401k Plan data: KNIGHT BROADBAND, LLC WELFARE BENEFITS PLAN plan

KNIGHT BROADBAND, LLC WELFARE BENEFITS PLAN 401k Plan overview

Plan Name	KNIGHT BROADBAND, LLC WELFARE BENEFITS PLAN
Plan identification number	522

KNIGHT BROADBAND, LLC WELFARE BENEFITS 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

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

Company Name: KNIGHT BROADBAND, LLC

Employer identification number (EIN): 845064061

NAIC Classification: 237100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KNIGHT BROADBAND, LLC WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
522 2020-05-01 JILL WILLIAMS 2021-11-15

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
522	2020-05-01	JILL WILLIAMS	2021-11-15

Plan Statistics for KNIGHT BROADBAND, LLC WELFARE BENEFITS PLAN

401k plan membership statisitcs for KNIGHT BROADBAND, LLC WELFARE BENEFITS PLAN

Measure Date Value
2020: KNIGHT BROADBAND, LLC WELFARE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-05-01 298
Total number of active participants reported on line 7a of the Form 5500 2020-05-01 0
Number of retired or separated participants receiving benefits 2020-05-01 0
Number of other retired or separated participants entitled to future benefits 2020-05-01 0
Total of all active and inactive participants 2020-05-01 0
Number of employers contributing to the scheme 2020-05-01 0

Measure	Date	Value
2020: KNIGHT BROADBAND, LLC WELFARE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-05-01	298
Total number of active participants reported on line 7a of the Form 5500	2020-05-01	0
Number of retired or separated participants receiving benefits	2020-05-01	0
Number of other retired or separated participants entitled to future benefits	2020-05-01	0
Total of all active and inactive participants	2020-05-01	0
Number of employers contributing to the scheme	2020-05-01	0

Form 5500 Responses for KNIGHT BROADBAND, LLC WELFARE BENEFITS PLAN

2020: KNIGHT BROADBAND, LLC WELFARE BENEFITS PLAN 2020 form 5500 responses
2020-05-01	Type of plan entity	Single employer plan
2020-05-01	First time form 5500 has been submitted	Yes
2020-05-01	This submission is the final filing	Yes
2020-05-01	Plan funding arrangement – Insurance	Yes
2020-05-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-05-01	Plan benefit arrangement – Insurance	Yes
2020-05-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 )

Policy contract number

38545

Policy instance

Insurance contract or identification number	38545
Number of Individuals Covered	50
Insurance policy start date	2020-05-01
Insurance policy end date	2021-04-30
Total amount of commissions paid to insurance broker	USD $19,675
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $18,076
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95089 )

Policy contract number

38545

Policy instance

Insurance contract or identification number	38545
Number of Individuals Covered	121
Insurance policy start date	2020-05-01
Insurance policy end date	2021-04-30
Total amount of commissions paid to insurance broker	USD $49,894
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $45,926
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10261369

Policy instance

Insurance contract or identification number	10261369
Number of Individuals Covered	325
Insurance policy start date	2020-05-01
Insurance policy end date	2021-04-30
Total amount of commissions paid to insurance broker	USD $39,820
Total amount of fees paid to insurance company	USD $10,577
Health Insurance Welfare Benefit	No
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
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT,EMPLOYEE ASSISTANCE PROGRAM,ACCIDENT
Welfare Benefit Premiums Paid to Carrier	USD $316,458
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $39,820
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	ADMINISTRATION

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Company Name:	KNIGHT BROADBAND, LLC
Employer identification number (EIN):	845064061
NAIC Classification:	237100