401k Plan data: PRINT NW EMPLOYEE BENEFIT DENTAL & LIFE PLAN plan

PRINT NW EMPLOYEE BENEFIT DENTAL & LIFE PLAN 401k Plan overview

Plan Name	PRINT NW EMPLOYEE BENEFIT DENTAL & LIFE PLAN
Plan identification number	501

PRINT NW EMPLOYEE BENEFIT DENTAL & LIFE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	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

PRINT NW LLC has sponsored the creation of one or more 401k plans.

Company Name: PRINT NW LLC

Employer identification number (EIN): 912149639

NAIC Classification: 541990
NAIC Description: All Other Professional, Scientific, and Technical Services

Additional information about PRINT NW LLC

Jurisdiction of Incorporation: Washington Secretary of State Corporations Division

Incorporation Date: 2001-10-12

Company Identification Number: 602154923

Legal Registered Office Address: 14205 SE 36TH ST STE 100

BELLEVUE
United States of America (USA)
980061553

More information about PRINT NW LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PRINT NW EMPLOYEE BENEFIT DENTAL & LIFE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2018-01-01 LENA SMITH 2019-07-30
501 2017-01-01 JOHN OLNICK
501 2016-01-01 JOHN OLNICK
501 2015-01-01 LENA SMITH
501 2014-01-01 NED WITTING NED WITTING 2015-07-22

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2018-01-01	LENA SMITH	2019-07-30
501	2017-01-01	JOHN OLNICK
501	2016-01-01	JOHN OLNICK
501	2015-01-01	LENA SMITH
501	2014-01-01	NED WITTING		NED WITTING	2015-07-22

Plan Statistics for PRINT NW EMPLOYEE BENEFIT DENTAL & LIFE PLAN

401k plan membership statisitcs for PRINT NW EMPLOYEE BENEFIT DENTAL & LIFE PLAN

Measure Date Value
2018: PRINT NW EMPLOYEE BENEFIT DENTAL & LIFE PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 58
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 0
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 0
Total of all active and inactive participants 2018-01-01 0
2017: PRINT NW EMPLOYEE BENEFIT DENTAL & LIFE PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 102
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 58
Total of all active and inactive participants 2017-01-01 58
Total participants 2017-01-01 58
2016: PRINT NW EMPLOYEE BENEFIT DENTAL & LIFE PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 121
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 102
Total of all active and inactive participants 2016-01-01 102
Total participants 2016-01-01 102
2015: PRINT NW EMPLOYEE BENEFIT DENTAL & LIFE PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 120
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 150
Total of all active and inactive participants 2015-01-01 150
Total participants 2015-01-01 0
2014: PRINT NW EMPLOYEE BENEFIT DENTAL & LIFE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 123
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 120
Total of all active and inactive participants 2014-01-01 120

Measure	Date	Value
2018: PRINT NW EMPLOYEE BENEFIT DENTAL & LIFE PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	58
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	0
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	0
Total of all active and inactive participants	2018-01-01	0
2017: PRINT NW EMPLOYEE BENEFIT DENTAL & LIFE PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	102
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	58
Total of all active and inactive participants	2017-01-01	58
Total participants	2017-01-01	58
2016: PRINT NW EMPLOYEE BENEFIT DENTAL & LIFE PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	121
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	102
Total of all active and inactive participants	2016-01-01	102
Total participants	2016-01-01	102
2015: PRINT NW EMPLOYEE BENEFIT DENTAL & LIFE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	120
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	150
Total of all active and inactive participants	2015-01-01	150
Total participants	2015-01-01	0
2014: PRINT NW EMPLOYEE BENEFIT DENTAL & LIFE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	123
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	120
Total of all active and inactive participants	2014-01-01	120

Form 5500 Responses for PRINT NW EMPLOYEE BENEFIT DENTAL & LIFE PLAN

2018: PRINT NW EMPLOYEE BENEFIT DENTAL & LIFE PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	Yes
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: PRINT NW EMPLOYEE BENEFIT DENTAL & LIFE PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: PRINT NW EMPLOYEE BENEFIT DENTAL & LIFE PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: PRINT NW EMPLOYEE BENEFIT DENTAL & LIFE PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: PRINT NW EMPLOYEE BENEFIT DENTAL & LIFE PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	First time form 5500 has been submitted	Yes
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

TS05357409

Policy instance

Insurance contract or identification number	TS05357409
Number of Individuals Covered	91
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $20,578
Total amount of fees paid to insurance company	USD $10,234
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
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	AD&D
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $110,974
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $16,450
Amount paid for insurance broker fees	61
Additional information about fees paid to insurance broker	NON-MONETARY COMPENSATION
Insurance broker organization code?	3

METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )

Policy contract number

TS05357409

Policy instance

Insurance contract or identification number	TS05357409
Number of Individuals Covered	58
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $9,760
Total amount of fees paid to insurance company	USD $4,224
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $84,142
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,760
Amount paid for insurance broker fees	31
Additional information about fees paid to insurance broker	NON-MONETARY COMPENSATION
Insurance broker organization code?	3
Insurance broker name	LIAZON BENEFITS INC

LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )

Policy contract number

WA300474

Policy instance

Insurance contract or identification number	WA300474
Number of Individuals Covered	150
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $4,037
Dental Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $83,372
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,037
Insurance broker name	BROWN & BROWN OF WASHINGTON INC

LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )

Policy contract number

WA300474

Policy instance

Insurance contract or identification number	WA300474
Number of Individuals Covered	120
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $3,500
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH & DISMEMBERMENT
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Welfare Benefit Premiums Paid to Carrier	USD $68,291
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,500
Insurance broker organization code?	3
Insurance broker name	BROWN & BROWN OF WASHINGTON INC

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Company Name:	PRINT NW LLC
Employer identification number (EIN):	912149639
NAIC Classification:	541990
NAIC Description:	All Other Professional, Scientific, and Technical Services

Jurisdiction of Incorporation:	Washington Secretary of State Corporations Division
Incorporation Date:	2001-10-12
Company Identification Number:	602154923
Legal Registered Office Address:	14205 SE 36TH ST STE 100 BELLEVUE United States of America (USA) 980061553