401k Plan data: WESCON MANAGEMENT GROUP MAJOR MEDICAL PLAN plan

WESCON MANAGEMENT GROUP MAJOR MEDICAL PLAN 401k Plan overview

Plan Name	WESCON MANAGEMENT GROUP MAJOR MEDICAL PLAN
Plan identification number	508

WESCON MANAGEMENT GROUP MAJOR MEDICAL PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision)

401k Sponsoring company profile

WESCON MANAGEMENT GROUP has sponsored the creation of one or more 401k plans.

Company Name: WESCON MANAGEMENT GROUP

Employer identification number (EIN): 752320403

NAIC Classification: 445120
NAIC Description: Convenience Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WESCON MANAGEMENT GROUP MAJOR MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
508 2018-01-01
508 2018-01-01 NETTY BAEZA 2020-10-06
508 2017-01-01 BLAIR ALDERSON
508 2016-01-01 BLAIR ALDERSON
508 2015-07-01 JOIE BROWN
508 2014-07-01 JOIE BROWN

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
508	2018-01-01
508	2018-01-01	NETTY BAEZA	2020-10-06
508	2017-01-01	BLAIR ALDERSON
508	2016-01-01	BLAIR ALDERSON
508	2015-07-01	JOIE BROWN
508	2014-07-01	JOIE BROWN

Plan Statistics for WESCON MANAGEMENT GROUP MAJOR MEDICAL PLAN

401k plan membership statisitcs for WESCON MANAGEMENT GROUP MAJOR MEDICAL PLAN

Measure Date Value
2018: WESCON MANAGEMENT GROUP MAJOR MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 196
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 208
Number of retired or separated participants receiving benefits 2018-01-01 4
Number of other retired or separated participants entitled to future benefits 2018-01-01 0
Total of all active and inactive participants 2018-01-01 212
Number of employers contributing to the scheme 2018-01-01 0
2017: WESCON MANAGEMENT GROUP MAJOR MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 126
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 196
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 196
2016: WESCON MANAGEMENT GROUP MAJOR MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 129
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 126
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 126
2015: WESCON MANAGEMENT GROUP MAJOR MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 129
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 129
Number of retired or separated participants receiving benefits 2015-07-01 0
Number of other retired or separated participants entitled to future benefits 2015-07-01 0
Total of all active and inactive participants 2015-07-01 129
2014: WESCON MANAGEMENT GROUP MAJOR MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year 2014-07-01 134
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 129
Number of retired or separated participants receiving benefits 2014-07-01 0
Number of other retired or separated participants entitled to future benefits 2014-07-01 0
Total of all active and inactive participants 2014-07-01 129

Measure	Date	Value
2018: WESCON MANAGEMENT GROUP MAJOR MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	196
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	208
Number of retired or separated participants receiving benefits	2018-01-01	4
Number of other retired or separated participants entitled to future benefits	2018-01-01	0
Total of all active and inactive participants	2018-01-01	212
Number of employers contributing to the scheme	2018-01-01	0
2017: WESCON MANAGEMENT GROUP MAJOR MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	126
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	196
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	196
2016: WESCON MANAGEMENT GROUP MAJOR MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	129
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	126
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	126
2015: WESCON MANAGEMENT GROUP MAJOR MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	129
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	129
Number of retired or separated participants receiving benefits	2015-07-01	0
Number of other retired or separated participants entitled to future benefits	2015-07-01	0
Total of all active and inactive participants	2015-07-01	129
2014: WESCON MANAGEMENT GROUP MAJOR MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year	2014-07-01	134
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	129
Number of retired or separated participants receiving benefits	2014-07-01	0
Number of other retired or separated participants entitled to future benefits	2014-07-01	0
Total of all active and inactive participants	2014-07-01	129

Form 5500 Responses for WESCON MANAGEMENT GROUP MAJOR MEDICAL PLAN

2018: WESCON MANAGEMENT GROUP MAJOR MEDICAL PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: WESCON MANAGEMENT GROUP MAJOR MEDICAL PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: WESCON MANAGEMENT GROUP MAJOR MEDICAL PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: WESCON MANAGEMENT GROUP MAJOR MEDICAL PLAN 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	Submission has been amended	No
2015-07-01	This submission is the final filing	No
2015-07-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2015-07-01	Plan is a collectively bargained plan	No
2015-07-01	Plan funding arrangement – Insurance	Yes
2015-07-01	Plan benefit arrangement – Insurance	Yes
2014: WESCON MANAGEMENT GROUP MAJOR MEDICAL PLAN 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	First time form 5500 has been submitted	Yes
2014-07-01	Submission has been amended	No
2014-07-01	This submission is the final filing	No
2014-07-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-07-01	Plan is a collectively bargained plan	No
2014-07-01	Plan funding arrangement – Insurance	Yes
2014-07-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

003395

Policy instance

Insurance contract or identification number	003395
Number of Individuals Covered	208
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $45,463
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	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 $928,148
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $45,463
Insurance broker organization code?	3

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

3395

Policy instance

Insurance contract or identification number	3395
Number of Individuals Covered	208
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $45,463
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $928,148
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $45,463
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

003395

Policy instance

Insurance contract or identification number	003395
Number of Individuals Covered	196
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $44,308
Total amount of fees paid to insurance company	USD $36
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 $888,902
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $44,308
Insurance broker organization code?	3
Amount paid for insurance broker fees	36
Additional information about fees paid to insurance broker	SUPPLEMENTAL COMPENSATION
Insurance broker name	CBIZ BENEFITS & INSURANCE SERVICES

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

003395

Policy instance

Insurance contract or identification number	003395
Number of Individuals Covered	212
Insurance policy start date	2015-07-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $25,020
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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 $518,570
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $25,020
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	CBIZ BENEFITS & INSURANCE SERVICES

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )

Policy contract number

003395

Policy instance

Insurance contract or identification number	003395
Number of Individuals Covered	210
Insurance policy start date	2014-07-01
Insurance policy end date	2015-06-30
Total amount of commissions paid to insurance broker	USD $41,447
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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 $861,623
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $41,447
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3
Insurance broker name	CBIZ BENEFITS & INSURANCE SERVICES

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Company Name:	WESCON MANAGEMENT GROUP
Employer identification number (EIN):	752320403
NAIC Classification:	445120
NAIC Description:	Convenience Stores