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CUSTOM COOLER INC. MEDICAL AND LIFE BENEFITS PLAN 401k Plan overview

Plan NameCUSTOM COOLER INC. MEDICAL AND LIFE BENEFITS PLAN
Plan identification number 501

CUSTOM COOLER INC. MEDICAL AND LIFE BENEFITS PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

CCI GLOBAL, LLC has sponsored the creation of one or more 401k plans.

Company Name:CCI GLOBAL, LLC
Employer identification number (EIN):814539322
NAIC Classification:333310

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CUSTOM COOLER INC. MEDICAL AND LIFE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012018-08-01

Plan Statistics for CUSTOM COOLER INC. MEDICAL AND LIFE BENEFITS PLAN

401k plan membership statisitcs for CUSTOM COOLER INC. MEDICAL AND LIFE BENEFITS PLAN

Measure Date Value
2018: CUSTOM COOLER INC. MEDICAL AND LIFE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year2018-08-01128
Total number of active participants reported on line 7a of the Form 55002018-08-01143
Total of all active and inactive participants2018-08-01143

Form 5500 Responses for CUSTOM COOLER INC. MEDICAL AND LIFE BENEFITS PLAN

2018: CUSTOM COOLER INC. MEDICAL AND LIFE BENEFITS PLAN 2018 form 5500 responses
2018-08-01Type of plan entitySingle employer plan
2018-08-01Plan funding arrangement – InsuranceYes
2018-08-01Plan funding arrangement – General assets of the sponsorYes
2018-08-01Plan benefit arrangement – InsuranceYes
2018-08-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

HEALTH NET (National Association of Insurance Commissioners NAIC id number: 00623 )
Policy contract numberS4361A
Policy instance 1
Insurance contract or identification numberS4361A
Number of Individuals Covered143
Insurance policy start date2018-08-01
Insurance policy end date2019-07-31
Total amount of commissions paid to insurance brokerUSD $40,878
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $845,781
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $40,878
Insurance broker organization code?3

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