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ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 401k Plan overview

Plan NameROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN
Plan identification number 512

ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Dental
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Other welfare benefit cover

401k Sponsoring company profile

ROSENBOOM MACHINE & TOOL, INC has sponsored the creation of one or more 401k plans.

Company Name:ROSENBOOM MACHINE & TOOL, INC
Employer identification number (EIN):421258906
NAIC Classification:332900

Additional information about ROSENBOOM MACHINE & TOOL, INC

Jurisdiction of Incorporation: Iowa Secretary of State Business Entities
Incorporation Date: 1985-08-05
Company Identification Number: 103648
Legal Registered Office Address: 1530 WESTERN AVE

SHELDON
United States of America (USA)
51201

More information about ROSENBOOM MACHINE & TOOL, INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5122022-01-01
5122021-01-01
5122020-01-01
5122019-01-01
5122018-01-01VIVIAN ROSENBOOM
5122017-01-01VIVIAN ROSENBOOM
5122016-01-01VIVIAN ROSENBOOM
5122015-01-01VIVIAN ROSENBOOM
5122014-01-01VIVIAN ROSENBOOM
5122013-01-01VIVIAN ROSENBOOM
5122012-01-01VIVIAN ROSENBOOM
5122011-01-01VIVIAN ROSENBOOM2013-07-15
5122010-01-01VIVIAN ROSENBOOM2011-08-23
5122009-01-01VIVIAN ROSENBOOM2010-07-20

Plan Statistics for ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN

401k plan membership statisitcs for ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN

Measure Date Value
2022: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01160
Total number of active participants reported on line 7a of the Form 55002022-01-01148
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01148
2021: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01165
Total number of active participants reported on line 7a of the Form 55002021-01-01160
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01160
2020: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01186
Total number of active participants reported on line 7a of the Form 55002020-01-01165
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01165
2019: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01223
Total number of active participants reported on line 7a of the Form 55002019-01-01186
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01186
2018: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01179
Total number of active participants reported on line 7a of the Form 55002018-01-01223
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01223
2017: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01173
Total number of active participants reported on line 7a of the Form 55002017-01-01179
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01179
2016: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01182
Total number of active participants reported on line 7a of the Form 55002016-01-01173
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01173
2015: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01238
Total number of active participants reported on line 7a of the Form 55002015-01-01182
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01182
2014: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01207
Total number of active participants reported on line 7a of the Form 55002014-01-01238
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01238
2013: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01168
Total number of active participants reported on line 7a of the Form 55002013-01-01207
Total of all active and inactive participants2013-01-01207
2012: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01133
Total number of active participants reported on line 7a of the Form 55002012-01-01168
Total of all active and inactive participants2012-01-01168
2009: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01120
Total number of active participants reported on line 7a of the Form 55002009-01-0169
Number of retired or separated participants receiving benefits2009-01-012
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-0171

Form 5500 Responses for ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN

2022: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 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: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 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: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 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: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 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: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 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: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 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: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 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: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 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: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 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: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2009: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number10000544
Policy instance 1
Insurance contract or identification number10000544
Number of Individuals Covered148
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $9,382
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedSHORT-TERM DISABILITY
Welfare Benefit Premiums Paid to CarrierUSD $88,523
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,382
Insurance broker organization code?3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number10000544
Policy instance 1
Insurance contract or identification number10000544
Number of Individuals Covered160
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $8,614
Total amount of fees paid to insurance companyUSD $2,151
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedSHORT-TERM DISABILITY
Welfare Benefit Premiums Paid to CarrierUSD $83,645
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,542
Amount paid for insurance broker fees2151
Additional information about fees paid to insurance brokerSERVICE FEES
Insurance broker organization code?3
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number004896
Policy instance 1
Insurance contract or identification number004896
Number of Individuals Covered165
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $10,892
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $162,527
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,892
Additional information about fees paid to insurance brokerSERVICE FEES
Insurance broker organization code?3
MONY (National Association of Insurance Commissioners NAIC id number: 78077 )
Policy contract number004896
Policy instance 1
Insurance contract or identification number004896
Number of Individuals Covered186
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $11,742
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $183,880
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,742
Additional information about fees paid to insurance brokerSERVICE FEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00508664
Policy instance 1
Insurance contract or identification number00508664
Number of Individuals Covered223
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $9,307
Total amount of fees paid to insurance companyUSD $5,386
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,307
Amount paid for insurance broker fees5386
Insurance broker organization code?4
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00508664
Policy instance 1
Insurance contract or identification number00508664
Number of Individuals Covered179
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $6,710
Total amount of fees paid to insurance companyUSD $4,922
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $145,925
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,710
Amount paid for insurance broker fees4922
Insurance broker organization code?4
Insurance broker nameKAMINSKY & ASSOCIATES, INC.
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00508664
Policy instance 4
Insurance contract or identification number00508664
Number of Individuals Covered68
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $647
Other welfare benefits providedCRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $4,315
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $647
Insurance broker nameKAMINSKY & ASSOC INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00508664
Policy instance 3
Insurance contract or identification number00508664
Number of Individuals Covered77
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $199
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,993
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $199
Insurance broker nameKAMINSKY & ASSOC INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00508664
Policy instance 2
Insurance contract or identification number00508664
Number of Individuals Covered42
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $609
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $6,093
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $609
Insurance broker nameKAMINSKY & ASSOC INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00508664
Policy instance 1
Insurance contract or identification number00508664
Number of Individuals Covered182
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $2,093
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,926
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,093
Insurance broker nameKAMINSKY & ASSOC INC
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number503R83 & BP0330
Policy instance 2
Insurance contract or identification number503R83 & BP0330
Number of Individuals Covered30
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $537
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,505
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $537
Insurance broker nameKAMINSKY & ASSOC INC
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number503R83 & BP0330
Policy instance 1
Insurance contract or identification number503R83 & BP0330
Number of Individuals Covered238
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $2,126
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,501
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,126
Insurance broker nameKAMINSKY & ASSOC INC
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number503R83
Policy instance 2
Insurance contract or identification number503R83
Number of Individuals Covered25
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $700
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $4,234
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $700
Insurance broker nameKAMINSKY & ASSOC INC
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number503R83
Policy instance 1
Insurance contract or identification number503R83
Number of Individuals Covered207
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $2,147
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,162
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,147
Insurance broker nameKAMINSKY & ASSOC INC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number212895
Policy instance 2
Insurance contract or identification number212895
Number of Individuals Covered21
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $595
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,964
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $595
Insurance broker nameKAMINSKY & ASSOC INC
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number212895
Policy instance 1
Insurance contract or identification number212895
Number of Individuals Covered168
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,385
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $16,215
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,385
Insurance broker nameKAMINSKY & ASSOC INC

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