401k Plan data: STENO HEALTH AND WELFARE PLAN plan

STENO HEALTH AND WELFARE PLAN 401k Plan overview

Plan Name	STENO HEALTH AND WELFARE PLAN
Plan identification number	501

STENO 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

STENO AGENCY, INC. has sponsored the creation of one or more 401k plans.

Company Name: STENO AGENCY, INC.

Employer identification number (EIN): 832309297

NAIC Classification: 711100
NAIC Description: Performing Arts Companies

Form 5500 Filing Information

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

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-01-01 MIKE JACOBSON 2024-07-23

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2023-01-01	MIKE JACOBSON	2024-07-23

Plan Statistics for STENO HEALTH AND WELFARE PLAN

401k plan membership statisitcs for STENO HEALTH AND WELFARE PLAN

Measure Date Value
2023: STENO HEALTH AND WELFARE PLAN 2023 401k membership
Total participants, beginning-of-year 2023-01-01 167
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 212
Number of retired or separated participants receiving benefits 2023-01-01 2
Number of other retired or separated participants entitled to future benefits 2023-01-01 0
Total of all active and inactive participants 2023-01-01 214
Number of employers contributing to the scheme 2023-01-01 0

Measure	Date	Value
2023: STENO HEALTH AND WELFARE PLAN 2023 401k membership
Total participants, beginning-of-year	2023-01-01	167
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	212
Number of retired or separated participants receiving benefits	2023-01-01	2
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	214
Number of employers contributing to the scheme	2023-01-01	0

Form 5500 Responses for STENO HEALTH AND WELFARE PLAN

2023: STENO HEALTH AND WELFARE 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

BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

L06908

Policy instance

Insurance contract or identification number	L06908
Number of Individuals Covered	334
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $80,744
Total amount of fees paid to insurance company	USD $14,244
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $1,861,867
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

236087

Policy instance

Insurance contract or identification number	236087
Number of Individuals Covered	48
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $12,809
Total amount of fees paid to insurance company	USD $1
Health Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $282,432
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

41740

Policy instance

Insurance contract or identification number	41740
Number of Individuals Covered	230
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $23,317
Total amount of fees paid to insurance company	USD $1,546
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, ACCIDENT, CRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to Carrier	USD $143,176
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )

Policy contract number

123659001

Policy instance

Insurance contract or identification number	123659001
Number of Individuals Covered	2
Insurance policy start date	2023-01-01
Insurance policy end date	2023-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $19,320
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	STENO AGENCY, INC.
Employer identification number (EIN):	832309297
NAIC Classification:	711100
NAIC Description:	Performing Arts Companies