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ST. CROIX OF PARK FALLS, LTD. LIFE PLAN 401k Plan overview

Plan NameST. CROIX OF PARK FALLS, LTD. LIFE PLAN
Plan identification number 501

ST. CROIX OF PARK FALLS, LTD. LIFE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

ST. CROIX OF PARK FALLS, LTD has sponsored the creation of one or more 401k plans.

Company Name:ST. CROIX OF PARK FALLS, LTD
Employer identification number (EIN):391287923
NAIC Classification:339900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ST. CROIX OF PARK FALLS, LTD. LIFE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012017-10-01PAUL RYBAK
5012016-10-01PAUL RYBAK PAUL RYBAK2018-04-27
5012015-10-01PAUL RYBAK
5012014-10-01WARREN WEAVER WARREN WEAVER2016-04-27
5012013-10-01WARREN WEAVER WARREN WEAVER2015-04-28
5012012-10-01WARREN WEAVER WARREN WEAVER2014-05-01
5012011-10-01DAWN STREHLOW DAWN STREHLOW2013-04-30
5012009-10-01DAWN STREHLOW

Plan Statistics for ST. CROIX OF PARK FALLS, LTD. LIFE PLAN

401k plan membership statisitcs for ST. CROIX OF PARK FALLS, LTD. LIFE PLAN

Measure Date Value
2017: ST. CROIX OF PARK FALLS, LTD. LIFE PLAN 2017 401k membership
Total participants, beginning-of-year2017-10-01136
Total number of active participants reported on line 7a of the Form 55002017-10-010
Number of retired or separated participants receiving benefits2017-10-010
Number of other retired or separated participants entitled to future benefits2017-10-010
Total of all active and inactive participants2017-10-010
2016: ST. CROIX OF PARK FALLS, LTD. LIFE PLAN 2016 401k membership
Total participants, beginning-of-year2016-10-01130
Total number of active participants reported on line 7a of the Form 55002016-10-01137
Total of all active and inactive participants2016-10-01137
Total participants2016-10-01137
2015: ST. CROIX OF PARK FALLS, LTD. LIFE PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-01127
Total number of active participants reported on line 7a of the Form 55002015-10-01130
Total of all active and inactive participants2015-10-01130
Total participants2015-10-01130
2014: ST. CROIX OF PARK FALLS, LTD. LIFE PLAN 2014 401k membership
Total participants, beginning-of-year2014-10-01137
Total number of active participants reported on line 7a of the Form 55002014-10-01127
Total of all active and inactive participants2014-10-01127
Total participants2014-10-01127
2013: ST. CROIX OF PARK FALLS, LTD. LIFE PLAN 2013 401k membership
Total participants, beginning-of-year2013-10-01132
Total number of active participants reported on line 7a of the Form 55002013-10-01137
Total of all active and inactive participants2013-10-01137
Total participants2013-10-01137
2012: ST. CROIX OF PARK FALLS, LTD. LIFE PLAN 2012 401k membership
Total participants, beginning-of-year2012-10-01117
Total number of active participants reported on line 7a of the Form 55002012-10-01132
Total of all active and inactive participants2012-10-01132
Total participants2012-10-01132
2011: ST. CROIX OF PARK FALLS, LTD. LIFE PLAN 2011 401k membership
Total participants, beginning-of-year2011-10-01111
Total number of active participants reported on line 7a of the Form 55002011-10-01117
Total of all active and inactive participants2011-10-01117
Total participants2011-10-01117
Number of employers contributing to the scheme2011-10-010
2009: ST. CROIX OF PARK FALLS, LTD. LIFE PLAN 2009 401k membership
Total participants, beginning-of-year2009-10-01100
Total number of active participants reported on line 7a of the Form 55002009-10-01108
Number of retired or separated participants receiving benefits2009-10-010
Number of other retired or separated participants entitled to future benefits2009-10-010
Total of all active and inactive participants2009-10-01108

Form 5500 Responses for ST. CROIX OF PARK FALLS, LTD. LIFE PLAN

2017: ST. CROIX OF PARK FALLS, LTD. LIFE PLAN 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01Submission has been amendedNo
2017-10-01This submission is the final filingYes
2017-10-01This return/report is a short plan year return/report (less than 12 months)Yes
2017-10-01Plan is a collectively bargained planNo
2017-10-01Plan funding arrangement – InsuranceYes
2017-10-01Plan benefit arrangement – InsuranceYes
2016: ST. CROIX OF PARK FALLS, LTD. LIFE PLAN 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01Submission has been amendedNo
2016-10-01This submission is the final filingNo
2016-10-01This return/report is a short plan year return/report (less than 12 months)No
2016-10-01Plan is a collectively bargained planNo
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan benefit arrangement – InsuranceYes
2015: ST. CROIX OF PARK FALLS, LTD. LIFE PLAN 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01Submission has been amendedNo
2015-10-01This submission is the final filingNo
2015-10-01This return/report is a short plan year return/report (less than 12 months)No
2015-10-01Plan is a collectively bargained planNo
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan benefit arrangement – InsuranceYes
2014: ST. CROIX OF PARK FALLS, LTD. LIFE PLAN 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01Submission has been amendedNo
2014-10-01This submission is the final filingNo
2014-10-01This return/report is a short plan year return/report (less than 12 months)No
2014-10-01Plan is a collectively bargained planNo
2014-10-01Plan funding arrangement – InsuranceYes
2014-10-01Plan benefit arrangement – InsuranceYes
2013: ST. CROIX OF PARK FALLS, LTD. LIFE PLAN 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01Submission has been amendedNo
2013-10-01This submission is the final filingNo
2013-10-01This return/report is a short plan year return/report (less than 12 months)No
2013-10-01Plan is a collectively bargained planNo
2013-10-01Plan funding arrangement – InsuranceYes
2013-10-01Plan benefit arrangement – InsuranceYes
2012: ST. CROIX OF PARK FALLS, LTD. LIFE PLAN 2012 form 5500 responses
2012-10-01Type of plan entitySingle employer plan
2012-10-01Submission has been amendedNo
2012-10-01This submission is the final filingNo
2012-10-01This return/report is a short plan year return/report (less than 12 months)No
2012-10-01Plan is a collectively bargained planNo
2012-10-01Plan funding arrangement – InsuranceYes
2012-10-01Plan benefit arrangement – InsuranceYes
2011: ST. CROIX OF PARK FALLS, LTD. LIFE PLAN 2011 form 5500 responses
2011-10-01Type of plan entitySingle employer plan
2011-10-01Submission has been amendedNo
2011-10-01This submission is the final filingNo
2011-10-01This return/report is a short plan year return/report (less than 12 months)No
2011-10-01Plan is a collectively bargained planNo
2011-10-01Plan funding arrangement – InsuranceYes
2011-10-01Plan benefit arrangement – InsuranceYes
2009: ST. CROIX OF PARK FALLS, LTD. LIFE PLAN 2009 form 5500 responses
2009-10-01Type of plan entitySingle employer plan
2009-10-01Submission has been amendedNo
2009-10-01This submission is the final filingNo
2009-10-01This return/report is a short plan year return/report (less than 12 months)No
2009-10-01Plan is a collectively bargained planNo
2009-10-01Plan funding arrangement – InsuranceYes
2009-10-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number090420
Policy instance 1
Insurance contract or identification number090420
Number of Individuals Covered138
Insurance policy start date2017-10-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $2,883
Total amount of fees paid to insurance companyUSD $352
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 BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
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 $23,889
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,883
Amount paid for insurance broker fees352
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
Insurance broker nameANSAY & ASSOCIATES LLC

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