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VIOCITY GROUP, INC. HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameVIOCITY GROUP, INC. HEALTH AND WELFARE PLAN
Plan identification number 501

VIOCITY GROUP, INC. HEALTH AND WELFARE PLAN Benefits

401k Plan TypeWelfare 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

VIOCITY GROUP has sponsored the creation of one or more 401k plans.

Company Name:VIOCITY GROUP
Employer identification number (EIN):854366539
NAIC Classification:331400

Form 5500 Filing Information

Submission information for form 5500 for 401k plan VIOCITY GROUP, INC. HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012024-01-01SASHA WAWRZYNIAK
5012023-01-01
5012023-01-01SASHA WAWRZYNIAK
5012022-01-01
5012022-01-01SASHA WAWRZYNIAK
5012021-01-01
5012021-01-01SASHA WAWRZYNIAK

Plan Statistics for VIOCITY GROUP, INC. HEALTH AND WELFARE PLAN

401k plan membership statisitcs for VIOCITY GROUP, INC. HEALTH AND WELFARE PLAN

Measure Date Value
2023: VIOCITY GROUP, INC. HEALTH AND WELFARE PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-01120
Total number of active participants reported on line 7a of the Form 55002023-01-01127
Number of retired or separated participants receiving benefits2023-01-010
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-01127
2022: VIOCITY GROUP, INC. HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01175
Total number of active participants reported on line 7a of the Form 55002022-01-01201
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01201
2021: VIOCITY GROUP, INC. HEALTH AND WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01132
Total number of active participants reported on line 7a of the Form 55002021-01-01175
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01175

Form 5500 Responses for VIOCITY GROUP, INC. HEALTH AND WELFARE PLAN

2023: VIOCITY GROUP, INC. HEALTH AND WELFARE PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – InsuranceYes
2022: VIOCITY GROUP, INC. HEALTH AND WELFARE PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: VIOCITY GROUP, INC. HEALTH AND WELFARE PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01First time form 5500 has been submittedYes
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number10910
Policy instance 6
Insurance contract or identification number10910
Number of Individuals Covered198
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $43,804
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AYYJ
Policy instance 1
Insurance contract or identification numberG000AYYJ
Number of Individuals Covered127
Insurance policy start date2023-01-01
Insurance policy end date2024-01-01
Total amount of commissions paid to insurance brokerUSD $2,380
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $23,796
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AYYJ
Policy instance 2
Insurance contract or identification numberG000AYYJ
Number of Individuals Covered127
Insurance policy start date2023-01-01
Insurance policy end date2024-01-01
Total amount of commissions paid to insurance brokerUSD $5,708
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $57,076
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AYYJ
Policy instance 3
Insurance contract or identification numberG000AYYJ
Number of Individuals Covered67
Insurance policy start date2023-01-01
Insurance policy end date2024-01-01
Total amount of commissions paid to insurance brokerUSD $1,766
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,657
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AYYJ
Policy instance 4
Insurance contract or identification numberG000AYYJ
Number of Individuals Covered40
Insurance policy start date2023-01-01
Insurance policy end date2024-01-01
Total amount of commissions paid to insurance brokerUSD $1,855
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,548
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number084598
Policy instance 5
Insurance contract or identification number084598
Number of Individuals Covered184
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $47,461
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Other welfare benefits providedHRA
Welfare Benefit Premiums Paid to CarrierUSD $1,399,864
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number10910
Policy instance 6
Insurance contract or identification number10910
Number of Individuals Covered201
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $67,604
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number084598
Policy instance 5
Insurance contract or identification number084598
Number of Individuals Covered171
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $47,373
Health Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,441,500
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AYYJ
Policy instance 4
Insurance contract or identification numberG000AYYJ
Number of Individuals Covered42
Insurance policy start date2022-01-01
Insurance policy end date2023-01-01
Total amount of commissions paid to insurance brokerUSD $1,904
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,043
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AYYJ
Policy instance 3
Insurance contract or identification numberG000AYYJ
Number of Individuals Covered65
Insurance policy start date2022-01-01
Insurance policy end date2023-01-01
Total amount of commissions paid to insurance brokerUSD $1,751
Other welfare benefits providedSTD ASO
Welfare Benefit Premiums Paid to CarrierUSD $17,505
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AYYJ
Policy instance 2
Insurance contract or identification numberG000AYYJ
Number of Individuals Covered120
Insurance policy start date2022-01-01
Insurance policy end date2023-01-01
Total amount of commissions paid to insurance brokerUSD $5,779
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $57,790
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AYYJ
Policy instance 1
Insurance contract or identification numberG000AYYJ
Number of Individuals Covered120
Insurance policy start date2022-01-01
Insurance policy end date2023-01-01
Total amount of commissions paid to insurance brokerUSD $2,346
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $23,460
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUPR0AYYJ
Policy instance 2
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGUSISAYYJ
Policy instance 3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0AYYJ
Policy instance 4
HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )
Policy contract number084598
Policy instance 5
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number10910
Policy instance 6
CAPITAL ADVANTAGE ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 14411 )
Policy contract number00700452
Policy instance 7
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number6839
Policy instance 8
AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 )
Policy contract numberG00615636
Policy instance 9
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberG000AYYJ
Policy instance 1

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