401k Plan data: ASCENTIST, LLC BENEFIT PLAN plan

ASCENTIST, LLC BENEFIT PLAN 401k Plan overview

Plan Name	ASCENTIST, LLC BENEFIT PLAN
Plan identification number	501

ASCENTIST, LLC BENEFIT 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 Other welfare benefit cover

401k Sponsoring company profile

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

Company Name: ASCENTIST, LLC

Employer identification number (EIN): 814598060

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

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ASCENTIST, LLC BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2024-01-01 DOUGLAS COWAN
501 2023-01-01
501 2023-01-01 DOUGLAS COWAN
501 2022-01-01
501 2022-01-01 ALAN MEISINGER

Plan Statistics for ASCENTIST, LLC BENEFIT PLAN

401k plan membership statisitcs for ASCENTIST, LLC BENEFIT PLAN

Measure Date Value
2023: ASCENTIST, LLC BENEFIT PLAN 2023 401k membership
Total participants, beginning-of-year 2023-01-01 237
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 257
Number of retired or separated participants receiving benefits 2023-01-01 0
Number of other retired or separated participants entitled to future benefits 2023-01-01 0
Total of all active and inactive participants 2023-01-01 257
2022: ASCENTIST, LLC BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 237
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 237
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 237

Measure	Date	Value
2023: ASCENTIST, LLC BENEFIT PLAN 2023 401k membership
Total participants, beginning-of-year	2023-01-01	237
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	257
Number of retired or separated participants receiving benefits	2023-01-01	0
Number of other retired or separated participants entitled to future benefits	2023-01-01	0
Total of all active and inactive participants	2023-01-01	257
2022: ASCENTIST, LLC BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	237
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	237
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	237

Form 5500 Responses for ASCENTIST, LLC BENEFIT PLAN

2023: ASCENTIST, LLC BENEFIT PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2022: ASCENTIST, LLC BENEFIT PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	First time form 5500 has been submitted	Yes
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

SURENCY LIFE AND HEALTH (National Association of Insurance Commissioners NAIC id number: 13175 )

Policy contract number

55062

Policy instance

Insurance contract or identification number	55062
Number of Individuals Covered	78
Insurance policy start date	2023-04-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $643
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $8,137
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )

Policy contract number

HCL40540

Policy instance

Insurance contract or identification number	HCL40540
Number of Individuals Covered	306
Insurance policy start date	2023-08-01
Insurance policy end date	2023-12-31
Welfare Benefit Premiums Paid to Carrier	USD $255,344
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

SURENCY LIFE AND HEALTH (National Association of Insurance Commissioners NAIC id number: 13175 )

Policy contract number

55061

Policy instance

Insurance contract or identification number	55061
Number of Individuals Covered	83
Insurance policy start date	2023-04-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $586
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $5,985
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00048954

Policy instance

Insurance contract or identification number	00048954
Number of Individuals Covered	257
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $20,202
Total amount of fees paid to insurance company	USD $1,295
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D, ACCIDENT, VOLUNTARY: CI, HI
Welfare Benefit Premiums Paid to Carrier	USD $71,209
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )

Policy contract number

55062

Policy instance

Insurance contract or identification number	55062
Number of Individuals Covered	60
Insurance policy start date	2023-04-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $1,735
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $28,913
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

DELTA DENTAL OF KANSAS (National Association of Insurance Commissioners NAIC id number: 54615 )

Policy contract number

55061

Policy instance

Insurance contract or identification number	55061
Number of Individuals Covered	126
Insurance policy start date	2023-04-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $3,118
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $51,966
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

ADVANTICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 12278 )

Policy contract number

901, 2, 3, 4, 5

Policy instance

Insurance contract or identification number	901, 2, 3, 4, 5
Number of Individuals Covered	471
Insurance policy start date	2023-01-01
Insurance policy end date	2023-03-31
Total amount of commissions paid to insurance broker	USD $326
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $7,324
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 )

Policy contract number

19512046

Policy instance

Insurance contract or identification number	19512046
Number of Individuals Covered	275
Insurance policy start date	2023-01-01
Insurance policy end date	2023-03-31
Total amount of commissions paid to insurance broker	USD $2,513
Total amount of fees paid to insurance company	USD $940
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $52,027
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 )

Policy contract number

46016000

Policy instance

Insurance contract or identification number	46016000
Number of Individuals Covered	223
Insurance policy start date	2023-04-01
Insurance policy end date	2023-07-31
Total amount of commissions paid to insurance broker	USD $13,392
Total amount of fees paid to insurance company	USD $3,690
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

MULTIPLE

Policy instance

Insurance contract or identification number	MULTIPLE
Number of Individuals Covered	27
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $6,673
Total amount of fees paid to insurance company	USD $215
Other welfare benefits provided	VOLUNTARY BENEFITS
Welfare Benefit Premiums Paid to Carrier	USD $34,131
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

ADVANTICA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 12278 )

Policy contract number

901, 902, 903

Policy instance

Insurance contract or identification number	901, 902, 903
Number of Individuals Covered	297
Insurance policy start date	2021-04-01
Insurance policy end date	2022-03-31
Total amount of commissions paid to insurance broker	USD $468
Total amount of fees paid to insurance company	USD $45
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $17,115
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

DELTA DENTAL OF MISSOURI (National Association of Insurance Commissioners NAIC id number: 55697 )

Policy contract number

19512046

Policy instance

Insurance contract or identification number	19512046
Number of Individuals Covered	365
Insurance policy start date	2021-04-01
Insurance policy end date	2022-03-31
Total amount of commissions paid to insurance broker	USD $5,656
Total amount of fees paid to insurance company	USD $927
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $121,172
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS AND BLUE SHIELD OF KANSAS CITY (National Association of Insurance Commissioners NAIC id number: 47171 )

Policy contract number

46016000

Policy instance

Insurance contract or identification number	46016000
Number of Individuals Covered	341
Insurance policy start date	2021-04-01
Insurance policy end date	2022-03-31
Total amount of commissions paid to insurance broker	USD $40,393
Total amount of fees paid to insurance company	USD $23,281
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )

Policy contract number

UG368

Policy instance

Insurance contract or identification number	UG368
Number of Individuals Covered	17
Insurance policy start date	2021-04-01
Insurance policy end date	2022-03-31
Total amount of commissions paid to insurance broker	USD $4,751
Total amount of fees paid to insurance company	USD $182
Other welfare benefits provided	VOLUNTARY BENEFITS
Welfare Benefit Premiums Paid to Carrier	USD $27,840
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

164018

Policy instance

Insurance contract or identification number	164018
Number of Individuals Covered	237
Insurance policy start date	2021-04-01
Insurance policy end date	2022-03-31
Total amount of commissions paid to insurance broker	USD $1,529
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	ASCENTIST, LLC
Employer identification number (EIN):	814598060
NAIC Classification:	621111
NAIC Description:	Offices of Physicians (except Mental Health Specialists)

Plan id#	Filing Submission Date	Name of Administrator
501	2024-01-01	DOUGLAS COWAN
501	2023-01-01
501	2023-01-01	DOUGLAS COWAN
501	2022-01-01
501	2022-01-01	ALAN MEISINGER