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LAKE SUPERIOR CONSULTING, LLC HEALTH & WELFARE PLAN 401k Plan overview

Plan NameLAKE SUPERIOR CONSULTING, LLC HEALTH & WELFARE PLAN
Plan identification number 502

LAKE SUPERIOR CONSULTING, LLC HEALTH & WELFARE 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)

401k Sponsoring company profile

LAKE SUPERIOR CONSULTING has sponsored the creation of one or more 401k plans.

Company Name:LAKE SUPERIOR CONSULTING
Employer identification number (EIN):562300936
NAIC Classification:237990
NAIC Description:Other Heavy and Civil Engineering Construction

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LAKE SUPERIOR CONSULTING, LLC HEALTH & WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022023-01-01IVY KOLQUIST2024-09-18

Plan Statistics for LAKE SUPERIOR CONSULTING, LLC HEALTH & WELFARE PLAN

401k plan membership statisitcs for LAKE SUPERIOR CONSULTING, LLC HEALTH & WELFARE PLAN

Measure Date Value
2023: LAKE SUPERIOR CONSULTING, LLC HEALTH & WELFARE PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-01366
Total number of active participants reported on line 7a of the Form 55002023-01-01284
Number of retired or separated participants receiving benefits2023-01-010
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-01284
Number of employers contributing to the scheme2023-01-010

Form 5500 Responses for LAKE SUPERIOR CONSULTING, LLC HEALTH & WELFARE PLAN

2023: LAKE SUPERIOR CONSULTING, LLC HEALTH & WELFARE PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01First time form 5500 has been submittedYes
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

Insurance Providers Used on plan

BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract number296164
Policy instance 1
Insurance contract or identification number296164
Number of Individuals Covered307
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $14,842
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,560,966
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 number10411521001
Policy instance 2
Insurance contract or identification number10411521001
Number of Individuals Covered420
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $2,834
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $34,123
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )
Policy contract number10272745
Policy instance 3
Insurance contract or identification number10272745
Number of Individuals Covered284
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $27,707
Total amount of fees paid to insurance companyUSD $4,785
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $138,532
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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