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FOREST COUNTY POTAWATOMI COMMUNITY EMPLOYEE GROUP TERM LIFE PLAN 401k Plan overview

Plan NameFOREST COUNTY POTAWATOMI COMMUNITY EMPLOYEE GROUP TERM LIFE PLAN
Plan identification number 501

FOREST COUNTY POTAWATOMI COMMUNITY EMPLOYEE GROUP TERM LIFE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)

401k Sponsoring company profile

FOREST COUNTY POTAWATOMI COMMUNITY has sponsored the creation of one or more 401k plans.

Company Name:FOREST COUNTY POTAWATOMI COMMUNITY
Employer identification number (EIN):391225059
NAIC Classification:921000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FOREST COUNTY POTAWATOMI COMMUNITY EMPLOYEE GROUP TERM LIFE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-04-01MEGAN GERBER, CONTROLLER2024-01-16
5012021-04-01KEVIN L. HANSON, CFO2023-01-11
5012020-04-01KEVIN L. HANSON, CFO2022-02-07
5012019-04-01KEVIN L. HANSON, CFO2021-01-12
5012018-04-01KEVIN L. HANSON, CFO2019-10-28
5012017-04-01KEVIN L. HANSON, CFO2019-09-12
5012016-04-01KEVIN L. HANSON, CFO2019-09-12
5012015-04-01KEVIN L. HANSON, CFO2019-09-13
5012014-04-01KEVIN L. HANSON, CFO2019-09-12
5012013-04-01KEVIN L. HANSON, CFO2019-09-12

Plan Statistics for FOREST COUNTY POTAWATOMI COMMUNITY EMPLOYEE GROUP TERM LIFE PLAN

401k plan membership statisitcs for FOREST COUNTY POTAWATOMI COMMUNITY EMPLOYEE GROUP TERM LIFE PLAN

Measure Date Value
2022: FOREST COUNTY POTAWATOMI COMMUNITY EMPLOYEE GROUP TERM LIFE PLAN 2022 401k membership
Total participants, beginning-of-year2022-04-01506
Total number of active participants reported on line 7a of the Form 55002022-04-01506
Total of all active and inactive participants2022-04-01506
2021: FOREST COUNTY POTAWATOMI COMMUNITY EMPLOYEE GROUP TERM LIFE PLAN 2021 401k membership
Total participants, beginning-of-year2021-04-01489
Total number of active participants reported on line 7a of the Form 55002021-04-01506
Total of all active and inactive participants2021-04-01506
2020: FOREST COUNTY POTAWATOMI COMMUNITY EMPLOYEE GROUP TERM LIFE PLAN 2020 401k membership
Total participants, beginning-of-year2020-04-01622
Total number of active participants reported on line 7a of the Form 55002020-04-01489
Total of all active and inactive participants2020-04-01489
2019: FOREST COUNTY POTAWATOMI COMMUNITY EMPLOYEE GROUP TERM LIFE PLAN 2019 401k membership
Total participants, beginning-of-year2019-04-01620
Total number of active participants reported on line 7a of the Form 55002019-04-01622
Total of all active and inactive participants2019-04-01622
2018: FOREST COUNTY POTAWATOMI COMMUNITY EMPLOYEE GROUP TERM LIFE PLAN 2018 401k membership
Total participants, beginning-of-year2018-04-01612
Total number of active participants reported on line 7a of the Form 55002018-04-01620
Total of all active and inactive participants2018-04-01620
2017: FOREST COUNTY POTAWATOMI COMMUNITY EMPLOYEE GROUP TERM LIFE PLAN 2017 401k membership
Total participants, beginning-of-year2017-04-01587
Total number of active participants reported on line 7a of the Form 55002017-04-01612
Total of all active and inactive participants2017-04-01612
2016: FOREST COUNTY POTAWATOMI COMMUNITY EMPLOYEE GROUP TERM LIFE PLAN 2016 401k membership
Total participants, beginning-of-year2016-04-01572
Total number of active participants reported on line 7a of the Form 55002016-04-01587
Total of all active and inactive participants2016-04-01587
2015: FOREST COUNTY POTAWATOMI COMMUNITY EMPLOYEE GROUP TERM LIFE PLAN 2015 401k membership
Total participants, beginning-of-year2015-04-01587
Total number of active participants reported on line 7a of the Form 55002015-04-01572
Total of all active and inactive participants2015-04-01572
2014: FOREST COUNTY POTAWATOMI COMMUNITY EMPLOYEE GROUP TERM LIFE PLAN 2014 401k membership
Total participants, beginning-of-year2014-04-01586
Total number of active participants reported on line 7a of the Form 55002014-04-01587
Total of all active and inactive participants2014-04-01587
2013: FOREST COUNTY POTAWATOMI COMMUNITY EMPLOYEE GROUP TERM LIFE PLAN 2013 401k membership
Total participants, beginning-of-year2013-04-01529
Total number of active participants reported on line 7a of the Form 55002013-04-01586
Total of all active and inactive participants2013-04-01586

Form 5500 Responses for FOREST COUNTY POTAWATOMI COMMUNITY EMPLOYEE GROUP TERM LIFE PLAN

2022: FOREST COUNTY POTAWATOMI COMMUNITY EMPLOYEE GROUP TERM LIFE PLAN 2022 form 5500 responses
2022-04-01Type of plan entitySingle employer plan
2022-04-01Plan funding arrangement – InsuranceYes
2022-04-01Plan funding arrangement – General assets of the sponsorYes
2022-04-01Plan benefit arrangement – InsuranceYes
2022-04-01Plan benefit arrangement – General assets of the sponsorYes
2021: FOREST COUNTY POTAWATOMI COMMUNITY EMPLOYEE GROUP TERM LIFE PLAN 2021 form 5500 responses
2021-04-01Type of plan entitySingle employer plan
2021-04-01Plan funding arrangement – InsuranceYes
2021-04-01Plan funding arrangement – General assets of the sponsorYes
2021-04-01Plan benefit arrangement – InsuranceYes
2021-04-01Plan benefit arrangement – General assets of the sponsorYes
2020: FOREST COUNTY POTAWATOMI COMMUNITY EMPLOYEE GROUP TERM LIFE PLAN 2020 form 5500 responses
2020-04-01Type of plan entitySingle employer plan
2020-04-01Plan funding arrangement – InsuranceYes
2020-04-01Plan funding arrangement – General assets of the sponsorYes
2020-04-01Plan benefit arrangement – InsuranceYes
2020-04-01Plan benefit arrangement – General assets of the sponsorYes
2019: FOREST COUNTY POTAWATOMI COMMUNITY EMPLOYEE GROUP TERM LIFE PLAN 2019 form 5500 responses
2019-04-01Type of plan entitySingle employer plan
2019-04-01Plan funding arrangement – InsuranceYes
2019-04-01Plan funding arrangement – General assets of the sponsorYes
2019-04-01Plan benefit arrangement – InsuranceYes
2019-04-01Plan benefit arrangement – General assets of the sponsorYes
2018: FOREST COUNTY POTAWATOMI COMMUNITY EMPLOYEE GROUP TERM LIFE PLAN 2018 form 5500 responses
2018-04-01Type of plan entitySingle employer plan
2018-04-01Plan funding arrangement – InsuranceYes
2018-04-01Plan funding arrangement – General assets of the sponsorYes
2018-04-01Plan benefit arrangement – InsuranceYes
2018-04-01Plan benefit arrangement – General assets of the sponsorYes
2017: FOREST COUNTY POTAWATOMI COMMUNITY EMPLOYEE GROUP TERM LIFE PLAN 2017 form 5500 responses
2017-04-01Type of plan entitySingle employer plan
2017-04-01Plan funding arrangement – InsuranceYes
2017-04-01Plan funding arrangement – General assets of the sponsorYes
2017-04-01Plan benefit arrangement – InsuranceYes
2017-04-01Plan benefit arrangement – General assets of the sponsorYes
2016: FOREST COUNTY POTAWATOMI COMMUNITY EMPLOYEE GROUP TERM LIFE PLAN 2016 form 5500 responses
2016-04-01Type of plan entitySingle employer plan
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: FOREST COUNTY POTAWATOMI COMMUNITY EMPLOYEE GROUP TERM LIFE 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: FOREST COUNTY POTAWATOMI COMMUNITY EMPLOYEE GROUP TERM LIFE PLAN 2014 form 5500 responses
2014-04-01Type of plan entitySingle employer plan
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: FOREST COUNTY POTAWATOMI COMMUNITY EMPLOYEE GROUP TERM LIFE PLAN 2013 form 5500 responses
2013-04-01Type of plan entitySingle employer plan
2013-04-01First time form 5500 has been submittedYes
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

Insurance Providers Used on plan

SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-017760-00
Policy instance 1
Insurance contract or identification number01-017760-00
Number of Individuals Covered650
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $16,754
Total amount of fees paid to insurance companyUSD $7,438
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $335,072
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,754
Amount paid for insurance broker fees7438
Additional information about fees paid to insurance brokerGROUP VOLUME BONUS
Insurance broker organization code?3
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-017760-00
Policy instance 1
Insurance contract or identification number01-017760-00
Number of Individuals Covered650
Insurance policy start date2021-04-01
Insurance policy end date2022-03-31
Total amount of commissions paid to insurance brokerUSD $16,754
Total amount of fees paid to insurance companyUSD $7,438
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $335,072
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,754
Amount paid for insurance broker fees7438
Additional information about fees paid to insurance brokerGROUP VOLUME BONUS
Insurance broker organization code?3
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-017760-00
Policy instance 1
Insurance contract or identification number01-017760-00
Number of Individuals Covered665
Insurance policy start date2020-04-01
Insurance policy end date2021-03-31
Total amount of commissions paid to insurance brokerUSD $14,432
Total amount of fees paid to insurance companyUSD $9,345
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $288,633
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,432
Amount paid for insurance broker fees9345
Additional information about fees paid to insurance brokerGROUP VOLUME BONUS
Insurance broker organization code?3
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-017760-00
Policy instance 1
Insurance contract or identification number01-017760-00
Number of Individuals Covered876
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $19,440
Total amount of fees paid to insurance companyUSD $11,417
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $388,805
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,440
Amount paid for insurance broker fees11417
Additional information about fees paid to insurance brokerGROUP VOLUME BONUS
Insurance broker organization code?3
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-017760-00
Policy instance 1
Insurance contract or identification number01-017760-00
Number of Individuals Covered828
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $17,831
Total amount of fees paid to insurance companyUSD $7,610
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $356,626
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,831
Amount paid for insurance broker fees7610
Additional information about fees paid to insurance brokerGROUP VOLUME BONUS
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80012 )
Policy contract number0865231-0865232
Policy instance 1
Insurance contract or identification number0865231-0865232
Number of Individuals Covered1045
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $29,170
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $615,936
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80012 )
Policy contract number0865231-0865232
Policy instance 1
Insurance contract or identification number0865231-0865232
Number of Individuals Covered1116
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $35,158
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $558,098
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,158
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80012 )
Policy contract number0865231-0865232
Policy instance 1
Insurance contract or identification number0865231-0865232
Number of Individuals Covered1064
Insurance policy start date2013-04-01
Insurance policy end date2014-03-31
Total amount of commissions paid to insurance brokerUSD $17,567
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $440,939
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,567
Insurance broker organization code?3

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