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O-AT-KA MILK PRODUCTS COOPERATIVE, INC. BLUE CROSS BLUE SHIELD PLAN 401k Plan overview

Plan NameO-AT-KA MILK PRODUCTS COOPERATIVE, INC. BLUE CROSS BLUE SHIELD PLAN
Plan identification number 501

O-AT-KA MILK PRODUCTS COOPERATIVE, INC. BLUE CROSS BLUE SHIELD PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental

401k Sponsoring company profile

O-AT-KA MILK PRODUCTS COOPERATIVE I has sponsored the creation of one or more 401k plans.

Company Name:O-AT-KA MILK PRODUCTS COOPERATIVE I
Employer identification number (EIN):160819699
NAIC Classification:311500
NAIC Description: Dairy Product Manufacturing

Form 5500 Filing Information

Submission information for form 5500 for 401k plan O-AT-KA MILK PRODUCTS COOPERATIVE, INC. BLUE CROSS BLUE SHIELD PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012016-04-01KATHRYN RIBBECK KATHRYN RIBBECK2017-06-22
5012015-04-01KATHRYN RIBBECK KATHRYN RIBBECK2016-09-29
5012014-04-01KATHRYN RIBBECK KATHRYN RIBBECK2016-01-04
5012013-04-01LORI LUKASIK LORI LUKASIK2014-10-31
5012012-04-01LORI LUKASIK LORI LUKASIK2013-10-24
5012011-04-01LORI LUKASIK
5012010-04-01DANIEL DAUDELIN
5012009-04-01DANIEL DAUDELIN
5012009-04-01DANIEL DAUDELIN
5012009-04-01DANIEL DAUDELIN

Plan Statistics for O-AT-KA MILK PRODUCTS COOPERATIVE, INC. BLUE CROSS BLUE SHIELD PLAN

401k plan membership statisitcs for O-AT-KA MILK PRODUCTS COOPERATIVE, INC. BLUE CROSS BLUE SHIELD PLAN

Measure Date Value
2016: O-AT-KA MILK PRODUCTS COOPERATIVE, INC. BLUE CROSS BLUE SHIELD PLAN 2016 401k membership
Total participants, beginning-of-year2016-04-01470
Total number of active participants reported on line 7a of the Form 55002016-04-010
Total of all active and inactive participants2016-04-010
Total participants2016-04-010
2015: O-AT-KA MILK PRODUCTS COOPERATIVE, INC. BLUE CROSS BLUE SHIELD PLAN 2015 401k membership
Total participants, beginning-of-year2015-04-01434
Total number of active participants reported on line 7a of the Form 55002015-04-01433
Number of retired or separated participants receiving benefits2015-04-011
Total of all active and inactive participants2015-04-01434
Total participants2015-04-01434
2014: O-AT-KA MILK PRODUCTS COOPERATIVE, INC. BLUE CROSS BLUE SHIELD PLAN 2014 401k membership
Total participants, beginning-of-year2014-04-01302
Total number of active participants reported on line 7a of the Form 55002014-04-01276
Number of retired or separated participants receiving benefits2014-04-015
Number of other retired or separated participants entitled to future benefits2014-04-013
Total of all active and inactive participants2014-04-01284
Total participants2014-04-01284
2013: O-AT-KA MILK PRODUCTS COOPERATIVE, INC. BLUE CROSS BLUE SHIELD PLAN 2013 401k membership
Total participants, beginning-of-year2013-04-01282
Total number of active participants reported on line 7a of the Form 55002013-04-01276
Number of retired or separated participants receiving benefits2013-04-014
Total of all active and inactive participants2013-04-01280
Total participants2013-04-01280
2012: O-AT-KA MILK PRODUCTS COOPERATIVE, INC. BLUE CROSS BLUE SHIELD PLAN 2012 401k membership
Total participants, beginning-of-year2012-04-01279
Total number of active participants reported on line 7a of the Form 55002012-04-01276
Number of retired or separated participants receiving benefits2012-04-016
Total of all active and inactive participants2012-04-01282
Total participants2012-04-01282
2011: O-AT-KA MILK PRODUCTS COOPERATIVE, INC. BLUE CROSS BLUE SHIELD PLAN 2011 401k membership
Total participants, beginning-of-year2011-04-01277
Total number of active participants reported on line 7a of the Form 55002011-04-01276
Number of retired or separated participants receiving benefits2011-04-012
Total of all active and inactive participants2011-04-01278
Total participants2011-04-01278
2010: O-AT-KA MILK PRODUCTS COOPERATIVE, INC. BLUE CROSS BLUE SHIELD PLAN 2010 401k membership
Total participants, beginning-of-year2010-04-01271
Total number of active participants reported on line 7a of the Form 55002010-04-01272
Number of retired or separated participants receiving benefits2010-04-012
Total of all active and inactive participants2010-04-01274
Total participants2010-04-01274
2009: O-AT-KA MILK PRODUCTS COOPERATIVE, INC. BLUE CROSS BLUE SHIELD PLAN 2009 401k membership
Total participants, beginning-of-year2009-04-01277
Total number of active participants reported on line 7a of the Form 55002009-04-01274
Number of retired or separated participants receiving benefits2009-04-012
Total of all active and inactive participants2009-04-01276
Total participants2009-04-01276

Form 5500 Responses for O-AT-KA MILK PRODUCTS COOPERATIVE, INC. BLUE CROSS BLUE SHIELD PLAN

2016: O-AT-KA MILK PRODUCTS COOPERATIVE, INC. BLUE CROSS BLUE SHIELD PLAN 2016 form 5500 responses
2016-04-01Type of plan entitySingle employer plan
2016-04-01Submission has been amendedNo
2016-04-01This submission is the final filingYes
2016-04-01This return/report is a short plan year return/report (less than 12 months)No
2016-04-01Plan is a collectively bargained planNo
2016-04-01Plan funding arrangement – InsuranceYes
2016-04-01Plan funding arrangement – General assets of the sponsorYes
2016-04-01Plan benefit arrangement – InsuranceYes
2016-04-01Plan benefit arrangement – General assets of the sponsorYes
2015: O-AT-KA MILK PRODUCTS COOPERATIVE, INC. BLUE CROSS BLUE SHIELD PLAN 2015 form 5500 responses
2015-04-01Type of plan entitySingle employer plan
2015-04-01Submission has been amendedNo
2015-04-01This submission is the final filingNo
2015-04-01This return/report is a short plan year return/report (less than 12 months)No
2015-04-01Plan is a collectively bargained planNo
2015-04-01Plan funding arrangement – InsuranceYes
2015-04-01Plan funding arrangement – General assets of the sponsorYes
2015-04-01Plan benefit arrangement – InsuranceYes
2015-04-01Plan benefit arrangement – General assets of the sponsorYes
2014: O-AT-KA MILK PRODUCTS COOPERATIVE, INC. BLUE CROSS BLUE SHIELD PLAN 2014 form 5500 responses
2014-04-01Type of plan entitySingle employer plan
2014-04-01Submission has been amendedNo
2014-04-01This submission is the final filingNo
2014-04-01This return/report is a short plan year return/report (less than 12 months)No
2014-04-01Plan is a collectively bargained planNo
2014-04-01Plan funding arrangement – InsuranceYes
2014-04-01Plan funding arrangement – General assets of the sponsorYes
2014-04-01Plan benefit arrangement – InsuranceYes
2014-04-01Plan benefit arrangement – General assets of the sponsorYes
2013: O-AT-KA MILK PRODUCTS COOPERATIVE, INC. BLUE CROSS BLUE SHIELD PLAN 2013 form 5500 responses
2013-04-01Type of plan entitySingle employer plan
2013-04-01First time form 5500 has been submittedYes
2013-04-01Submission has been amendedNo
2013-04-01This submission is the final filingNo
2013-04-01This return/report is a short plan year return/report (less than 12 months)No
2013-04-01Plan is a collectively bargained planNo
2013-04-01Plan funding arrangement – InsuranceYes
2013-04-01Plan funding arrangement – General assets of the sponsorYes
2013-04-01Plan benefit arrangement – InsuranceYes
2013-04-01Plan benefit arrangement – General assets of the sponsorYes
2012: O-AT-KA MILK PRODUCTS COOPERATIVE, INC. BLUE CROSS BLUE SHIELD PLAN 2012 form 5500 responses
2012-04-01Type of plan entitySingle employer plan
2012-04-01First time form 5500 has been submittedYes
2012-04-01Submission has been amendedNo
2012-04-01This submission is the final filingNo
2012-04-01This return/report is a short plan year return/report (less than 12 months)No
2012-04-01Plan is a collectively bargained planNo
2012-04-01Plan funding arrangement – InsuranceYes
2012-04-01Plan funding arrangement – General assets of the sponsorYes
2012-04-01Plan benefit arrangement – InsuranceYes
2012-04-01Plan benefit arrangement – General assets of the sponsorYes
2011: O-AT-KA MILK PRODUCTS COOPERATIVE, INC. BLUE CROSS BLUE SHIELD PLAN 2011 form 5500 responses
2011-04-01Type of plan entitySingle employer plan
2011-04-01First time form 5500 has been submittedYes
2011-04-01Submission has been amendedNo
2011-04-01This submission is the final filingNo
2011-04-01This return/report is a short plan year return/report (less than 12 months)No
2011-04-01Plan is a collectively bargained planNo
2011-04-01Plan funding arrangement – InsuranceYes
2011-04-01Plan funding arrangement – General assets of the sponsorYes
2011-04-01Plan benefit arrangement – InsuranceYes
2011-04-01Plan benefit arrangement – General assets of the sponsorYes
2010: O-AT-KA MILK PRODUCTS COOPERATIVE, INC. BLUE CROSS BLUE SHIELD PLAN 2010 form 5500 responses
2010-04-01Type of plan entitySingle employer plan
2010-04-01First time form 5500 has been submittedYes
2010-04-01Submission has been amendedNo
2010-04-01This submission is the final filingNo
2010-04-01This return/report is a short plan year return/report (less than 12 months)No
2010-04-01Plan is a collectively bargained planNo
2010-04-01Plan funding arrangement – InsuranceYes
2010-04-01Plan funding arrangement – General assets of the sponsorYes
2010-04-01Plan benefit arrangement – InsuranceYes
2010-04-01Plan benefit arrangement – General assets of the sponsorYes
2009: O-AT-KA MILK PRODUCTS COOPERATIVE, INC. BLUE CROSS BLUE SHIELD PLAN 2009 form 5500 responses
2009-04-01Type of plan entitySingle employer plan
2009-04-01Submission has been amendedYes
2009-04-01This submission is the final filingNo
2009-04-01This return/report is a short plan year return/report (less than 12 months)No
2009-04-01Plan is a collectively bargained planNo
2009-04-01Plan funding arrangement – InsuranceYes
2009-04-01Plan funding arrangement – General assets of the sponsorYes
2009-04-01Plan benefit arrangement – InsuranceYes
2009-04-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

HEATHNOW OF NEW YORK, INC (National Association of Insurance Commissioners NAIC id number: 55204 )
Policy contract number00090147
Policy instance 1
Insurance contract or identification number00090147
Number of Individuals Covered275
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Total amount of commissions paid to insurance brokerUSD $24,500
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 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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $24,500
Insurance broker nameLAWLEY BENEFITS GROUP
HEATHNOW OF NEW YORK, INC (National Association of Insurance Commissioners NAIC id number: 55204 )
Policy contract number00417959
Policy instance 2
Insurance contract or identification number00417959
Number of Individuals Covered434
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Total amount of commissions paid to insurance brokerUSD $28,019
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 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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $28,019
Insurance broker nameLAWLEY BENEFITS GROUP
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number00090147
Policy instance 1
Insurance contract or identification number00090147
Number of Individuals Covered278
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $35,938
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 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 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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,938
Insurance broker nameLAWLEY BENEFITS GROUP
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number00090147
Policy instance 1
Insurance contract or identification number00090147
Number of Individuals Covered663
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $51,136
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 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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedPOS
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $51,136
Insurance broker nameLAWLEY BENEFIT GROUP
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number00090147
Policy instance 1
Insurance contract or identification number00090147
Number of Individuals Covered683
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $47,660
Other welfare benefits providedPOS
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $47,660
Insurance broker nameLAWLEY BENEFIT GROUP
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number00090147
Policy instance 1
Insurance contract or identification number00090147
Number of Individuals Covered704
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Total amount of commissions paid to insurance brokerUSD $62,115
Other welfare benefits providedPOS
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTHNOW NEW YORK, INC. DBA BLUESHIELD OF NORTHEASTERN NEW YORK (National Association of Insurance Commissioners NAIC id number: )
Policy contract number00090147
Policy instance 1
Insurance contract or identification number00090147
Number of Individuals Covered672
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $52,350
Other welfare benefits providedPOS
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $52,350
Insurance broker nameLAWLEY BENEFITS GRP

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