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| Plan Name | GERIATRIC SERVICES OF MINNESOTA MEDICAL INSURANCE |
| Plan identification number | 505 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | GERIATRIC SERVICES OF MINNESOTA D/B/A GENEVIVE |
| Employer identification number (EIN): | 453357936 |
| NAIC Classification: | 621111 |
| NAIC Description: | Offices of Physicians (except Mental Health Specialists) |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 505 | 2023-05-01 | ||||
| 505 | 2022-05-01 | ||||
| 505 | 2021-05-01 | ||||
| 505 | 2020-05-01 |
| Measure | Date | Value |
|---|---|---|
| 2023: GERIATRIC SERVICES OF MINNESOTA MEDICAL INSURANCE 2023 401k membership | ||
| Total participants, beginning-of-year | 2023-05-01 | 129 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-05-01 | 147 |
| Number of retired or separated participants receiving benefits | 2023-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2023-05-01 | 0 |
| Total of all active and inactive participants | 2023-05-01 | 147 |
| 2022: GERIATRIC SERVICES OF MINNESOTA MEDICAL INSURANCE 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-05-01 | 135 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-05-01 | 129 |
| Number of retired or separated participants receiving benefits | 2022-05-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2022-05-01 | 0 |
| Total of all active and inactive participants | 2022-05-01 | 130 |
| 2021: GERIATRIC SERVICES OF MINNESOTA MEDICAL INSURANCE 2021 401k membership | ||
| Total participants, beginning-of-year | 2021-05-01 | 129 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-05-01 | 127 |
| Number of retired or separated participants receiving benefits | 2021-05-01 | 5 |
| Number of other retired or separated participants entitled to future benefits | 2021-05-01 | 0 |
| Total of all active and inactive participants | 2021-05-01 | 132 |
| 2020: GERIATRIC SERVICES OF MINNESOTA MEDICAL INSURANCE 2020 401k membership | ||
| Total participants, beginning-of-year | 2020-05-01 | 125 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-05-01 | 128 |
| Number of retired or separated participants receiving benefits | 2020-05-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2020-05-01 | 0 |
| Total of all active and inactive participants | 2020-05-01 | 130 |
| 2023: GERIATRIC SERVICES OF MINNESOTA MEDICAL INSURANCE 2023 form 5500 responses | ||
|---|---|---|
| 2023-05-01 | Type of plan entity | Single employer plan |
| 2023-05-01 | Submission has been amended | No |
| 2023-05-01 | This submission is the final filing | No |
| 2023-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2023-05-01 | Plan is a collectively bargained plan | No |
| 2023-05-01 | Plan funding arrangement – Insurance | Yes |
| 2023-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: GERIATRIC SERVICES OF MINNESOTA MEDICAL INSURANCE 2022 form 5500 responses | ||
| 2022-05-01 | Type of plan entity | Single employer plan |
| 2022-05-01 | Submission has been amended | No |
| 2022-05-01 | This submission is the final filing | No |
| 2022-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-05-01 | Plan is a collectively bargained plan | No |
| 2022-05-01 | Plan funding arrangement – Insurance | Yes |
| 2022-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: GERIATRIC SERVICES OF MINNESOTA MEDICAL INSURANCE 2021 form 5500 responses | ||
| 2021-05-01 | Type of plan entity | Single employer plan |
| 2021-05-01 | Submission has been amended | No |
| 2021-05-01 | This submission is the final filing | No |
| 2021-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-05-01 | Plan is a collectively bargained plan | No |
| 2021-05-01 | Plan funding arrangement – Insurance | Yes |
| 2021-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: GERIATRIC SERVICES OF MINNESOTA MEDICAL INSURANCE 2020 form 5500 responses | ||
| 2020-05-01 | Type of plan entity | Single employer plan |
| 2020-05-01 | First time form 5500 has been submitted | Yes |
| 2020-05-01 | Submission has been amended | No |
| 2020-05-01 | This submission is the final filing | No |
| 2020-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-05-01 | Plan is a collectively bargained plan | No |
| 2020-05-01 | Plan funding arrangement – Insurance | Yes |
| 2020-05-01 | Plan benefit arrangement – Insurance | Yes |
| BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 206762 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||
| BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 206762 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||
| BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 206762 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||
| BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 206762 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
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