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| Plan Name | PLAYMONSTER GROUP, LLC BENEFIT PLAN |
| Plan identification number | 515 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | PLAYMONSTER GROUP, LLC |
| Employer identification number (EIN): | 874285692 |
| NAIC Classification: | 339900 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 515 | 2023-01-01 | BRYAN MARGNER | 2024-07-09 | ||
| 515 | 2022-01-01 | CHRISTINE PHILLIPS | 2023-06-01 |
| Measure | Date | Value |
|---|---|---|
| 2023: PLAYMONSTER GROUP, LLC BENEFIT PLAN 2023 401k membership | ||
| Total participants, beginning-of-year | 2023-01-01 | 104 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-01-01 | 79 |
| 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 | 81 |
| 2022: PLAYMONSTER GROUP, LLC BENEFIT PLAN 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-01-01 | 103 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 99 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 5 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 104 |
| 2023: PLAYMONSTER GROUP, LLC BENEFIT PLAN 2023 form 5500 responses | ||
|---|---|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Submission has been amended | No |
| 2023-01-01 | This submission is the final filing | No |
| 2023-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2023-01-01 | Plan is a collectively bargained plan | No |
| 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 |
| 2022: PLAYMONSTER GROUP, LLC BENEFIT PLAN 2022 form 5500 responses | ||
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | First time form 5500 has been submitted | Yes |
| 2022-01-01 | Submission has been amended | No |
| 2022-01-01 | This submission is the final filing | No |
| 2022-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-01-01 | Plan is a collectively bargained plan | No |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| BLUE CROSS BLUE SHIELD OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54003 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | L05391 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 10038561001 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 162716 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| BLUE CROSS BLUE SHIELD OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54003 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | W80830 & L05391 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 10038561001 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 162716 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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