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| Plan Name | LONESOME OAK TRADING CO., INC. MEDICAL PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | LONESOME OAK TRADING CO., INC. |
| Employer identification number (EIN): | 582241306 |
| NAIC Classification: | 339900 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2019-06-01 | ||||
| 501 | 2017-06-01 | CLETE GREESON |
| Measure | Date | Value |
|---|---|---|
| 2019: LONESOME OAK TRADING CO., INC. MEDICAL PLAN 2019 401k membership | ||
| Total participants, beginning-of-year | 2019-06-01 | 295 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-06-01 | 0 |
| Number of retired or separated participants receiving benefits | 2019-06-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-06-01 | 0 |
| Total of all active and inactive participants | 2019-06-01 | 0 |
| 2017: LONESOME OAK TRADING CO., INC. MEDICAL PLAN 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-06-01 | 319 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-06-01 | 162 |
| Number of retired or separated participants receiving benefits | 2017-06-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-06-01 | 24 |
| Total of all active and inactive participants | 2017-06-01 | 186 |
| 2019: LONESOME OAK TRADING CO., INC. MEDICAL PLAN 2019 form 5500 responses | ||
|---|---|---|
| 2019-06-01 | Type of plan entity | Single employer plan |
| 2019-06-01 | Submission has been amended | No |
| 2019-06-01 | This submission is the final filing | Yes |
| 2019-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-06-01 | Plan is a collectively bargained plan | No |
| 2019-06-01 | Plan funding arrangement – Insurance | Yes |
| 2019-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: LONESOME OAK TRADING CO., INC. MEDICAL PLAN 2017 form 5500 responses | ||
| 2017-06-01 | Type of plan entity | Single employer plan |
| 2017-06-01 | Submission has been amended | No |
| 2017-06-01 | This submission is the final filing | No |
| 2017-06-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-06-01 | Plan is a collectively bargained plan | No |
| 2017-06-01 | Plan funding arrangement – Insurance | Yes |
| 2017-06-01 | Plan benefit arrangement – Insurance | Yes |
| ALLIANT HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 11256 ) | |
| Policy contract number | A03940001 |
| Policy instance | 1 |
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) | |
| Policy contract number | 1099088 |
| Policy instance | 2 |
| ALLIANT HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 11256 ) | |
| Policy contract number | A03940002 |
| Policy instance | 3 |
| ALLIANT HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 11256 ) | |
| Policy contract number | A03940003 |
| Policy instance | 4 |
| ALLIANT HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 11256 ) | |
| Policy contract number | A03940004 |
| Policy instance | 5 |
| ALLIANT HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 11256 ) | |
| Policy contract number | A03940005 |
| Policy instance | 6 |
| ALLIANT HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 11256 ) | |
| Policy contract number | A03940007 |
| Policy instance | 7 |
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) | |
| Policy contract number | 24649 |
| Policy instance | 8 |
| ALLIANT HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 11256 ) | |
| Policy contract number | A03940001 |
| Policy instance | 1 |
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