401k Plan data: AOA STAFFING HEALTH AND WELFARE PLAN plan

AOA STAFFING HEALTH AND WELFARE PLAN 401k Plan overview

Plan Name	AOA STAFFING HEALTH AND WELFARE PLAN
Plan identification number	501

AOA STAFFING 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

AOA STAFFING has sponsored the creation of one or more 401k plans.

Company Name: AOA STAFFING

Employer identification number (EIN): 813359504

NAIC Classification: 621111
NAIC Description: Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

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

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2018-04-01 PAUL PLATZMAN 2019-11-18

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2018-04-01	PAUL PLATZMAN	2019-11-18

Plan Statistics for AOA STAFFING HEALTH AND WELFARE PLAN

401k plan membership statisitcs for AOA STAFFING HEALTH AND WELFARE PLAN

Measure Date Value
2018: AOA STAFFING HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year 2018-04-01 148
Total number of active participants reported on line 7a of the Form 5500 2018-04-01 0
Number of retired or separated participants receiving benefits 2018-04-01 0
Number of other retired or separated participants entitled to future benefits 2018-04-01 0
Total of all active and inactive participants 2018-04-01 0
Number of employers contributing to the scheme 2018-04-01 0

Measure	Date	Value
2018: AOA STAFFING HEALTH AND WELFARE PLAN 2018 401k membership
Total participants, beginning-of-year	2018-04-01	148
Total number of active participants reported on line 7a of the Form 5500	2018-04-01	0
Number of retired or separated participants receiving benefits	2018-04-01	0
Number of other retired or separated participants entitled to future benefits	2018-04-01	0
Total of all active and inactive participants	2018-04-01	0
Number of employers contributing to the scheme	2018-04-01	0

Form 5500 Responses for AOA STAFFING HEALTH AND WELFARE PLAN

2018: AOA STAFFING HEALTH AND WELFARE PLAN 2018 form 5500 responses
2018-04-01	Type of plan entity	Single employer plan
2018-04-01	This submission is the final filing	Yes
2018-04-01	Plan funding arrangement – Insurance	Yes
2018-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-04-01	Plan benefit arrangement – Insurance	Yes
2018-04-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )

Policy contract number

608986

Policy instance

Insurance contract or identification number	608986
Number of Individuals Covered	152
Insurance policy start date	2018-04-01
Insurance policy end date	2019-03-31
Total amount of commissions paid to insurance broker	USD $12,366
Total amount of fees paid to insurance company	USD $6,414
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $124,560
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $12,366
Amount paid for insurance broker fees	232
Additional information about fees paid to insurance broker	GENERAL AGENT PAYMENTS
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

Policy instance

Number of Individuals Covered	0
Insurance policy start date	2018-04-01
Insurance policy end date	2019-03-31
Total amount of commissions paid to insurance broker	USD $25,583
Total amount of fees paid to insurance company	USD $14,351
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	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $165,739
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $25,583
Amount paid for insurance broker fees	1368
Additional information about fees paid to insurance broker	OVERRIDE
Insurance broker organization code?	3

CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )

Policy contract number

23415

Policy instance

Insurance contract or identification number	23415
Number of Individuals Covered	85
Insurance policy start date	2018-04-01
Insurance policy end date	2019-03-31
Total amount of commissions paid to insurance broker	USD $5,734
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	ACCIDENT, CRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to Carrier	USD $12,059
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,753
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

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Company Name:	AOA STAFFING
Employer identification number (EIN):	813359504
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)