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H.O.BOSTROM COMPANY INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN 401k Plan overview

Plan NameH.O.BOSTROM COMPANY INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN
Plan identification number 506

H.O.BOSTROM COMPANY INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

H.O.BOSTROM COMPANY, INC. has sponsored the creation of one or more 401k plans.

Company Name:H.O.BOSTROM COMPANY, INC.
Employer identification number (EIN):321212995
NAIC Classification:336300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan H.O.BOSTROM COMPANY INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5062011-01-01JOHN BOSTROM
5062009-01-01 JOHN BOSTROM2010-07-29
5062009-01-01JOHN BOSTROM

Plan Statistics for H.O.BOSTROM COMPANY INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN

401k plan membership statisitcs for H.O.BOSTROM COMPANY INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN

Measure Date Value
2011: H.O.BOSTROM COMPANY INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0128
Total number of active participants reported on line 7a of the Form 55002011-01-0129
Total of all active and inactive participants2011-01-0129
Total participants2011-01-0129
2009: H.O.BOSTROM COMPANY INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-0140
Total number of active participants reported on line 7a of the Form 55002009-01-0132
Total of all active and inactive participants2009-01-0132
Total participants2009-01-0132

Financial Data on H.O.BOSTROM COMPANY INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN

Measure Date Value
2011 : H.O.BOSTROM COMPANY INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2011 401k financial data
Total plan liabilities at end of year2011-12-31$0
Total plan liabilities at beginning of year2011-12-31$0
Total income from all sources2011-12-31$737,666
Expenses. Total of all expenses incurred2011-12-31$737,666
Benefits paid (including direct rollovers)2011-12-31$622,889
Total plan assets at end of year2011-12-31$0
Total plan assets at beginning of year2011-12-31$0
Value of fidelity bond covering the plan2011-12-31$120,000
Total contributions received or receivable from participants2011-12-31$97,309
Net income (gross income less expenses)2011-12-31$0
Net plan assets at end of year (total assets less liabilities)2011-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$0
Total contributions received or receivable from employer(s)2011-12-31$640,357
Expenses. Administrative service providers (salaries,fees and commissions)2011-12-31$114,777
2010 : H.O.BOSTROM COMPANY INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2010 401k financial data
Total plan liabilities at end of year2010-12-31$0
Total plan liabilities at beginning of year2010-12-31$0
Total income from all sources2010-12-31$572,419
Expenses. Total of all expenses incurred2010-12-31$572,419
Benefits paid (including direct rollovers)2010-12-31$449,467
Total plan assets at end of year2010-12-31$0
Total plan assets at beginning of year2010-12-31$0
Value of fidelity bond covering the plan2010-12-31$120,000
Total contributions received or receivable from participants2010-12-31$99,731
Net income (gross income less expenses)2010-12-31$0
Net plan assets at end of year (total assets less liabilities)2010-12-31$0
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$0
Total contributions received or receivable from employer(s)2010-12-31$472,688
Expenses. Administrative service providers (salaries,fees and commissions)2010-12-31$122,952

Form 5500 Responses for H.O.BOSTROM COMPANY INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN

2011: H.O.BOSTROM COMPANY INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement - TrustYes
2009: H.O.BOSTROM COMPANY INC. SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement - TrustYes

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