 |
|
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| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2024-07-01 | ANGELICA YOUNG | |||
| 501 | 2023-07-01 | ANGELICA YOUNG | |||
| 501 | 2022-07-01 | ||||
| 501 | 2022-07-01 | ANGELICA YOUNG | |||
| 501 | 2021-07-01 | ||||
| 501 | 2021-07-01 | ANGELICA YOUNG | |||
| 501 | 2020-07-01 |
| Measure | Date | Value |
|---|---|---|
| 2022: 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-07-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-07-01 | 100 |
| Number of retired or separated participants receiving benefits | 2022-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-07-01 | 0 |
| Total of all active and inactive participants | 2022-07-01 | 100 |
| 2021: 2021 401k membership | ||
| Total participants, beginning-of-year | 2021-07-01 | 105 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-07-01 | 105 |
| Number of retired or separated participants receiving benefits | 2021-07-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2021-07-01 | 0 |
| Total of all active and inactive participants | 2021-07-01 | 106 |
| 2020: 2020 401k membership | ||
| Total participants, beginning-of-year | 2020-07-01 | 103 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-07-01 | 103 |
| Number of retired or separated participants receiving benefits | 2020-07-01 | 64 |
| Number of other retired or separated participants entitled to future benefits | 2020-07-01 | 0 |
| Total of all active and inactive participants | 2020-07-01 | 167 |
| 2022: 2022 form 5500 responses | ||
|---|---|---|
| 2022-07-01 | Type of plan entity | Single employer plan |
| 2022-07-01 | Submission has been amended | No |
| 2022-07-01 | This submission is the final filing | No |
| 2022-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-07-01 | Plan is a collectively bargained plan | No |
| 2022-07-01 | Plan funding arrangement – Insurance | Yes |
| 2022-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: 2021 form 5500 responses | ||
| 2021-07-01 | Type of plan entity | Single employer plan |
| 2021-07-01 | Submission has been amended | No |
| 2021-07-01 | This submission is the final filing | No |
| 2021-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-07-01 | Plan is a collectively bargained plan | No |
| 2021-07-01 | Plan funding arrangement – Insurance | Yes |
| 2021-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: 2020 form 5500 responses | ||
| 2020-07-01 | Type of plan entity | Single employer plan |
| 2020-07-01 | Submission has been amended | No |
| 2020-07-01 | This submission is the final filing | No |
| 2020-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-07-01 | Plan is a collectively bargained plan | No |
| 2020-07-01 | Plan funding arrangement – Insurance | Yes |
| 2020-07-01 | Plan benefit arrangement – Insurance | Yes |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | 228579 |
| Policy instance | 8 |
| HEALTHPARTNERS INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 44547 ) | |
| Policy contract number | 25986 |
| Policy instance | 1 |
| DELTA DENTAL OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 ) | |
| Policy contract number | 334435 |
| Policy instance | 2 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | 5972517 |
| Policy instance | 3 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | 0228577 |
| Policy instance | 4 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | 0228578 |
| Policy instance | 5 |
| PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 130816 |
| Policy instance | 6 |
| TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 ) | |
| Policy contract number | ER00038674 |
| Policy instance | 7 |
| TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 ) | |
| Policy contract number | ER00038674 |
| Policy instance | 7 |
| PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 130816 |
| Policy instance | 6 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | 0228578 |
| Policy instance | 5 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | 0228577 |
| Policy instance | 4 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | 5972517 |
| Policy instance | 3 |
| DELTA DENTAL OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 ) | |
| Policy contract number | 334435 |
| Policy instance | 2 |
| HEALTHPARTNERS INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 44547 ) | |
| Policy contract number | 25986 |
| Policy instance | 1 |
| HEALTHPARTNERS INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 44547 ) | |
| Policy contract number | 25986 |
| Policy instance | 1 |
| DELTA DENTAL OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 ) | |
| Policy contract number | 334435 |
| Policy instance | 2 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | 5972517 |
| Policy instance | 3 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | 0228577 |
| Policy instance | 4 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | 0228578 |
| Policy instance | 5 |
| PRE-PAID LEGAL SERVICES DBA LEGAL SHIELD (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 130816 |
| Policy instance | 6 |
| TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 ) | |
| Policy contract number | ER00038674 |
| Policy instance | 7 |
| HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 95766 ) | |
| Policy contract number | 25986 |
| Policy instance | 1 |
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