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FLEET FARM BENEFIT TRUST 401k Plan overview

Plan NameFLEET FARM BENEFIT TRUST
Plan identification number 507

FLEET FARM BENEFIT TRUST Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover

401k Sponsoring company profile

FLEET FARM WHOLESALE SUPPLY COMPANY, LLC has sponsored the creation of one or more 401k plans.

Company Name:FLEET FARM WHOLESALE SUPPLY COMPANY, LLC
Employer identification number (EIN):410806238
NAIC Classification:452300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FLEET FARM BENEFIT TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5072022-07-01
5072021-07-01
5072020-07-01
5072019-07-01
5072018-07-01
5072017-07-01
5072016-07-01STEVE DERMANUELIAN STEVE DERMANUELIAN2018-04-06
5072015-07-01JEFFRY L. MEEK JEFFRY L. MEEK2017-04-06
5072014-07-01STEWART C. MILLS III STEWART C. MILLS III2016-01-21
5072013-07-01STEWART C. MILLS III STEWART C. MILLS III2015-01-29
5072012-07-01STEWART C. MILLS III STEWART C. MILLS III2014-01-29
5072011-07-01STEWART C. MILLS III STEWART C. MILLS III2013-01-28
5072009-07-01STEWART C. MILLS III STEWART C. MILLS III2011-04-01
5072009-01-01STEWART C. MILLS III STEWART C. MILLS III2010-03-10

Plan Statistics for FLEET FARM BENEFIT TRUST

401k plan membership statisitcs for FLEET FARM BENEFIT TRUST

Measure Date Value
2022: FLEET FARM BENEFIT TRUST 2022 401k membership
Total participants, beginning-of-year2022-07-011,548
Total number of active participants reported on line 7a of the Form 55002022-07-011,501
Total of all active and inactive participants2022-07-011,501
2021: FLEET FARM BENEFIT TRUST 2021 401k membership
Total participants, beginning-of-year2021-07-011,763
Total number of active participants reported on line 7a of the Form 55002021-07-011,548
Total of all active and inactive participants2021-07-011,548
2020: FLEET FARM BENEFIT TRUST 2020 401k membership
Total participants, beginning-of-year2020-07-011,958
Total number of active participants reported on line 7a of the Form 55002020-07-011,763
Total of all active and inactive participants2020-07-011,763
2019: FLEET FARM BENEFIT TRUST 2019 401k membership
Total participants, beginning-of-year2019-07-012,037
Total number of active participants reported on line 7a of the Form 55002019-07-011,958
Total of all active and inactive participants2019-07-011,958
2018: FLEET FARM BENEFIT TRUST 2018 401k membership
Total participants, beginning-of-year2018-07-012,165
Total number of active participants reported on line 7a of the Form 55002018-07-012,037
Total of all active and inactive participants2018-07-012,037
2017: FLEET FARM BENEFIT TRUST 2017 401k membership
Total participants, beginning-of-year2017-07-012,250
Total number of active participants reported on line 7a of the Form 55002017-07-012,165
Total of all active and inactive participants2017-07-012,165
2016: FLEET FARM BENEFIT TRUST 2016 401k membership
Total participants, beginning-of-year2016-07-012,369
Total number of active participants reported on line 7a of the Form 55002016-07-012,250
Total of all active and inactive participants2016-07-012,250
2015: FLEET FARM BENEFIT TRUST 2015 401k membership
Total participants, beginning-of-year2015-07-012,755
Total number of active participants reported on line 7a of the Form 55002015-07-012,369
Total of all active and inactive participants2015-07-012,369
2014: FLEET FARM BENEFIT TRUST 2014 401k membership
Total participants, beginning-of-year2014-07-012,723
Total number of active participants reported on line 7a of the Form 55002014-07-012,755
Total of all active and inactive participants2014-07-012,755
2013: FLEET FARM BENEFIT TRUST 2013 401k membership
Total participants, beginning-of-year2013-07-012,751
Total number of active participants reported on line 7a of the Form 55002013-07-012,723
Total of all active and inactive participants2013-07-012,723
2012: FLEET FARM BENEFIT TRUST 2012 401k membership
Total participants, beginning-of-year2012-07-012,749
Total number of active participants reported on line 7a of the Form 55002012-07-012,751
Total of all active and inactive participants2012-07-012,751
2011: FLEET FARM BENEFIT TRUST 2011 401k membership
Total participants, beginning-of-year2011-07-012,754
Total number of active participants reported on line 7a of the Form 55002011-07-012,749
Total of all active and inactive participants2011-07-012,749
2009: FLEET FARM BENEFIT TRUST 2009 401k membership
Total participants, beginning-of-year2009-07-013,026
Total number of active participants reported on line 7a of the Form 55002009-07-012,849
Total of all active and inactive participants2009-07-012,849
Total participants, beginning-of-year2009-01-010
Total number of active participants reported on line 7a of the Form 55002009-01-013,026
Total of all active and inactive participants2009-01-013,026

Financial Data on FLEET FARM BENEFIT TRUST

Measure Date Value
2017 : FLEET FARM BENEFIT TRUST 2017 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-06-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-06-30$3,768,492
Total income from all sources (including contributions)2017-06-30$33,117,678
Total of all expenses incurred2017-06-30$33,682,958
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-06-30$31,836,611
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-06-30$32,201,483
Value of total assets at end of year2017-06-30$0
Value of total assets at beginning of year2017-06-30$4,333,772
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-06-30$1,846,347
Total dividends received (eg from common stock, registered investment company shares)2017-06-30$53,768
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2017-06-30$53,768
Was this plan covered by a fidelity bond2017-06-30Yes
Value of fidelity bond cover2017-06-30$3,000,000
Were there any nonexempt tranactions with any party-in-interest2017-06-30No
Contributions received from participants2017-06-30$5,051,248
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2017-06-30$701,326
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2017-06-30$1,104,100
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-06-30$1,135,467
Other income not declared elsewhere2017-06-30$880,239
Administrative expenses (other) incurred2017-06-30$204,468
Total non interest bearing cash at end of year2017-06-30$0
Total non interest bearing cash at beginning of year2017-06-30$514,715
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-06-30No
Income. Non cash contributions2017-06-30$2,473,483
Value of net income/loss2017-06-30$-565,280
Value of net assets at end of year (total assets less liabilities)2017-06-30$0
Value of net assets at beginning of year (total assets less liabilities)2017-06-30$565,280
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2017-06-30No
Were any leases to which the plan was party in default or uncollectible2017-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-06-30$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-06-30$2,714,957
Expenses. Payments to insurance carriers foe the provision of benefits2017-06-30$1,228,475
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-06-30$-17,812
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-06-30Yes
Was there a failure to transmit to the plan any participant contributions2017-06-30No
Has the plan failed to provide any benefit when due under the plan2017-06-30No
Contributions received in cash from employer2017-06-30$24,676,752
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-06-30$29,906,810
Contract administrator fees2017-06-30$1,641,879
Liabilities. Value of benefit claims payable at end of year2017-06-30$0
Liabilities. Value of benefit claims payable at beginning of year2017-06-30$2,633,025
Did the plan have assets held for investment2017-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-06-30Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-06-30No
Opinion of an independent qualified public accountant for this plan2017-06-30Unqualified
Accountancy firm name2017-06-30JOHN A. KNUTSON & CO., PLLP
Accountancy firm EIN2017-06-30410879566
2016 : FLEET FARM BENEFIT TRUST 2016 401k financial data
Total transfer of assets from this plan2016-06-30$-153,905
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-06-30$3,768,492
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-06-30$6,330,574
Total income from all sources (including contributions)2016-06-30$36,289,981
Total of all expenses incurred2016-06-30$35,878,606
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-06-30$33,754,332
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-06-30$33,234,900
Value of total assets at end of year2016-06-30$4,333,772
Value of total assets at beginning of year2016-06-30$6,330,574
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-06-30$2,124,274
Total dividends received (eg from common stock, registered investment company shares)2016-06-30$61,899
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2016-06-30$61,899
Was this plan covered by a fidelity bond2016-06-30Yes
Value of fidelity bond cover2016-06-30$3,000,000
Were there any nonexempt tranactions with any party-in-interest2016-06-30No
Contributions received from participants2016-06-30$5,925,730
Assets. Other investments not covered elsewhere at beginning of year2016-06-30$89,272
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2016-06-30$911,379
Value of other receiveables (less allowance for doubtful accounts) at end of year2016-06-30$1,104,100
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2016-06-30$1,110,748
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2016-06-30$1,135,467
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2016-06-30$1,157,490
Other income not declared elsewhere2016-06-30$2,955,663
Administrative expenses (other) incurred2016-06-30$306,500
Total non interest bearing cash at end of year2016-06-30$514,715
Total non interest bearing cash at beginning of year2016-06-30$62,095
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-06-30No
Value of net income/loss2016-06-30$411,375
Value of net assets at end of year (total assets less liabilities)2016-06-30$565,280
Value of net assets at beginning of year (total assets less liabilities)2016-06-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2016-06-30No
Were any leases to which the plan was party in default or uncollectible2016-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2016-06-30$2,714,957
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2016-06-30$2,634,677
Expenses. Payments to insurance carriers foe the provision of benefits2016-06-30$1,123,122
Net investment gain/loss from registered investment companies (e.g. mutual funds)2016-06-30$37,519
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-06-30Yes
Was there a failure to transmit to the plan any participant contributions2016-06-30No
Has the plan failed to provide any benefit when due under the plan2016-06-30No
Contributions received in cash from employer2016-06-30$27,309,170
Employer contributions (assets) at end of year2016-06-30$0
Employer contributions (assets) at beginning of year2016-06-30$2,433,782
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-06-30$31,719,831
Contract administrator fees2016-06-30$1,817,774
Liabilities. Value of benefit claims payable at end of year2016-06-30$2,633,025
Liabilities. Value of benefit claims payable at beginning of year2016-06-30$5,173,084
Did the plan have assets held for investment2016-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-06-30No
Opinion of an independent qualified public accountant for this plan2016-06-30Unqualified
Accountancy firm name2016-06-30JOHN A. KNUTSON & CO., PLLP
Accountancy firm EIN2016-06-30410879566
2015 : FLEET FARM BENEFIT TRUST 2015 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-06-30$6,330,574
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-06-30$3,596,449
Total income from all sources (including contributions)2015-06-30$37,011,687
Total of all expenses incurred2015-06-30$37,522,937
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-06-30$35,068,617
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-06-30$36,364,548
Value of total assets at end of year2015-06-30$6,330,574
Value of total assets at beginning of year2015-06-30$4,107,699
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-06-30$2,454,320
Total interest from all sources2015-06-30$0
Total dividends received (eg from common stock, registered investment company shares)2015-06-30$64,869
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2015-06-30$64,869
Was this plan covered by a fidelity bond2015-06-30Yes
Value of fidelity bond cover2015-06-30$3,000,000
If this is an individual account plan, was there a blackout period2015-06-30No
Were there any nonexempt tranactions with any party-in-interest2015-06-30No
Contributions received from participants2015-06-30$6,506,882
Assets. Other investments not covered elsewhere at end of year2015-06-30$89,272
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2015-06-30$848,333
Value of other receiveables (less allowance for doubtful accounts) at end of year2015-06-30$1,110,748
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2015-06-30$616,496
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2015-06-30$1,157,490
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2015-06-30$1,056,672
Other income not declared elsewhere2015-06-30$654,475
Administrative expenses (other) incurred2015-06-30$396,626
Liabilities. Value of operating payables at end of year2015-06-30$0
Liabilities. Value of operating payables at beginning of year2015-06-30$144,524
Total non interest bearing cash at end of year2015-06-30$62,095
Total non interest bearing cash at beginning of year2015-06-30$830,187
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-06-30No
Value of net income/loss2015-06-30$-511,250
Value of net assets at end of year (total assets less liabilities)2015-06-30$0
Value of net assets at beginning of year (total assets less liabilities)2015-06-30$511,250
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2015-06-30No
Were any leases to which the plan was party in default or uncollectible2015-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2015-06-30$2,634,677
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2015-06-30$2,661,016
Interest earned on other investments2015-06-30$0
Expenses. Payments to insurance carriers foe the provision of benefits2015-06-30$1,387,108
Net investment gain/loss from registered investment companies (e.g. mutual funds)2015-06-30$-72,205
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-06-30Yes
Was there a failure to transmit to the plan any participant contributions2015-06-30No
Has the plan failed to provide any benefit when due under the plan2015-06-30No
Contributions received in cash from employer2015-06-30$29,857,666
Employer contributions (assets) at end of year2015-06-30$2,433,782
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-06-30$32,833,176
Contract administrator fees2015-06-30$2,057,694
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-06-30No
Liabilities. Value of benefit claims payable at end of year2015-06-30$5,173,084
Liabilities. Value of benefit claims payable at beginning of year2015-06-30$2,395,253
Did the plan have assets held for investment2015-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-06-30No
Opinion of an independent qualified public accountant for this plan2015-06-30Unqualified
Accountancy firm name2015-06-30JOHN A. KNUTSON& CO., PLLP
Accountancy firm EIN2015-06-30410879566
2014 : FLEET FARM BENEFIT TRUST 2014 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-06-30$3,596,449
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-06-30$3,868,682
Total income from all sources (including contributions)2014-06-30$33,854,526
Total of all expenses incurred2014-06-30$33,343,276
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-06-30$31,423,286
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-06-30$33,003,406
Value of total assets at end of year2014-06-30$4,107,699
Value of total assets at beginning of year2014-06-30$3,868,682
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-06-30$1,919,990
Total interest from all sources2014-06-30$107
Total dividends received (eg from common stock, registered investment company shares)2014-06-30$61,555
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2014-06-30$61,555
Was this plan covered by a fidelity bond2014-06-30Yes
Value of fidelity bond cover2014-06-30$3,000,000
If this is an individual account plan, was there a blackout period2014-06-30No
Were there any nonexempt tranactions with any party-in-interest2014-06-30No
Contributions received from participants2014-06-30$6,517,768
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2014-06-30$708,362
Value of other receiveables (less allowance for doubtful accounts) at end of year2014-06-30$616,496
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2014-06-30$721,511
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2014-06-30$1,056,672
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2014-06-30$1,041,005
Other income not declared elsewhere2014-06-30$690,678
Administrative expenses (other) incurred2014-06-30$87,465
Liabilities. Value of operating payables at end of year2014-06-30$144,524
Liabilities. Value of operating payables at beginning of year2014-06-30$33,203
Total non interest bearing cash at end of year2014-06-30$830,187
Total non interest bearing cash at beginning of year2014-06-30$576,993
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-06-30No
Value of net income/loss2014-06-30$511,250
Value of net assets at end of year (total assets less liabilities)2014-06-30$511,250
Value of net assets at beginning of year (total assets less liabilities)2014-06-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2014-06-30No
Were any leases to which the plan was party in default or uncollectible2014-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2014-06-30$2,661,016
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2014-06-30$2,519,572
Interest earned on other investments2014-06-30$107
Expenses. Payments to insurance carriers foe the provision of benefits2014-06-30$1,046,219
Net investment gain/loss from registered investment companies (e.g. mutual funds)2014-06-30$98,780
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-06-30No
Was there a failure to transmit to the plan any participant contributions2014-06-30No
Has the plan failed to provide any benefit when due under the plan2014-06-30No
Contributions received in cash from employer2014-06-30$26,485,638
Employer contributions (assets) at end of year2014-06-30$0
Employer contributions (assets) at beginning of year2014-06-30$50,606
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-06-30$29,668,705
Contract administrator fees2014-06-30$1,832,525
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32014-06-30No
Liabilities. Value of benefit claims payable at end of year2014-06-30$2,395,253
Liabilities. Value of benefit claims payable at beginning of year2014-06-30$2,794,474
Did the plan have assets held for investment2014-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-06-30No
Opinion of an independent qualified public accountant for this plan2014-06-30Unqualified
Accountancy firm name2014-06-30JOHN A. KNUTSON & CO., PLLP
Accountancy firm EIN2014-06-30410879566
2013 : FLEET FARM BENEFIT TRUST 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-06-30$3,868,682
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-06-30$4,118,623
Total income from all sources (including contributions)2013-06-30$34,715,543
Total of all expenses incurred2013-06-30$34,715,543
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-06-30$32,008,421
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-06-30$32,813,773
Value of total assets at end of year2013-06-30$3,868,682
Value of total assets at beginning of year2013-06-30$4,118,623
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-06-30$2,707,122
Total interest from all sources2013-06-30$92
Total dividends received (eg from common stock, registered investment company shares)2013-06-30$61,092
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2013-06-30$61,092
Was this plan covered by a fidelity bond2013-06-30Yes
Value of fidelity bond cover2013-06-30$3,000,000
If this is an individual account plan, was there a blackout period2013-06-30No
Were there any nonexempt tranactions with any party-in-interest2013-06-30No
Contributions received from participants2013-06-30$5,541,099
Value of other receiveables (less allowance for doubtful accounts) at end of year2013-06-30$721,511
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2013-06-30$441,104
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2013-06-30$1,041,005
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2013-06-30$906,449
Other income not declared elsewhere2013-06-30$1,886,771
Administrative expenses (other) incurred2013-06-30$836,575
Liabilities. Value of operating payables at end of year2013-06-30$33,203
Liabilities. Value of operating payables at beginning of year2013-06-30$5,378
Total non interest bearing cash at end of year2013-06-30$576,993
Total non interest bearing cash at beginning of year2013-06-30$154,301
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-06-30No
Value of net income/loss2013-06-30$0
Value of net assets at end of year (total assets less liabilities)2013-06-30$0
Value of net assets at beginning of year (total assets less liabilities)2013-06-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2013-06-30No
Were any leases to which the plan was party in default or uncollectible2013-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-06-30$2,519,572
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-06-30$2,021,841
Interest earned on other investments2013-06-30$92
Expenses. Payments to insurance carriers foe the provision of benefits2013-06-30$935,861
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-06-30$-46,185
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-06-30Yes
Was there a failure to transmit to the plan any participant contributions2013-06-30No
Has the plan failed to provide any benefit when due under the plan2013-06-30No
Contributions received in cash from employer2013-06-30$27,272,674
Employer contributions (assets) at end of year2013-06-30$50,606
Employer contributions (assets) at beginning of year2013-06-30$1,501,377
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-06-30$31,072,560
Contract administrator fees2013-06-30$1,870,547
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-06-30No
Liabilities. Value of benefit claims payable at end of year2013-06-30$2,794,474
Liabilities. Value of benefit claims payable at beginning of year2013-06-30$3,206,796
Did the plan have assets held for investment2013-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-06-30No
Opinion of an independent qualified public accountant for this plan2013-06-30Unqualified
Accountancy firm name2013-06-30JOHN A. KNUTSON & CO., PLLP
Accountancy firm EIN2013-06-30410879566
2012 : FLEET FARM BENEFIT TRUST 2012 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-06-30$4,118,623
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-06-30$3,559,463
Total income from all sources (including contributions)2012-06-30$33,810,514
Total of all expenses incurred2012-06-30$33,810,514
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-06-30$31,113,761
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-06-30$32,772,198
Value of total assets at end of year2012-06-30$4,118,623
Value of total assets at beginning of year2012-06-30$3,559,463
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-06-30$2,696,753
Total interest from all sources2012-06-30$8
Total dividends received (eg from common stock, registered investment company shares)2012-06-30$12,721
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-06-30No
Total dividends received from registered investment company shares (eg mutual funds)2012-06-30$12,721
Was this plan covered by a fidelity bond2012-06-30Yes
Value of fidelity bond cover2012-06-30$3,000,000
If this is an individual account plan, was there a blackout period2012-06-30No
Were there any nonexempt tranactions with any party-in-interest2012-06-30No
Contributions received from participants2012-06-30$5,475,400
Assets. Other investments not covered elsewhere at beginning of year2012-06-30$94,684
Value of other receiveables (less allowance for doubtful accounts) at end of year2012-06-30$441,104
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2012-06-30$479,264
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2012-06-30$906,449
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2012-06-30$765,651
Other income not declared elsewhere2012-06-30$1,016,110
Administrative expenses (other) incurred2012-06-30$756,394
Liabilities. Value of operating payables at end of year2012-06-30$5,378
Liabilities. Value of operating payables at beginning of year2012-06-30$4,303
Total non interest bearing cash at end of year2012-06-30$154,301
Total non interest bearing cash at beginning of year2012-06-30$2,693,080
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-06-30No
Value of net income/loss2012-06-30$0
Value of net assets at end of year (total assets less liabilities)2012-06-30$0
Value of net assets at beginning of year (total assets less liabilities)2012-06-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2012-06-30No
Were any leases to which the plan was party in default or uncollectible2012-06-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-06-30$2,021,841
Interest earned on other investments2012-06-30$8
Expenses. Payments to insurance carriers foe the provision of benefits2012-06-30$1,212,208
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-06-30$9,477
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-06-30Yes
Was there a failure to transmit to the plan any participant contributions2012-06-30No
Has the plan failed to provide any benefit when due under the plan2012-06-30No
Contributions received in cash from employer2012-06-30$27,296,798
Employer contributions (assets) at end of year2012-06-30$1,501,377
Employer contributions (assets) at beginning of year2012-06-30$292,435
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-06-30$29,901,553
Contract administrator fees2012-06-30$1,940,359
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-06-30No
Liabilities. Value of benefit claims payable at end of year2012-06-30$3,206,796
Liabilities. Value of benefit claims payable at beginning of year2012-06-30$2,789,509
Did the plan have assets held for investment2012-06-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-06-30No
Opinion of an independent qualified public accountant for this plan2012-06-30Unqualified
Accountancy firm name2012-06-30JOHN A. KNUTSON & CO., PLLP
Accountancy firm EIN2012-06-30410879566
2011 : FLEET FARM BENEFIT TRUST 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-06-30$3,559,463
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-06-30$4,504,948
Total income from all sources (including contributions)2011-06-30$29,521,195
Total of all expenses incurred2011-06-30$29,521,195
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-06-30$27,098,335
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-06-30$28,759,725
Value of total assets at end of year2011-06-30$3,559,463
Value of total assets at beginning of year2011-06-30$4,504,948
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-06-30$2,422,860
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-06-30No
Was this plan covered by a fidelity bond2011-06-30Yes
Value of fidelity bond cover2011-06-30$3,000,000
If this is an individual account plan, was there a blackout period2011-06-30No
Were there any nonexempt tranactions with any party-in-interest2011-06-30No
Contributions received from participants2011-06-30$5,336,746
Assets. Other investments not covered elsewhere at end of year2011-06-30$94,684
Assets. Other investments not covered elsewhere at beginning of year2011-06-30$98,439
Value of other receiveables (less allowance for doubtful accounts) at end of year2011-06-30$120,840
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2011-06-30$270,109
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2011-06-30$765,651
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2011-06-30$671,568
Other income not declared elsewhere2011-06-30$761,470
Administrative expenses (other) incurred2011-06-30$602,111
Liabilities. Value of operating payables at end of year2011-06-30$4,303
Liabilities. Value of operating payables at beginning of year2011-06-30$13,958
Total non interest bearing cash at end of year2011-06-30$2,693,080
Total non interest bearing cash at beginning of year2011-06-30$3,086,187
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-06-30No
Value of net income/loss2011-06-30$0
Value of net assets at end of year (total assets less liabilities)2011-06-30$0
Value of net assets at beginning of year (total assets less liabilities)2011-06-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-06-30No
Were any loans by the plan or fixed income obligations due to the plan in default2011-06-30No
Were any leases to which the plan was party in default or uncollectible2011-06-30No
Investment advisory and management fees2011-06-30$0
Expenses. Payments to insurance carriers foe the provision of benefits2011-06-30$1,162,980
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-06-30No
Was there a failure to transmit to the plan any participant contributions2011-06-30No
Has the plan failed to provide any benefit when due under the plan2011-06-30No
Contributions received in cash from employer2011-06-30$23,422,979
Employer contributions (assets) at end of year2011-06-30$650,859
Employer contributions (assets) at beginning of year2011-06-30$1,050,213
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-06-30$25,935,355
Contract administrator fees2011-06-30$1,820,749
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-06-30No
Liabilities. Value of benefit claims payable at end of year2011-06-30$2,789,509
Liabilities. Value of benefit claims payable at beginning of year2011-06-30$3,819,422
Did the plan have assets held for investment2011-06-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-06-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-06-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-06-30No
Opinion of an independent qualified public accountant for this plan2011-06-30Unqualified
Accountancy firm name2011-06-30JOHN A. KNUTSON & CO., PLLP
Accountancy firm EIN2011-06-30410879566

Form 5500 Responses for FLEET FARM BENEFIT TRUST

2022: FLEET FARM BENEFIT TRUST 2022 form 5500 responses
2022-07-01Type of plan entitySingle employer plan
2022-07-01Plan funding arrangement – InsuranceYes
2022-07-01Plan funding arrangement – General assets of the sponsorYes
2022-07-01Plan benefit arrangement – InsuranceYes
2022-07-01Plan benefit arrangement – General assets of the sponsorYes
2021: FLEET FARM BENEFIT TRUST 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan funding arrangement – General assets of the sponsorYes
2021-07-01Plan benefit arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – General assets of the sponsorYes
2020: FLEET FARM BENEFIT TRUST 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan funding arrangement – General assets of the sponsorYes
2020-07-01Plan benefit arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – General assets of the sponsorYes
2019: FLEET FARM BENEFIT TRUST 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan funding arrangement – General assets of the sponsorYes
2019-07-01Plan benefit arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – General assets of the sponsorYes
2018: FLEET FARM BENEFIT TRUST 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan funding arrangement – General assets of the sponsorYes
2018-07-01Plan benefit arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – General assets of the sponsorYes
2017: FLEET FARM BENEFIT TRUST 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan funding arrangement – General assets of the sponsorYes
2017-07-01Plan benefit arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – General assets of the sponsorYes
2016: FLEET FARM BENEFIT TRUST 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan funding arrangement – TrustYes
2016-07-01Plan benefit arrangement – InsuranceYes
2016-07-01Plan benefit arrangement - TrustYes
2015: FLEET FARM BENEFIT TRUST 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan funding arrangement – TrustYes
2015-07-01Plan benefit arrangement – InsuranceYes
2015-07-01Plan benefit arrangement - TrustYes
2014: FLEET FARM BENEFIT TRUST 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan funding arrangement – TrustYes
2014-07-01Plan benefit arrangement – InsuranceYes
2014-07-01Plan benefit arrangement - TrustYes
2013: FLEET FARM BENEFIT TRUST 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan funding arrangement – TrustYes
2013-07-01Plan benefit arrangement – InsuranceYes
2013-07-01Plan benefit arrangement - TrustYes
2012: FLEET FARM BENEFIT TRUST 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan funding arrangement – TrustYes
2012-07-01Plan benefit arrangement – InsuranceYes
2012-07-01Plan benefit arrangement - TrustYes
2011: FLEET FARM BENEFIT TRUST 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan funding arrangement – TrustYes
2011-07-01Plan benefit arrangement – InsuranceYes
2011-07-01Plan benefit arrangement - TrustYes
2009: FLEET FARM BENEFIT TRUST 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01This submission is the final filingNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan funding arrangement – TrustYes
2009-07-01Plan benefit arrangement – InsuranceYes
2009-07-01Plan benefit arrangement - TrustYes
2009-01-01Type of plan entitySingle employer plan
2009-01-01First time form 5500 has been submittedYes
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number50003181001
Policy instance 3
Insurance contract or identification number50003181001
Number of Individuals Covered2832
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $102,786
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number70101-7
Policy instance 2
Insurance contract or identification number70101-7
Number of Individuals Covered1967
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $64,055
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $699,683
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $64,055
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract number179973
Policy instance 1
Insurance contract or identification number179973
Number of Individuals Covered2576
Insurance policy start date2022-07-01
Insurance policy end date2023-06-30
Total amount of commissions paid to insurance brokerUSD $100,000
Total amount of fees paid to insurance companyUSD $21,450
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $100,000
Amount paid for insurance broker fees21450
Insurance broker organization code?3
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number50003181001
Policy instance 3
Insurance contract or identification number50003181001
Number of Individuals Covered2913
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $108,886
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number70101-7
Policy instance 2
Insurance contract or identification number70101-7
Number of Individuals Covered2003
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $44,475
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $339,677
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $44,475
Insurance broker organization code?3
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract number179973
Policy instance 1
Insurance contract or identification number179973
Number of Individuals Covered2756
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $100,000
Total amount of fees paid to insurance companyUSD $9,000
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $100,000
Amount paid for insurance broker fees9000
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number70101-7
Policy instance 3
Insurance contract or identification number70101-7
Number of Individuals Covered1961
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $38,287
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $340,986
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $38,287
Insurance broker organization code?3
DELTA DENTAL PLAN OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number641766
Policy instance 2
Insurance contract or identification number641766
Number of Individuals Covered3045
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,086,930
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 number179973
Policy instance 1
Insurance contract or identification number179973
Number of Individuals Covered3113
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $100,000
Total amount of fees paid to insurance companyUSD $13,200
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $100,000
Amount paid for insurance broker fees13200
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number70101-7
Policy instance 3
Insurance contract or identification number70101-7
Number of Individuals Covered2369
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $35,300
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $352,998
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $35,300
Insurance broker organization code?3
DELTA DENTAL PLAN OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number641766
Policy instance 2
Insurance contract or identification number641766
Number of Individuals Covered3681
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,033,439
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 number179973
Policy instance 1
Insurance contract or identification number179973
Number of Individuals Covered3439
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $100,000
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $100,000
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number70101-7
Policy instance 3
Insurance contract or identification number70101-7
Number of Individuals Covered2536
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $34,625
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $346,253
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,625
Insurance broker organization code?3
DELTA DENTAL PLAN OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number0000118946
Policy instance 2
Insurance contract or identification number0000118946
Number of Individuals Covered3970
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,282,480
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 number179973
Policy instance 1
Insurance contract or identification number179973
Number of Individuals Covered3750
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $100,000
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $100,000
Insurance broker organization code?3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number70101-7
Policy instance 3
Insurance contract or identification number70101-7
Number of Individuals Covered2623
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $22,025
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $156,568
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number0000118946
Policy instance 2
Insurance contract or identification number0000118946
Number of Individuals Covered4217
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,348,690
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 number179973
Policy instance 1
Insurance contract or identification number179973
Number of Individuals Covered4075
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $100,000
Total amount of fees paid to insurance companyUSD $8,400
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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