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CATHOLIC CHARITIES OF THE DIOCESE OF ST CLOUD HMO PLAN 401k Plan overview

Plan NameCATHOLIC CHARITIES OF THE DIOCESE OF ST CLOUD HMO PLAN
Plan identification number 502

CATHOLIC CHARITIES OF THE DIOCESE OF ST CLOUD HMO PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Vision
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

THE CATHOLIC CHARITIES OF THE DIOCESE OF ST CLOUD has sponsored the creation of one or more 401k plans.

Company Name:THE CATHOLIC CHARITIES OF THE DIOCESE OF ST CLOUD
Employer identification number (EIN):410737799
NAIC Classification:813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CATHOLIC CHARITIES OF THE DIOCESE OF ST CLOUD HMO PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022017-01-01JOANNE BROSCHOFSKY
5022016-01-01JOANNE BROSCHOFSKY
5022015-01-01JOANNE BROSCHOFSKY
5022014-01-01JOANNE BROSCHOFSKY JOANNE BROSCHOFSKY2015-05-14
5022013-01-01JOANNE BROSCHOFSKY JOANNE BROSCHOFSKY2014-04-03
5022012-01-01JOANNE BROSCHOFSKY JOANNE BROSCHOFSKY2013-07-16
5022011-01-01JOANNE BROSCHOFSKY
5022009-01-01JOANNE BROSCHOFSKY

Plan Statistics for CATHOLIC CHARITIES OF THE DIOCESE OF ST CLOUD HMO PLAN

401k plan membership statisitcs for CATHOLIC CHARITIES OF THE DIOCESE OF ST CLOUD HMO PLAN

Measure Date Value
2017: CATHOLIC CHARITIES OF THE DIOCESE OF ST CLOUD HMO PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01129
Total number of active participants reported on line 7a of the Form 55002017-01-0193
Number of retired or separated participants receiving benefits2017-01-011
Total of all active and inactive participants2017-01-0194
Total participants2017-01-0194
2016: CATHOLIC CHARITIES OF THE DIOCESE OF ST CLOUD HMO PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01135
Total number of active participants reported on line 7a of the Form 55002016-01-01128
Number of retired or separated participants receiving benefits2016-01-011
Total of all active and inactive participants2016-01-01129
Total participants2016-01-01129
2015: CATHOLIC CHARITIES OF THE DIOCESE OF ST CLOUD HMO PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01146
Total number of active participants reported on line 7a of the Form 55002015-01-01134
Number of retired or separated participants receiving benefits2015-01-011
Total of all active and inactive participants2015-01-01135
Total participants2015-01-01135
2014: CATHOLIC CHARITIES OF THE DIOCESE OF ST CLOUD HMO PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01177
Total number of active participants reported on line 7a of the Form 55002014-01-01145
Number of retired or separated participants receiving benefits2014-01-011
Total of all active and inactive participants2014-01-01146
Total participants2014-01-01146
2013: CATHOLIC CHARITIES OF THE DIOCESE OF ST CLOUD HMO PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01179
Total number of active participants reported on line 7a of the Form 55002013-01-01176
Number of retired or separated participants receiving benefits2013-01-011
Total of all active and inactive participants2013-01-01177
Total participants2013-01-01177
2012: CATHOLIC CHARITIES OF THE DIOCESE OF ST CLOUD HMO PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01187
Total number of active participants reported on line 7a of the Form 55002012-01-01176
Number of retired or separated participants receiving benefits2012-01-013
Total of all active and inactive participants2012-01-01179
Total participants2012-01-01179
2011: CATHOLIC CHARITIES OF THE DIOCESE OF ST CLOUD HMO PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01246
Total number of active participants reported on line 7a of the Form 55002011-01-01184
Number of retired or separated participants receiving benefits2011-01-013
Total of all active and inactive participants2011-01-01187
Total participants2011-01-01187
2009: CATHOLIC CHARITIES OF THE DIOCESE OF ST CLOUD HMO PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01243
Total number of active participants reported on line 7a of the Form 55002009-01-01247
Number of retired or separated participants receiving benefits2009-01-012
Total of all active and inactive participants2009-01-01249
Total participants2009-01-01249

Form 5500 Responses for CATHOLIC CHARITIES OF THE DIOCESE OF ST CLOUD HMO PLAN

2017: CATHOLIC CHARITIES OF THE DIOCESE OF ST CLOUD HMO PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: CATHOLIC CHARITIES OF THE DIOCESE OF ST CLOUD HMO PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: CATHOLIC CHARITIES OF THE DIOCESE OF ST CLOUD HMO PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: CATHOLIC CHARITIES OF THE DIOCESE OF ST CLOUD HMO PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: CATHOLIC CHARITIES OF THE DIOCESE OF ST CLOUD HMO PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: CATHOLIC CHARITIES OF THE DIOCESE OF ST CLOUD HMO PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: CATHOLIC CHARITIES OF THE DIOCESE OF ST CLOUD HMO PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: CATHOLIC CHARITIES OF THE DIOCESE OF ST CLOUD HMO PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

DELTA DENTAL PLAN OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number000006040800122
Policy instance 1
Insurance contract or identification number000006040800122
Number of Individuals Covered92
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,329
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $30,795
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,329
Insurance broker organization code?3
Insurance broker nameNORTH RISK PARTNERS LLC
PREFERREDONE ADMINISTRATIVE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: )
Policy contract numberPKA20080
Policy instance 2
Insurance contract or identification numberPKA20080
Number of Individuals Covered94
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $20,040
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $470,638
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,040
Insurance broker organization code?3
Insurance broker nameNORTH RISK PARTNERS LLC

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