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NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA 401k Plan overview

Plan NameNORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA
Plan identification number 502

NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

NORTH COUNTRY BUSINESS PRODUCTS INC has sponsored the creation of one or more 401k plans.

Company Name:NORTH COUNTRY BUSINESS PRODUCTS INC
Employer identification number (EIN):410944999
NAIC Classification:453210
NAIC Description:Office Supplies and Stationery Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-01-01TAMRA ROERING2023-10-11
5022021-01-01DANA KLUCK2022-07-28
5022020-01-01DANA KLUCK2021-07-27
5022019-01-01DANA KLUCK2020-07-23
5022018-01-01
5022017-01-01
5022016-01-01
5022015-01-01
5022014-01-01
5022013-01-01
5022012-01-01DEAN CROTTY
5022011-01-01DEAN CROTTY
5022009-01-01DEAN CROTTY

Plan Statistics for NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA

401k plan membership statisitcs for NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA

Measure Date Value
2022: NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA 2022 401k membership
Total participants, beginning-of-year2022-01-01141
Total number of active participants reported on line 7a of the Form 55002022-01-01145
Total of all active and inactive participants2022-01-01145
2021: NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA 2021 401k membership
Total participants, beginning-of-year2021-01-01143
Total number of active participants reported on line 7a of the Form 55002021-01-01141
Total of all active and inactive participants2021-01-01141
2020: NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA 2020 401k membership
Total participants, beginning-of-year2020-01-01148
Total number of active participants reported on line 7a of the Form 55002020-01-01143
Total of all active and inactive participants2020-01-01143
2019: NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA 2019 401k membership
Total participants, beginning-of-year2019-01-01152
Total number of active participants reported on line 7a of the Form 55002019-01-01148
Total of all active and inactive participants2019-01-01148
2018: NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA 2018 401k membership
Total participants, beginning-of-year2018-01-01151
Total number of active participants reported on line 7a of the Form 55002018-01-01152
Total of all active and inactive participants2018-01-01152
2017: NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA 2017 401k membership
Total participants, beginning-of-year2017-01-01165
Total number of active participants reported on line 7a of the Form 55002017-01-01151
Total of all active and inactive participants2017-01-01151
2016: NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA 2016 401k membership
Total participants, beginning-of-year2016-01-01200
Total number of active participants reported on line 7a of the Form 55002016-01-01165
Total of all active and inactive participants2016-01-01165
2015: NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA 2015 401k membership
Total participants, beginning-of-year2015-01-01203
Total number of active participants reported on line 7a of the Form 55002015-01-01200
Total of all active and inactive participants2015-01-01200
2014: NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA 2014 401k membership
Total participants, beginning-of-year2014-01-01184
Total number of active participants reported on line 7a of the Form 55002014-01-01203
Total of all active and inactive participants2014-01-01203
2013: NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA 2013 401k membership
Total participants, beginning-of-year2013-01-01177
Total number of active participants reported on line 7a of the Form 55002013-01-01184
Total of all active and inactive participants2013-01-01184
2012: NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA 2012 401k membership
Total participants, beginning-of-year2012-01-01186
Total number of active participants reported on line 7a of the Form 55002012-01-01177
Total of all active and inactive participants2012-01-01177
2011: NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA 2011 401k membership
Total participants, beginning-of-year2011-01-01194
Total number of active participants reported on line 7a of the Form 55002011-01-01186
Total of all active and inactive participants2011-01-01186
2009: NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA 2009 401k membership
Total participants, beginning-of-year2009-01-01221
Total number of active participants reported on line 7a of the Form 55002009-01-01209
Total of all active and inactive participants2009-01-01209

Form 5500 Responses for NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA

2022: NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01This submission is the final filingYes
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: NORTH COUNTRY BUSINESS - LIFE INSURANCE & AD&D PLA 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number158219/129168
Policy instance 1
Insurance contract or identification number158219/129168
Number of Individuals Covered145
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $10,336
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $91,912
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,336
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number158219/129168
Policy instance 1
Insurance contract or identification number158219/129168
Number of Individuals Covered141
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $9,182
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $83,054
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,182
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number158219/129168
Policy instance 1
Insurance contract or identification number158219/129168
Number of Individuals Covered143
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $6,497
Total amount of fees paid to insurance companyUSD $265
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $55,920
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,942
Amount paid for insurance broker fees265
Additional information about fees paid to insurance brokerTOTAL ADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract number158219/129168
Policy instance 1
Insurance contract or identification number158219/129168
Number of Individuals Covered148
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $6,204
Total amount of fees paid to insurance companyUSD $1,656
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $53,056
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,204
Amount paid for insurance broker fees1656
Additional information about fees paid to insurance brokerTOTAL ADMINISTRATIVE AND OTHER FEES
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0847453
Policy instance 1
Insurance contract or identification number0847453
Number of Individuals Covered152
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $6,498
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $55,540
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,853
Insurance broker organization code?3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0847453
Policy instance 1
Insurance contract or identification number0847453
Number of Individuals Covered151
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $7,553
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 $64,982
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,553
Insurance broker organization code?3
Insurance broker nameAON RISK SERVCES CENTRAL INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0847453
Policy instance 1
Insurance contract or identification number0847453
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $7,108
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 $62,709
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,108
Insurance broker organization code?3
Insurance broker nameAON RISK SERVCES CENTRAL INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0847453
Policy instance 1
Insurance contract or identification number0847453
Number of Individuals Covered203
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $7,047
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $63,233
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,047
Insurance broker organization code?3
Insurance broker nameAON RISK SERVCES CENTRAL INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number0847453
Policy instance 1
Insurance contract or identification number0847453
Number of Individuals Covered184
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $6,100
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $59,101
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,100
Insurance broker organization code?3
Insurance broker nameAON CONSULTING OF NEW JERSEY INC
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number867560G
Policy instance 1
Insurance contract or identification number867560G
Number of Individuals Covered177
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $5,040
Total amount of fees paid to insurance companyUSD $778
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $43,511
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,040
Amount paid for insurance broker fees778
Additional information about fees paid to insurance brokerADDITIONAL COMPENSATION
Insurance broker organization code?3
Insurance broker nameAON CONSULTING OF NEW JERSEY INC
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number867560G
Policy instance 1
Insurance contract or identification number867560G
Number of Individuals Covered186
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $5,187
Total amount of fees paid to insurance companyUSD $343
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $45,035
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number867560G
Policy instance 1
Insurance contract or identification number867560G
Number of Individuals Covered194
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $5,327
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $46,056
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,327
Insurance broker organization code?3
Insurance broker nameAON CONSULTING INC

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