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EASTER SEALS-GOODWILL NORTHERN ROCKY MOUNTAIN, INC. SUPPLEMENTAL PLAN 401k Plan overview

Plan NameEASTER SEALS-GOODWILL NORTHERN ROCKY MOUNTAIN, INC. SUPPLEMENTAL PLAN
Plan identification number 507

EASTER SEALS-GOODWILL NORTHERN ROCKY MOUNTAIN, INC. SUPPLEMENTAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Other welfare benefit cover
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

EASTERSEALS-GOODWILL NORTHERN ROCKY MOUNTAIN, INC. CAFETERIA PLAN has sponsored the creation of one or more 401k plans.

Company Name:EASTERSEALS-GOODWILL NORTHERN ROCKY MOUNTAIN, INC. CAFETERIA PLAN
Employer identification number (EIN):810232125
NAIC Classification:624100
NAIC Description: Individual and Family Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EASTER SEALS-GOODWILL NORTHERN ROCKY MOUNTAIN, INC. SUPPLEMENTAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5072013-07-01MARY BERGAN MARY BERGAN2017-02-10
5072012-07-01MARY BERGAN MARY BERGAN2016-08-01
5072011-07-01MARY BERGAN MARY BERGAN2016-08-01

Plan Statistics for EASTER SEALS-GOODWILL NORTHERN ROCKY MOUNTAIN, INC. SUPPLEMENTAL PLAN

401k plan membership statisitcs for EASTER SEALS-GOODWILL NORTHERN ROCKY MOUNTAIN, INC. SUPPLEMENTAL PLAN

Measure Date Value
2013: EASTER SEALS-GOODWILL NORTHERN ROCKY MOUNTAIN, INC. SUPPLEMENTAL PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-01111
Total number of active participants reported on line 7a of the Form 55002013-07-0197
Total of all active and inactive participants2013-07-0197
Total participants2013-07-0197
2012: EASTER SEALS-GOODWILL NORTHERN ROCKY MOUNTAIN, INC. SUPPLEMENTAL PLAN 2012 401k membership
Total participants, beginning-of-year2012-07-01154
Total number of active participants reported on line 7a of the Form 55002012-07-01128
Total of all active and inactive participants2012-07-01128
Total participants2012-07-01128
2011: EASTER SEALS-GOODWILL NORTHERN ROCKY MOUNTAIN, INC. SUPPLEMENTAL PLAN 2011 401k membership
Total participants, beginning-of-year2011-07-01106
Total number of active participants reported on line 7a of the Form 55002011-07-01104
Total of all active and inactive participants2011-07-01104
Total participants2011-07-01104

Form 5500 Responses for EASTER SEALS-GOODWILL NORTHERN ROCKY MOUNTAIN, INC. SUPPLEMENTAL PLAN

2013: EASTER SEALS-GOODWILL NORTHERN ROCKY MOUNTAIN, INC. SUPPLEMENTAL PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Submission has been amendedYes
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – InsuranceYes
2012: EASTER SEALS-GOODWILL NORTHERN ROCKY MOUNTAIN, INC. SUPPLEMENTAL PLAN 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – InsuranceYes
2011: EASTER SEALS-GOODWILL NORTHERN ROCKY MOUNTAIN, INC. SUPPLEMENTAL PLAN 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number7653
Policy instance 1
Insurance contract or identification number7653
Number of Individuals Covered97
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $15,493
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedSUPPLEMENTAL INSURANCE
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $53,283
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,785
Insurance broker organization code?3
Insurance broker nameDAWN D SHEUE
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number7653
Policy instance 1
Insurance contract or identification number7653
Number of Individuals Covered128
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $23,704
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedSUPPLEMENTAL INSURANCE
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $57,472
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,593
Insurance broker organization code?3
Insurance broker nameLESLIE J BAILEY
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number7653
Policy instance 1
Insurance contract or identification number7653
Number of Individuals Covered104
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $29,816
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedSUPPLEMENTAL
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $41,744
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,557
Insurance broker organization code?3
Insurance broker nameGERALD R THEIS, JR.

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