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GARDEN VALLEY HEALTH INSURANCE PLAN 401k Plan overview

Plan NameGARDEN VALLEY HEALTH INSURANCE PLAN
Plan identification number 501

GARDEN VALLEY HEALTH INSURANCE PLAN Benefits

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

401k Sponsoring company profile

GARDEN VALLEY TELEPHONE COMPANY has sponsored the creation of one or more 401k plans.

Company Name:GARDEN VALLEY TELEPHONE COMPANY
Employer identification number (EIN):410271520
NAIC Classification:517000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GARDEN VALLEY HEALTH INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012016-01-01MARK KLINKHAMMER MARK KLINKHAMMER2017-05-16
5012016-01-01MARK KLINKHAMMER MARK KLINKHAMMER2018-07-11
5012015-01-01MARK KLINKHAMMER MARK KLINKHAMMER2016-06-20
5012014-01-01MARK KLINKHAMMER MARK KLINKHAMMER2015-05-07
5012013-01-01MARK KLINKHAMMER MARK KLINKHAMMER2014-05-13
5012012-01-01MARK KLINKHAMMER
5012011-01-01MARK KLINKHAMMER
5012009-01-01MARK KLINKHAMMER

Plan Statistics for GARDEN VALLEY HEALTH INSURANCE PLAN

401k plan membership statisitcs for GARDEN VALLEY HEALTH INSURANCE PLAN

Measure Date Value
2016: GARDEN VALLEY HEALTH INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01102
Total number of active participants reported on line 7a of the Form 55002016-01-0182
Number of retired or separated participants receiving benefits2016-01-0120
Total of all active and inactive participants2016-01-01102
Total participants2016-01-01102
Number of other retired or separated participants entitled to future benefits2016-01-010
2015: GARDEN VALLEY HEALTH INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01101
Total number of active participants reported on line 7a of the Form 55002015-01-0182
Number of retired or separated participants receiving benefits2015-01-0120
Total of all active and inactive participants2015-01-01102
Total participants2015-01-01102
2014: GARDEN VALLEY HEALTH INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01105
Total number of active participants reported on line 7a of the Form 55002014-01-0181
Number of retired or separated participants receiving benefits2014-01-0120
Total of all active and inactive participants2014-01-01101
Total participants2014-01-01101
2013: GARDEN VALLEY HEALTH INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01110
Total number of active participants reported on line 7a of the Form 55002013-01-0185
Number of retired or separated participants receiving benefits2013-01-0120
Total of all active and inactive participants2013-01-01105
Total participants2013-01-01105
2012: GARDEN VALLEY HEALTH INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01116
Total number of active participants reported on line 7a of the Form 55002012-01-0189
Number of retired or separated participants receiving benefits2012-01-0121
Total of all active and inactive participants2012-01-01110
Total participants2012-01-01110
2011: GARDEN VALLEY HEALTH INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01118
Total number of active participants reported on line 7a of the Form 55002011-01-0193
Number of retired or separated participants receiving benefits2011-01-0123
Total of all active and inactive participants2011-01-01116
Total participants2011-01-01116
2009: GARDEN VALLEY HEALTH INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01113
Total number of active participants reported on line 7a of the Form 55002009-01-0193
Number of retired or separated participants receiving benefits2009-01-0120
Total of all active and inactive participants2009-01-01113
Total participants2009-01-01113

Financial Data on GARDEN VALLEY HEALTH INSURANCE PLAN

Measure Date Value
2016 : GARDEN VALLEY HEALTH INSURANCE PLAN 2016 401k financial data
Total plan liabilities at end of year2016-12-31$0
Total plan liabilities at beginning of year2016-12-31$0
Total income from all sources2016-12-31$1,327,472
Expenses. Total of all expenses incurred2016-12-31$1,327,472
Benefits paid (including direct rollovers)2016-12-31$1,327,472
Total plan assets at end of year2016-12-31$0
Total plan assets at beginning of year2016-12-31$0
Total contributions received or receivable from participants2016-12-31$195,088
Net income (gross income less expenses)2016-12-31$0
Net plan assets at end of year (total assets less liabilities)2016-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$0
Total contributions received or receivable from employer(s)2016-12-31$1,132,384
2015 : GARDEN VALLEY HEALTH INSURANCE PLAN 2015 401k financial data
Total plan liabilities at end of year2015-12-31$0
Total plan liabilities at beginning of year2015-12-31$0
Total income from all sources2015-12-31$1,340,132
Expenses. Total of all expenses incurred2015-12-31$1,340,132
Benefits paid (including direct rollovers)2015-12-31$1,340,132
Total plan assets at end of year2015-12-31$0
Total plan assets at beginning of year2015-12-31$0
Total contributions received or receivable from participants2015-12-31$209,808
Net income (gross income less expenses)2015-12-31$0
Net plan assets at end of year (total assets less liabilities)2015-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$0
Total contributions received or receivable from employer(s)2015-12-31$1,130,324
2014 : GARDEN VALLEY HEALTH INSURANCE PLAN 2014 401k financial data
Total plan liabilities at end of year2014-12-31$0
Total plan liabilities at beginning of year2014-12-31$0
Total income from all sources2014-12-31$1,605,186
Expenses. Total of all expenses incurred2014-12-31$1,605,186
Benefits paid (including direct rollovers)2014-12-31$1,605,186
Total plan assets at end of year2014-12-31$0
Total plan assets at beginning of year2014-12-31$0
Total contributions received or receivable from participants2014-12-31$225,962
Net income (gross income less expenses)2014-12-31$0
Net plan assets at end of year (total assets less liabilities)2014-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$0
Total contributions received or receivable from employer(s)2014-12-31$1,379,224
2013 : GARDEN VALLEY HEALTH INSURANCE PLAN 2013 401k financial data
Total plan liabilities at end of year2013-12-31$0
Total plan liabilities at beginning of year2013-12-31$0
Total income from all sources2013-12-31$1,391,064
Expenses. Total of all expenses incurred2013-12-31$1,391,064
Benefits paid (including direct rollovers)2013-12-31$1,391,064
Total plan assets at end of year2013-12-31$0
Total plan assets at beginning of year2013-12-31$0
Total contributions received or receivable from participants2013-12-31$231,263
Net income (gross income less expenses)2013-12-31$0
Net plan assets at end of year (total assets less liabilities)2013-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$0
Total contributions received or receivable from employer(s)2013-12-31$1,159,801
2012 : GARDEN VALLEY HEALTH INSURANCE PLAN 2012 401k financial data
Total plan liabilities at end of year2012-12-31$0
Total plan liabilities at beginning of year2012-12-31$0
Total income from all sources2012-12-31$1,437,415
Expenses. Total of all expenses incurred2012-12-31$1,437,415
Benefits paid (including direct rollovers)2012-12-31$1,437,415
Total plan assets at end of year2012-12-31$0
Total plan assets at beginning of year2012-12-31$0
Total contributions received or receivable from participants2012-12-31$256,360
Net income (gross income less expenses)2012-12-31$0
Net plan assets at end of year (total assets less liabilities)2012-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$0
Total contributions received or receivable from employer(s)2012-12-31$1,181,055
2011 : GARDEN VALLEY HEALTH INSURANCE PLAN 2011 401k financial data
Total plan liabilities at end of year2011-12-31$0
Total plan liabilities at beginning of year2011-12-31$0
Total income from all sources2011-12-31$1,441,331
Expenses. Total of all expenses incurred2011-12-31$1,441,331
Benefits paid (including direct rollovers)2011-12-31$1,441,331
Total plan assets at end of year2011-12-31$0
Total plan assets at beginning of year2011-12-31$0
Total contributions received or receivable from participants2011-12-31$281,927
Net income (gross income less expenses)2011-12-31$0
Net plan assets at end of year (total assets less liabilities)2011-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$0
Total contributions received or receivable from employer(s)2011-12-31$1,159,404
2010 : GARDEN VALLEY HEALTH INSURANCE PLAN 2010 401k financial data
Total plan liabilities at end of year2010-12-31$0
Total plan liabilities at beginning of year2010-12-31$0
Total income from all sources2010-12-31$1,306,514
Expenses. Total of all expenses incurred2010-12-31$1,306,514
Benefits paid (including direct rollovers)2010-12-31$1,306,514
Total plan assets at end of year2010-12-31$0
Total plan assets at beginning of year2010-12-31$0
Total contributions received or receivable from participants2010-12-31$248,901
Net income (gross income less expenses)2010-12-31$0
Net plan assets at end of year (total assets less liabilities)2010-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$0
Total contributions received or receivable from employer(s)2010-12-31$1,057,613

Form 5500 Responses for GARDEN VALLEY HEALTH INSURANCE PLAN

2016: GARDEN VALLEY HEALTH INSURANCE PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planYes
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: GARDEN VALLEY HEALTH INSURANCE PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planYes
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: GARDEN VALLEY HEALTH INSURANCE PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planYes
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: GARDEN VALLEY HEALTH INSURANCE PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planYes
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: GARDEN VALLEY HEALTH INSURANCE PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planYes
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: GARDEN VALLEY HEALTH INSURANCE PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planYes
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: GARDEN VALLEY HEALTH INSURANCE PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planYes
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract numberGP914
Policy instance 1
Insurance contract or identification numberGP914
Number of Individuals Covered303
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $7,645
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
Welfare Benefit Premiums Paid to CarrierUSD $1,340,132
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,717
Amount paid for insurance broker fees928
Additional information about fees paid to insurance brokerAGENT/BROKER INCENTIVE PAYMENTS
Insurance broker nameERSKINE AGENCY, INC.
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract numberGP914
Policy instance 1
Insurance contract or identification numberGP914
Number of Individuals Covered286
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $7,441
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
Welfare Benefit Premiums Paid to CarrierUSD $1,605,186
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,441
Insurance broker nameERSKINE AGENCY, INC.
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract numberGP914
Policy instance 1
Insurance contract or identification numberGP914
Number of Individuals Covered293
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $6,332
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
Welfare Benefit Premiums Paid to CarrierUSD $1,391,064
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,332
Insurance broker nameERSKINE AGENCY, INC.
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract numberGP914
Policy instance 1
Insurance contract or identification numberGP914
Number of Individuals Covered308
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $7,191
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,437,415
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,191
Insurance broker nameERSKINE AGENCY, INC.
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract numberGP914
Policy instance 1
Insurance contract or identification numberGP914
Number of Individuals Covered313
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $6,630
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,441,331
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract numberGP914
Policy instance 1
Insurance contract or identification numberGP914
Number of Individuals Covered316
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $6,511
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,306,514
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,511
Insurance broker nameERSKINE AGENCY, INC.

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