangement – Insurance	Yes
2022-02-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 )

Policy contract number

26C17ERC

Policy instance

Insurance contract or identification number	26C17ERC
Number of Individuals Covered	157
Insurance policy start date	2022-02-01
Insurance policy end date	2023-01-31
Total amount of commissions paid to insurance broker	USD $48,354
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 $1,381,042
Commission paid to Insurance Broker	USD $48,354
Amount paid for insurance broker fees	11691
Additional information about fees paid to insurance broker	BCBC AGENCY BONUS
Insurance broker organization code?	3

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

1154149

Policy instance

Insurance contract or identification number	1154149
Number of Individuals Covered	167
Insurance policy start date	2022-02-01
Insurance policy end date	2023-01-31
Total amount of commissions paid to insurance broker	USD $21,785
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	Yes
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
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 $182,303
Commission paid to Insurance Broker	USD $21,785
Insurance broker organization code?	3

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Company Name:	GENERAL INFORMATICS, LLC
Employer identification number (EIN):	721511032
NAIC Classification:	541519
NAIC Description:	Other Computer Related Services

Jurisdiction of Incorporation:	Nevada Department of State
Incorporation Date:	2007-04-25
Company Identification Number:	20071678335
Legal Registered Office Address:	601 E CHARLESTON BLVD STE 100 LAS VEGAS United States of America (USA) 89104