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NORTH STAR FERTILITY PARTNERS HEALTH AND WELFARE BENEFIT PLAN 401k Plan overview

Plan NameNORTH STAR FERTILITY PARTNERS HEALTH AND WELFARE BENEFIT PLAN
Plan identification number 501

NORTH STAR FERTILITY PARTNERS HEALTH AND WELFARE BENEFIT 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
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

NORTH STAR FERTILITY PARTNERS, LLC has sponsored the creation of one or more 401k plans.

Company Name:NORTH STAR FERTILITY PARTNERS, LLC
Employer identification number (EIN):822729464
NAIC Classification:541990
NAIC Description:All Other Professional, Scientific, and Technical Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTH STAR FERTILITY PARTNERS HEALTH AND WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-02-01JEANNINE EDGREN2024-07-19

Plan Statistics for NORTH STAR FERTILITY PARTNERS HEALTH AND WELFARE BENEFIT PLAN

401k plan membership statisitcs for NORTH STAR FERTILITY PARTNERS HEALTH AND WELFARE BENEFIT PLAN

Measure Date Value
2023: NORTH STAR FERTILITY PARTNERS HEALTH AND WELFARE BENEFIT PLAN 2023 401k membership
Total participants, beginning-of-year2023-02-01169
Total number of active participants reported on line 7a of the Form 55002023-02-01169
Number of retired or separated participants receiving benefits2023-02-012
Number of other retired or separated participants entitled to future benefits2023-02-010
Total of all active and inactive participants2023-02-01171

Form 5500 Responses for NORTH STAR FERTILITY PARTNERS HEALTH AND WELFARE BENEFIT PLAN

2023: NORTH STAR FERTILITY PARTNERS HEALTH AND WELFARE BENEFIT PLAN 2023 form 5500 responses
2023-02-01Type of plan entitySingle employer plan
2023-02-01First time form 5500 has been submittedYes
2023-02-01Submission has been amendedNo
2023-02-01This submission is the final filingNo
2023-02-01This return/report is a short plan year return/report (less than 12 months)Yes
2023-02-01Plan is a collectively bargained planNo
2023-02-01Plan funding arrangement – InsuranceYes
2023-02-01Plan funding arrangement – General assets of the sponsorYes
2023-02-01Plan benefit arrangement – InsuranceYes
2023-02-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. (National Association of Insurance Commissioners NAIC id number: 53228 )
Policy contract number4956534
Policy instance 1
Insurance contract or identification number4956534
Number of Individuals Covered151
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $31,287
Total amount of fees paid to insurance companyUSD $8,400
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 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 $993,111
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30065276
Policy instance 2
Insurance contract or identification number30065276
Number of Individuals Covered74
Insurance policy start date2023-02-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $832
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
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 $11,288
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 numberG000C9GJ
Policy instance 3
Insurance contract or identification numberG000C9GJ
Number of Individuals Covered169
Insurance policy start date2023-02-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $13,426
Total amount of fees paid to insurance companyUSD $0
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 BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT,ACCIDENT, CRITICAL ILLNESS
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 $89,508
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

Potentially related plans

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