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NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL 401k Plan overview

Plan NameNORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL
Plan identification number 501

NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Other welfare benefit cover

401k Sponsoring company profile

NORTH COAST COOPERATIVE, INC. has sponsored the creation of one or more 401k plans.

Company Name:NORTH COAST COOPERATIVE, INC.
Employer identification number (EIN):942227181
NAIC Classification:445110
NAIC Description:Supermarkets and Other Grocery (except Convenience) Stores

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01SEAN NOLAN2023-06-19 SEAN NOLAN2023-06-19
5012021-01-01BARNEY DOYLE2022-08-01 BARNEY DOYLE2022-08-02
5012020-01-01ANTHONY ALVAREZ2021-10-08 ANTHONY ALVAREZ
5012019-01-01ANTHONY ALVAREZ2020-10-08 ANTHONY ALVAREZ2020-10-08
5012018-01-01MELANIE BETTENHAUSEN2019-10-04
5012017-01-01
5012016-01-01
5012015-01-01
5012014-01-01
5012013-01-01
5012012-01-01KELLI COSTA
5012011-01-01DAVID LIPPMAN
5012010-01-01DAVID LIPPMAN

Plan Statistics for NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL

401k plan membership statisitcs for NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL

Measure Date Value
2022: NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL 2022 401k membership
Total participants, beginning-of-year2022-01-01186
Total number of active participants reported on line 7a of the Form 55002022-01-01177
Number of retired or separated participants receiving benefits2022-01-013
Total of all active and inactive participants2022-01-01180
2021: NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL 2021 401k membership
Total participants, beginning-of-year2021-01-01185
Total number of active participants reported on line 7a of the Form 55002021-01-01182
Number of retired or separated participants receiving benefits2021-01-012
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01184
2020: NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL 2020 401k membership
Total participants, beginning-of-year2020-01-01187
Total number of active participants reported on line 7a of the Form 55002020-01-01177
Total of all active and inactive participants2020-01-01177
2019: NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL 2019 401k membership
Total participants, beginning-of-year2019-01-01194
Total number of active participants reported on line 7a of the Form 55002019-01-01187
Total of all active and inactive participants2019-01-01187
2018: NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL 2018 401k membership
Total participants, beginning-of-year2018-01-01214
Total number of active participants reported on line 7a of the Form 55002018-01-01215
Total of all active and inactive participants2018-01-01215
2017: NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL 2017 401k membership
Total participants, beginning-of-year2017-01-01148
Total number of active participants reported on line 7a of the Form 55002017-01-01214
Total of all active and inactive participants2017-01-01214
2016: NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL 2016 401k membership
Total participants, beginning-of-year2016-01-01145
Total number of active participants reported on line 7a of the Form 55002016-01-01148
Total of all active and inactive participants2016-01-01148
2015: NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL 2015 401k membership
Total participants, beginning-of-year2015-01-01144
Total number of active participants reported on line 7a of the Form 55002015-01-01145
Total of all active and inactive participants2015-01-01145
2014: NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL 2014 401k membership
Total participants, beginning-of-year2014-01-01140
Total number of active participants reported on line 7a of the Form 55002014-01-01154
Total of all active and inactive participants2014-01-01154
2013: NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL 2013 401k membership
Total participants, beginning-of-year2013-01-01179
Total number of active participants reported on line 7a of the Form 55002013-01-01163
Total of all active and inactive participants2013-01-01163
2012: NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL 2012 401k membership
Total participants, beginning-of-year2012-01-01157
Total number of active participants reported on line 7a of the Form 55002012-01-01153
Total of all active and inactive participants2012-01-01153
2011: NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL 2011 401k membership
Total participants, beginning-of-year2011-01-01165
Total number of active participants reported on line 7a of the Form 55002011-01-01157
Total of all active and inactive participants2011-01-01157
2010: NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL 2010 401k membership
Total participants, beginning-of-year2010-01-01161
Total number of active participants reported on line 7a of the Form 55002010-01-01165
Total of all active and inactive participants2010-01-01165
Total participants2010-01-01165

Financial Data on NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL

Measure Date Value
2013 : NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL 2013 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$67,716
Total income from all sources (including contributions)2013-12-31$1,004,691
Total of all expenses incurred2013-12-31$1,042,014
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$956,324
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$1,009,721
Value of total assets at end of year2013-12-31$5,436
Value of total assets at beginning of year2013-12-31$110,475
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$85,690
Total interest from all sources2013-12-31$1
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$2,186
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2013-12-31$2,186
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$30,000
If this is an individual account plan, was there a blackout period2013-12-31No
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$209,440
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2013-12-31$661,293
Total non interest bearing cash at end of year2013-12-31$5,278
Total non interest bearing cash at beginning of year2013-12-31$5,284
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$-37,323
Value of net assets at end of year (total assets less liabilities)2013-12-31$5,436
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$42,759
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2013-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2013-12-31$83,847
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2013-12-31$158
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2013-12-31$6,364
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2013-12-31$6,364
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2013-12-31$1
Expenses. Payments to insurance carriers foe the provision of benefits2013-12-31$295,031
Asset value of US Government securities at end of year2013-12-31$0
Asset value of US Government securities at beginning of year2013-12-31$14,980
Net investment gain/loss from registered investment companies (e.g. mutual funds)2013-12-31$-7,217
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31Yes
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Contributions received in cash from employer2013-12-31$800,281
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$479,746
Contract administrator fees2013-12-31$85,690
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32013-12-31No
Liabilities. Value of benefit claims payable at end of year2013-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2013-12-31$67,716
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31No
Opinion of an independent qualified public accountant for this plan2013-12-31Unqualified
Accountancy firm name2013-12-31WEGNER CPAS LLP
Accountancy firm EIN2013-12-31390974031
2012 : NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL 2012 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2012-12-31$3,364
Total unrealized appreciation/depreciation of assets2012-12-31$3,364
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$67,716
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$421,400
Total income from all sources (including contributions)2012-12-31$893,554
Total of all expenses incurred2012-12-31$872,315
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$729,371
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$888,079
Value of total assets at end of year2012-12-31$110,475
Value of total assets at beginning of year2012-12-31$442,920
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$142,944
Total interest from all sources2012-12-31$15
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$2,096
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31No
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$230,120
Assets. Other investments not covered elsewhere at end of year2012-12-31$83,847
Assets. Other investments not covered elsewhere at beginning of year2012-12-31$78,465
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$9,056
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2012-12-31$459,180
Administrative expenses (other) incurred2012-12-31$36,726
Total non interest bearing cash at end of year2012-12-31$5,284
Total non interest bearing cash at beginning of year2012-12-31$5,038
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$21,239
Value of net assets at end of year (total assets less liabilities)2012-12-31$42,759
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$21,520
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-12-31$6,364
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-12-31$6,359
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-12-31$6,359
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-12-31$15
Expenses. Payments to insurance carriers foe the provision of benefits2012-12-31$270,191
Asset value of US Government securities at end of year2012-12-31$14,980
Asset value of US Government securities at beginning of year2012-12-31$14,892
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Contributions received in cash from employer2012-12-31$648,903
Employer contributions (assets) at beginning of year2012-12-31$338,166
Income. Dividends from common stock2012-12-31$2,096
Contract administrator fees2012-12-31$106,218
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-12-31No
Liabilities. Value of benefit claims payable at end of year2012-12-31$67,716
Liabilities. Value of benefit claims payable at beginning of year2012-12-31$421,400
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31No
Opinion of an independent qualified public accountant for this plan2012-12-31Unqualified
Accountancy firm name2012-12-31DAVID L. MOONIE & CO., LLP
Accountancy firm EIN2012-12-31941056328
2011 : NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL 2011 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2011-12-31$6,569
Total unrealized appreciation/depreciation of assets2011-12-31$6,569
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$421,400
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$85,614
Total income from all sources (including contributions)2011-12-31$1,395,365
Total of all expenses incurred2011-12-31$1,408,231
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$1,253,314
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$1,386,069
Value of total assets at end of year2011-12-31$442,920
Value of total assets at beginning of year2011-12-31$120,000
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$154,917
Total interest from all sources2011-12-31$113
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$2,614
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31No
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$226,057
Assets. Other investments not covered elsewhere at end of year2011-12-31$78,465
Assets. Other investments not covered elsewhere at beginning of year2011-12-31$69,470
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$362,548
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2011-12-31$1,015,802
Administrative expenses (other) incurred2011-12-31$62,666
Total non interest bearing cash at end of year2011-12-31$5,038
Total non interest bearing cash at beginning of year2011-12-31$29,531
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-12,866
Value of net assets at end of year (total assets less liabilities)2011-12-31$21,520
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$34,386
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$6,359
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$6,400
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$6,400
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$113
Expenses. Payments to insurance carriers foe the provision of benefits2011-12-31$237,512
Asset value of US Government securities at end of year2011-12-31$14,892
Asset value of US Government securities at beginning of year2011-12-31$14,599
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Contributions received in cash from employer2011-12-31$797,464
Employer contributions (assets) at end of year2011-12-31$338,166
Income. Dividends from common stock2011-12-31$2,614
Contract administrator fees2011-12-31$92,251
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-12-31No
Liabilities. Value of benefit claims payable at end of year2011-12-31$421,400
Liabilities. Value of benefit claims payable at beginning of year2011-12-31$85,614
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31No
Opinion of an independent qualified public accountant for this plan2011-12-31Unqualified
Accountancy firm name2011-12-31DAVID L. MOONIE & CO., LLP
Accountancy firm EIN2011-12-31941056328
2010 : NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL 2010 401k financial data
Unrealized appreciation/depreciation of other (non real estate) assets2010-12-31$7,173
Total unrealized appreciation/depreciation of assets2010-12-31$7,173
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$85,614
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$104,683
Total income from all sources (including contributions)2010-12-31$1,084,415
Total loss/gain on sale of assets2010-12-31$-9,127
Total of all expenses incurred2010-12-31$1,350,765
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$1,159,877
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$1,081,506
Value of total assets at end of year2010-12-31$120,000
Value of total assets at beginning of year2010-12-31$386,350
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$190,888
Total interest from all sources2010-12-31$314
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$4,549
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31No
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$217,244
Assets. Other investments not covered elsewhere at end of year2010-12-31$69,470
Assets. Other investments not covered elsewhere at beginning of year2010-12-31$347,125
Income. Received or receivable in cash from other sources (including rollovers)2010-12-31$430,080
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2010-12-31$946,989
Administrative expenses (other) incurred2010-12-31$120,688
Total non interest bearing cash at end of year2010-12-31$29,531
Total non interest bearing cash at beginning of year2010-12-31$4,970
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$-266,350
Value of net assets at end of year (total assets less liabilities)2010-12-31$120,000
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$386,350
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$6,400
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$34,255
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$34,255
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$314
Expenses. Payments to insurance carriers foe the provision of benefits2010-12-31$193,871
Asset value of US Government securities at end of year2010-12-31$14,599
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Contributions received in cash from employer2010-12-31$864,262
Income. Dividends from common stock2010-12-31$4,549
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$966,006
Contract administrator fees2010-12-31$70,200
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32010-12-31No
Liabilities. Value of benefit claims payable at end of year2010-12-31$85,614
Liabilities. Value of benefit claims payable at beginning of year2010-12-31$104,683
Did the plan have assets held for investment2010-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Aggregate proceeds on sale of assets2010-12-31$258,948
Aggregate carrying amount (costs) on sale of assets2010-12-31$268,075
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31No
Opinion of an independent qualified public accountant for this plan2010-12-31Unqualified
Accountancy firm name2010-12-31DAVID L. MOONIE & CO., LLP
Accountancy firm EIN2010-12-31941056328

Form 5500 Responses for NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL

2022: NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedYes
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: NORTH COAST COOPERATIVE, INC. HEALTH AND DENTAL PL 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedYes
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract number281812
Policy instance 1
Insurance contract or identification number281812
Number of Individuals Covered146
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $1,922
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,095
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,922
Insurance broker organization code?3
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract number281812
Policy instance 1
Insurance contract or identification number281812
Number of Individuals Covered178
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $84
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,959
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $84
Insurance broker organization code?3
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract number281813
Policy instance 3
Insurance contract or identification number281813
Number of Individuals Covered150
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract number281812
Policy instance 2
Insurance contract or identification number281812
Number of Individuals Covered177
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $1,087
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,915
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $588
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number1001336
Policy instance 1
Insurance contract or identification number1001336
Number of Individuals Covered150
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $1,473
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedTRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $13,256
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,473
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number1001336
Policy instance 1
Insurance contract or identification number1001336
Number of Individuals Covered153
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $1,589
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedTRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $14,299
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,589
Insurance broker organization code?3
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract number281812
Policy instance 2
Insurance contract or identification number281812
Number of Individuals Covered192
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $959
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $8,738
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $959
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number657216
Policy instance 1
Insurance contract or identification number657216
Number of Individuals Covered153
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $18,706
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $355,410
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,706
Insurance broker organization code?3
HCC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 92711 )
Policy contract number1100109
Policy instance 2
Insurance contract or identification number1100109
Number of Individuals Covered153
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $2,256
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedORGAN TRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $20,297
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,128
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number399945
Policy instance 3
Insurance contract or identification number399945
Number of Individuals Covered215
Insurance policy start date2018-01-01
Insurance policy end date2018-08-01
Total amount of commissions paid to insurance brokerUSD $941
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $9,945
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $610
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number399945
Policy instance 3
Insurance contract or identification number399945
Number of Individuals Covered214
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $2,184
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $22,998
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,184
Insurance broker organization code?3
Insurance broker nameHEIDI OLSEN-KAVAJECZ
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number947-4185
Policy instance 2
Insurance contract or identification number947-4185
Number of Individuals Covered163
Insurance policy start date2016-07-01
Insurance policy end date2017-06-30
Total amount of commissions paid to insurance brokerUSD $2,068
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedORGAN TRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $20,680
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,034
Insurance broker organization code?3
Insurance broker nameHEIDI OLSEN-KAVAJECZ
WESTPOINT INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 39845 )
Policy contract number657216
Policy instance 1
Insurance contract or identification number657216
Number of Individuals Covered149
Insurance policy start date2016-07-01
Insurance policy end date2017-06-30
Total amount of commissions paid to insurance brokerUSD $16,045
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $320,898
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,045
Insurance broker organization code?3
Insurance broker nameSTOP LOSS INSURANCE SERVICES, INC.
WESTPOINT INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 39845 )
Policy contract number657216
Policy instance 1
Insurance contract or identification number657216
Number of Individuals Covered148
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $14,656
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $293,116
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,656
Insurance broker organization code?3
Insurance broker nameSTOP LOSS INSURANCE SERVICES, INC.
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number947-0029
Policy instance 2
Insurance contract or identification number947-0029
Number of Individuals Covered148
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $3,012
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedORGAN TRANSPLANT
Welfare Benefit Premiums Paid to CarrierUSD $21,111
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,506
Insurance broker organization code?3
Insurance broker nameHEIDI OLSEN-KAVAJECZ
WESTPOINT INSURANCE CORPORATION (National Association of Insurance Commissioners NAIC id number: 39845 )
Policy contract number657216
Policy instance 1
Insurance contract or identification number657216
Number of Individuals Covered145
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $11,283
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $279,710
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,283
Insurance broker organization code?3
Insurance broker nameSTOP LOSS INSURANCE SERVICES, INC.
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number148009
Policy instance 1
Insurance contract or identification number148009
Number of Individuals Covered166
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $3,406
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,406
Insurance broker organization code?3
Insurance broker namePAULI-HARBOUR INSURANCE SERVICES
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number949-0441
Policy instance 3
Insurance contract or identification number949-0441
Number of Individuals Covered108
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $819
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $819
Insurance broker organization code?3
Insurance broker nameSTOP LOSS INSURANCE SERVICES, INC.
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number148009
Policy instance 2
Insurance contract or identification number148009
Number of Individuals Covered153
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $3,530
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,530
Insurance broker namePAULI-HARBOUR INSURANCE SERVICES
HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )
Policy contract number403747 0010
Policy instance 1
Insurance contract or identification number403747 0010
Number of Individuals Covered160
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $12,600
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,600
Insurance broker organization code?3
Insurance broker nameSTOP LOSS INSURANCE SERVICES, INC.
ALTERNATIVE RISK SOLUTIONS, LLC (National Association of Insurance Commissioners NAIC id number: )
Policy contract number9960-7050
Policy instance 1
Insurance contract or identification number9960-7050
Number of Individuals Covered157
Insurance policy start date2011-07-01
Insurance policy end date2012-07-01
Total amount of commissions paid to insurance brokerUSD $13,215
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number148009
Policy instance 2
Insurance contract or identification number148009
Number of Individuals Covered157
Insurance policy start date2011-07-01
Insurance policy end date2012-07-01
Total amount of commissions paid to insurance brokerUSD $1,446
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )
Policy contract number148009
Policy instance 2
Insurance contract or identification number148009
Number of Individuals Covered165
Insurance policy start date2010-07-01
Insurance policy end date2011-07-01
Total amount of commissions paid to insurance brokerUSD $1,345
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ALTERNATIVE RISK SOLUTIONS, LLC (National Association of Insurance Commissioners NAIC id number: )
Policy contract number9960-7050
Policy instance 1
Insurance contract or identification number9960-7050
Number of Individuals Covered165
Insurance policy start date2010-07-01
Insurance policy end date2011-07-01
Total amount of commissions paid to insurance brokerUSD $11,551
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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