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NORTHERN FACTORY SALES, INC. HEALTH & WELFARE BENEFIT PLAN 401k Plan overview

Plan NameNORTHERN FACTORY SALES, INC. HEALTH & WELFARE BENEFIT PLAN
Plan identification number 501

NORTHERN FACTORY SALES, INC. HEALTH & WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

NORTHERN FACTORY SALES, INC. has sponsored the creation of one or more 401k plans.

Company Name:NORTHERN FACTORY SALES, INC.
Employer identification number (EIN):411571247
NAIC Classification:423100

Additional information about NORTHERN FACTORY SALES, INC.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2016-02-01
Company Identification Number: 0802377487
Legal Registered Office Address: PO BOX 660

WILLMAR
United States of America (USA)
56201

More information about NORTHERN FACTORY SALES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTHERN FACTORY SALES, INC. HEALTH & WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012024-01-01JENI GAFKJEN
5012023-01-01
5012023-01-01JENI GAFKJEN
5012022-01-01
5012022-01-01JENI GAFKJEN
5012021-01-01
5012021-01-01NORTHERN FACTORY SALES, INC.
5012020-01-01
5012020-01-01

Form 5500 Responses for NORTHERN FACTORY SALES, INC. HEALTH & WELFARE BENEFIT PLAN

2023: NORTHERN FACTORY SALES, INC. HEALTH & WELFARE BENEFIT PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan funding arrangement – General assets of the sponsorYes
2023-01-01Plan benefit arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – General assets of the sponsorYes
2022: NORTHERN FACTORY SALES, INC. HEALTH & WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: NORTHERN FACTORY SALES, INC. HEALTH & WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: NORTHERN FACTORY SALES, INC. HEALTH & WELFARE BENEFIT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01First time form 5500 has been submittedYes
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 )
Policy contract numberE4396396
Policy instance 7
Insurance contract or identification numberE4396396
Number of Individuals Covered20
Total amount of commissions paid to insurance brokerUSD $805
Total amount of fees paid to insurance companyUSD $330
Other welfare benefits providedACCIDENT, HOSPITAL INDEMNITY
Welfare Benefit Premiums Paid to CarrierUSD $3,102
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10199341001
Policy instance 1
Insurance contract or identification number10199341001
Number of Individuals Covered55
Total amount of commissions paid to insurance brokerUSD $1,093
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $7,282
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 95766 )
Policy contract number27370
Policy instance 2
Insurance contract or identification number27370
Number of Individuals Covered58
Total amount of commissions paid to insurance brokerUSD $2,769
Total amount of fees paid to insurance companyUSD $11
Dental Insurance Welfare BenefitYes
Other welfare benefits providedEAP
Welfare Benefit Premiums Paid to CarrierUSD $38,223
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSOK605819
Policy instance 3
Insurance contract or identification numberSOK605819
Number of Individuals Covered103
Total amount of commissions paid to insurance brokerUSD $152
Other welfare benefits providedBASIC & VOLUNTARY AD&D
Welfare Benefit Premiums Paid to CarrierUSD $2,224
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM607963
Policy instance 4
Insurance contract or identification numberSGM607963
Number of Individuals Covered103
Total amount of commissions paid to insurance brokerUSD $1,156
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $17,212
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGD608450
Policy instance 5
Insurance contract or identification numberSGD608450
Number of Individuals Covered103
Total amount of commissions paid to insurance brokerUSD $1,015
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,763
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICA (National Association of Insurance Commissioners NAIC id number: 12459 )
Policy contract number308399
Policy instance 6
Insurance contract or identification number308399
Number of Individuals Covered83
Total amount of commissions paid to insurance brokerUSD $30,652
Total amount of fees paid to insurance companyUSD $2,212
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $766,294
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 )
Policy contract numberE4396396
Policy instance 7
Insurance contract or identification numberE4396396
Number of Individuals Covered9
Total amount of commissions paid to insurance brokerUSD $143
Other welfare benefits providedACCIDENT, HOSPITAL INDEMNITY
Welfare Benefit Premiums Paid to CarrierUSD $2,028
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICA (National Association of Insurance Commissioners NAIC id number: 12459 )
Policy contract number308399
Policy instance 6
Insurance contract or identification number308399
Number of Individuals Covered82
Total amount of commissions paid to insurance brokerUSD $33,938
Total amount of fees paid to insurance companyUSD $2,593
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $848,452
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGD608450
Policy instance 5
Insurance contract or identification numberSGD608450
Number of Individuals Covered102
Total amount of commissions paid to insurance brokerUSD $1,230
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,252
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM607963
Policy instance 4
Insurance contract or identification numberSGM607963
Number of Individuals Covered104
Total amount of commissions paid to insurance brokerUSD $1,816
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $18,205
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSOK605819
Policy instance 3
Insurance contract or identification numberSOK605819
Number of Individuals Covered104
Total amount of commissions paid to insurance brokerUSD $211
Other welfare benefits providedBASIC & VOLUNTARY AD&D
Welfare Benefit Premiums Paid to CarrierUSD $2,112
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 95766 )
Policy contract number27370
Policy instance 2
Insurance contract or identification number27370
Number of Individuals Covered107
Total amount of commissions paid to insurance brokerUSD $2,388
Total amount of fees paid to insurance companyUSD $24
Dental Insurance Welfare BenefitYes
Other welfare benefits providedEAP
Welfare Benefit Premiums Paid to CarrierUSD $36,961
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10199341001
Policy instance 1
Insurance contract or identification number10199341001
Number of Individuals Covered55
Total amount of commissions paid to insurance brokerUSD $959
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,549
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 )
Policy contract numberE4396396
Policy instance 7
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10199341001
Policy instance 1
HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 95766 )
Policy contract number27370
Policy instance 2
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGD608450
Policy instance 3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM607963
Policy instance 4
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSOK605819
Policy instance 5
MEDICA (National Association of Insurance Commissioners NAIC id number: 12459 )
Policy contract number308399
Policy instance 6
MEDICA (National Association of Insurance Commissioners NAIC id number: 12459 )
Policy contract number308399
Policy instance 6
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSOK605819
Policy instance 5
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM607963
Policy instance 4
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGD608450
Policy instance 3
HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 95766 )
Policy contract number27370
Policy instance 2
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number10199341001
Policy instance 1

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