401k Plan data: IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN plan

IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN 401k Plan overview

Plan Name	IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN
Plan identification number	502

IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Dental Vision

401k Sponsoring company profile

IDAHO SUPREME POTATOES, INC. has sponsored the creation of one or more 401k plans.

Company Name: IDAHO SUPREME POTATOES, INC.

Employer identification number (EIN): 820374045

NAIC Classification: 311400
NAIC Description: Fruit and Vegetable Preserving and Specialty Food Manufacturing

Form 5500 Filing Information

Submission information for form 5500 for 401k plan IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2017-01-01 STEVEN PRESCOTT STEVEN PRESCOTT 2018-07-30
502 2016-01-01 STEVEN PRESCOTT STEVEN PRESCOTT 2017-06-06
502 2015-01-01 STEVEN PRESCOTT
502 2014-01-01 STEVEN PRESCOTT STEVEN PRESCOTT 2015-06-11
502 2013-01-01 STEVEN PRESCOTT STEVEN PRESCOTT 2014-06-30
502 2012-01-01 STEVEN PRESCOTT
502 2011-01-01 STEVEN PRESCOTT
502 2010-01-01 STEVEN PRESCOTT
502 2009-01-01 STEVEN PRESCOTT

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
502	2017-01-01	STEVEN PRESCOTT	STEVEN PRESCOTT	2018-07-30
502	2016-01-01	STEVEN PRESCOTT	STEVEN PRESCOTT	2017-06-06
502	2015-01-01	STEVEN PRESCOTT
502	2014-01-01	STEVEN PRESCOTT	STEVEN PRESCOTT	2015-06-11
502	2013-01-01	STEVEN PRESCOTT	STEVEN PRESCOTT	2014-06-30
502	2012-01-01	STEVEN PRESCOTT
502	2011-01-01	STEVEN PRESCOTT
502	2010-01-01	STEVEN PRESCOTT
502	2009-01-01	STEVEN PRESCOTT

Plan Statistics for IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN

401k plan membership statisitcs for IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN

Measure Date Value
2017: IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 180
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 175
Total of all active and inactive participants 2017-01-01 175
Total participants 2017-01-01 175
2016: IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 181
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 180
Total of all active and inactive participants 2016-01-01 180
Total participants 2016-01-01 180
2015: IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 201
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 181
Total of all active and inactive participants 2015-01-01 181
Total participants 2015-01-01 181
2014: IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 195
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 201
Total of all active and inactive participants 2014-01-01 201
Total participants 2014-01-01 201
2013: IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 205
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 195
Total of all active and inactive participants 2013-01-01 195
Total participants 2013-01-01 195
2012: IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 192
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 205
Total of all active and inactive participants 2012-01-01 205
Total participants 2012-01-01 205
2011: IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 195
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 192
Total of all active and inactive participants 2011-01-01 192
Total participants 2011-01-01 192
2010: IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 186
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 195
Total of all active and inactive participants 2010-01-01 195
Total participants 2010-01-01 195
2009: IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 169
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 186
Total of all active and inactive participants 2009-01-01 186
Total participants 2009-01-01 186

Measure	Date	Value
2017: IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	180
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	175
Total of all active and inactive participants	2017-01-01	175
Total participants	2017-01-01	175
2016: IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	181
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	180
Total of all active and inactive participants	2016-01-01	180
Total participants	2016-01-01	180
2015: IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	201
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	181
Total of all active and inactive participants	2015-01-01	181
Total participants	2015-01-01	181
2014: IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	195
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	201
Total of all active and inactive participants	2014-01-01	201
Total participants	2014-01-01	201
2013: IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	205
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	195
Total of all active and inactive participants	2013-01-01	195
Total participants	2013-01-01	195
2012: IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	192
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	205
Total of all active and inactive participants	2012-01-01	205
Total participants	2012-01-01	205
2011: IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	195
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	192
Total of all active and inactive participants	2011-01-01	192
Total participants	2011-01-01	192
2010: IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	186
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	195
Total of all active and inactive participants	2010-01-01	195
Total participants	2010-01-01	195
2009: IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	169
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	186
Total of all active and inactive participants	2009-01-01	186
Total participants	2009-01-01	186

Form 5500 Responses for IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN

2017: IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: IDAHO SUPREME POTATOES HEALTH & WELFARE PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

BLUE CROSS OF IDAHO HEALTH SERVICE INC. (National Association of Insurance Commissioners NAIC id number: 60095 )

Policy contract number

10030797

Policy instance

Insurance contract or identification number	10030797
Number of Individuals Covered	377
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $31,479
Total amount of fees paid to insurance company	USD $449,390
Are there contracts with allocated funds for individual policies?	0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $30,584
Amount paid for insurance broker fees	450285
Additional information about fees paid to insurance broker	MEDICAL,COBRA,REINSURANCE, DENTAL,VISION
Insurance broker organization code?	3
Insurance broker name	JEFFREY ANDERSON

Potentially related plans

IDAHO SUPREME POTATOES, LLC PROFIT SHARING PLAN [EIN = 364885669]

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Company Name:	IDAHO SUPREME POTATOES, INC.
Employer identification number (EIN):	820374045
NAIC Classification:	311400
NAIC Description:	Fruit and Vegetable Preserving and Specialty Food Manufacturing