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| Plan Name | ROTO-MIX, LLC EMPLOYEE MEDICAL BENEFIT PLAN |
| Plan identification number | 505 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | ROTO-MIX, LLC |
| Employer identification number (EIN): | 203977759 |
| NAIC Classification: | 333100 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 505 | 2023-06-01 | RODNEY R. NEIER | 2024-11-21 | ||
| 505 | 2022-06-01 | RODNEY R. NEIER | 2024-03-04 | ||
| 505 | 2016-06-01 | ||||
| 505 | 2015-06-01 | ||||
| 505 | 2014-06-01 | ROD NEIER | 2018-10-23 | ||
| 505 | 2013-06-01 | RODNEY R. NEIER |
| 2023: ROTO-MIX, LLC EMPLOYEE MEDICAL BENEFIT PLAN 2023 form 5500 responses | ||
|---|---|---|
| 2023-06-01 | Type of plan entity | Single employer plan |
| 2023-06-01 | Submission has been amended | No |
| 2023-06-01 | This submission is the final filing | No |
| 2023-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2023-06-01 | Plan is a collectively bargained plan | No |
| 2023-06-01 | Plan funding arrangement – Insurance | Yes |
| 2023-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2023-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2023-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2022: ROTO-MIX, LLC EMPLOYEE MEDICAL BENEFIT PLAN 2022 form 5500 responses | ||
| 2022-06-01 | Type of plan entity | Single employer plan |
| 2022-06-01 | Submission has been amended | No |
| 2022-06-01 | This submission is the final filing | No |
| 2022-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-06-01 | Plan is a collectively bargained plan | No |
| 2022-06-01 | Plan funding arrangement – Insurance | Yes |
| 2022-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: ROTO-MIX, LLC EMPLOYEE MEDICAL BENEFIT PLAN 2016 form 5500 responses | ||
| 2016-06-01 | Type of plan entity | Single employer plan |
| 2016-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: ROTO-MIX, LLC EMPLOYEE MEDICAL BENEFIT PLAN 2015 form 5500 responses | ||
| 2015-06-01 | Type of plan entity | Single employer plan |
| 2015-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: ROTO-MIX, LLC EMPLOYEE MEDICAL BENEFIT PLAN 2014 form 5500 responses | ||
| 2014-06-01 | Type of plan entity | Single employer plan |
| 2014-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: ROTO-MIX, LLC EMPLOYEE MEDICAL BENEFIT PLAN 2013 form 5500 responses | ||
| 2013-06-01 | Type of plan entity | Single employer plan |
| 2013-06-01 | First time form 5500 has been submitted | Yes |
| 2013-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | SY809 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
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| MEDICAL AIR SERVICES ASSOCIATION, INC. (National Association of Insurance Commissioners NAIC id number: 62191 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | B2BMLLC | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
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| KANSAS CITY LIFE (National Association of Insurance Commissioners NAIC id number: 65129 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 65129 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
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| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | SY809 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| MEDICAL AIR SERVICES ASSOCIATION, INC. (National Association of Insurance Commissioners NAIC id number: 62191 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | B2BMLLC | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| KANSAS CITY LIFE (National Association of Insurance Commissioners NAIC id number: 65129 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
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