401k Plan data: VERBIO NORTH AMERICA LLC HEALTH AND WELLNESS PLAN plan

VERBIO NORTH AMERICA LLC HEALTH AND WELLNESS PLAN 401k Plan overview

Plan Name	VERBIO NORTH AMERICA LLC HEALTH AND WELLNESS PLAN
Plan identification number	503

VERBIO NORTH AMERICA LLC HEALTH AND WELLNESS 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) Other welfare benefit cover

401k Sponsoring company profile

VERBIO NORTH AMERICA CORPORATION has sponsored the creation of one or more 401k plans.

Company Name: VERBIO NORTH AMERICA CORPORATION

Employer identification number (EIN): 824412116

NAIC Classification: 325200

Form 5500 Filing Information

Submission information for form 5500 for 401k plan VERBIO NORTH AMERICA LLC HEALTH AND WELLNESS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2023-01-01 AGNES SABATH 2024-08-22

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
503	2023-01-01	AGNES SABATH	2024-08-22

Form 5500 Responses for VERBIO NORTH AMERICA LLC HEALTH AND WELLNESS PLAN

2023: VERBIO NORTH AMERICA LLC HEALTH AND WELLNESS PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	First time form 5500 has been submitted	Yes
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

Insurance Providers Used on plan

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

Policy contract number

45567

Policy instance

Insurance contract or identification number	45567
Number of Individuals Covered	218
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $31,588
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to Carrier	USD $210,136
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 )

Policy contract number

289453

Policy instance

Insurance contract or identification number	289453
Number of Individuals Covered	355
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $33,668
Total amount of fees paid to insurance company	USD $1,467
Health 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:	VERBIO NORTH AMERICA CORPORATION
Employer identification number (EIN):	824412116
NAIC Classification:	325200