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| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | OUTLIER, LLC |
| Employer identification number (EIN): | 824000840 |
| NAIC Classification: | 621399 |
| NAIC Description: | Offices of All Other Miscellaneous Health Practitioners |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2022-10-01 | CRYSTAL FALLAS | 2024-03-25 |
| Measure | Date | Value |
|---|---|---|
| 2022: 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-10-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-10-01 | 235 |
| Number of retired or separated participants receiving benefits | 2022-10-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-10-01 | 0 |
| Total of all active and inactive participants | 2022-10-01 | 235 |
| Number of employers contributing to the scheme | 2022-10-01 | 0 |
| 2022: 2022 form 5500 responses | ||
|---|---|---|
| 2022-10-01 | Type of plan entity | Single employer plan |
| 2022-10-01 | Plan funding arrangement – Insurance | Yes |
| 2022-10-01 | Plan benefit arrangement – Insurance | Yes |
| BLUE CROSS BLUE SHIELD OF ARIZONA (National Association of Insurance Commissioners NAIC id number: 53589 ) | |
| Policy contract number | 040463 |
| Policy instance | 1 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) | |
| Policy contract number | 30099168 |
| Policy instance | 2 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |
| Policy contract number | GLUG0BCSQ` |
| Policy instance | 3 |
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