401k Plan data: NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN plan

NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN 401k Plan overview

Plan Name	NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN
Plan identification number	502

NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

NORTH STAR MUTUAL INSURANCE COMPANY has sponsored the creation of one or more 401k plans.

Company Name: NORTH STAR MUTUAL INSURANCE COMPANY

Employer identification number (EIN): 410446480

NAIC Classification: 524150

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2018-01-01
502 2017-01-01
502 2016-01-01
502 2015-01-01
502 2014-01-01
502 2013-01-01
502 2012-01-01 MELINDA SCHMIDT
502 2011-01-01 MELINDA SCHMIDT
502 2010-01-01 MELINDA SCHMIDT
502 2009-01-01 MELINDA SCHMIDT

Plan Statistics for NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN

401k plan membership statisitcs for NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN

Measure Date Value
2018: NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 250
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 0
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 0
Total of all active and inactive participants 2018-01-01 0
2017: NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 247
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 248
Number of retired or separated participants receiving benefits 2017-01-01 2
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 250
2016: NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 245
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 243
Number of retired or separated participants receiving benefits 2016-01-01 4
Total of all active and inactive participants 2016-01-01 247
2015: NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 225
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 242
Number of retired or separated participants receiving benefits 2015-01-01 3
Total of all active and inactive participants 2015-01-01 245
2014: NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 216
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 225
Number of other retired or separated participants entitled to future benefits 2014-01-01 1
Total of all active and inactive participants 2014-01-01 226
2013: NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 204
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 213
Number of other retired or separated participants entitled to future benefits 2013-01-01 3
Total of all active and inactive participants 2013-01-01 216
2012: NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 193
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 202
Number of other retired or separated participants entitled to future benefits 2012-01-01 2
Total of all active and inactive participants 2012-01-01 204
2011: NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 171
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 190
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 1
Total of all active and inactive participants 2011-01-01 191
2010: NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 166
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 171
Total of all active and inactive participants 2010-01-01 171
2009: NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 164
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 165
Number of retired or separated participants receiving benefits 2009-01-01 1
Total of all active and inactive participants 2009-01-01 166

Measure	Date	Value
2018: NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	250
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	0
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	0
Total of all active and inactive participants	2018-01-01	0
2017: NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	247
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	248
Number of retired or separated participants receiving benefits	2017-01-01	2
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	250
2016: NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	245
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	243
Number of retired or separated participants receiving benefits	2016-01-01	4
Total of all active and inactive participants	2016-01-01	247
2015: NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	225
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	242
Number of retired or separated participants receiving benefits	2015-01-01	3
Total of all active and inactive participants	2015-01-01	245
2014: NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	216
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	225
Number of other retired or separated participants entitled to future benefits	2014-01-01	1
Total of all active and inactive participants	2014-01-01	226
2013: NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	204
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	213
Number of other retired or separated participants entitled to future benefits	2013-01-01	3
Total of all active and inactive participants	2013-01-01	216
2012: NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	193
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	202
Number of other retired or separated participants entitled to future benefits	2012-01-01	2
Total of all active and inactive participants	2012-01-01	204
2011: NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	171
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	190
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	1
Total of all active and inactive participants	2011-01-01	191
2010: NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	166
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	171
Total of all active and inactive participants	2010-01-01	171
2009: NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	164
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	165
Number of retired or separated participants receiving benefits	2009-01-01	1
Total of all active and inactive participants	2009-01-01	166

Form 5500 Responses for NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN

2018: NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	This submission is the final filing	Yes
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2015: NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2010: NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2009: NORTH STAR MUTUAL INSURANCE COMPANY GROUP LIFE PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	This submission is the final filing	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00472404

Policy instance

Insurance contract or identification number	00472404
Number of Individuals Covered	254
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $5,554
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $91,762
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,554
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00472404

Policy instance

Insurance contract or identification number	00472404
Number of Individuals Covered	248
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $5,444
Total amount of fees paid to insurance company	USD $3,048
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $88,758
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,583
Amount paid for insurance broker fees	3048
Insurance broker organization code?	3
Insurance broker name	GALLAGHER BENEFIT SERVICE

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00472404

Policy instance

Insurance contract or identification number	00472404
Number of Individuals Covered	242
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $4,395
Total amount of fees paid to insurance company	USD $4,320
Life Insurance Welfare Benefit	Yes
Other welfare benefits provided	AD&D
Welfare Benefit Premiums Paid to Carrier	USD $56,821
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,433
Amount paid for insurance broker fees	4320
Additional information about fees paid to insurance broker	ADDITIONAL FEES
Insurance broker organization code?	3
Insurance broker name	GALLAGHER BENEFIT SERVICE

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00472404

Policy instance

Insurance contract or identification number	00472404
Number of Individuals Covered	225
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $4,157
Total amount of fees paid to insurance company	USD $4,021
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $52,170
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,157
Amount paid for insurance broker fees	4021
Additional information about fees paid to insurance broker	ADDITIONAL FEES
Insurance broker organization code?	3
Insurance broker name	DIGITAL INS INC

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00472404

Policy instance

Insurance contract or identification number	00472404
Number of Individuals Covered	216
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $3,886
Total amount of fees paid to insurance company	USD $1,319
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $48,074
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,886
Amount paid for insurance broker fees	1319
Additional information about fees paid to insurance broker	ADDITIONAL FEES
Insurance broker organization code?	3
Insurance broker name	DIGITAL INS INC

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00472404

Policy instance

Insurance contract or identification number	00472404
Number of Individuals Covered	204
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $3,914
Total amount of fees paid to insurance company	USD $61
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $44,210
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,432
Amount paid for insurance broker fees	61
Additional information about fees paid to insurance broker	MISCELLANEOUS
Insurance broker organization code?	3
Insurance broker name	FINANCIAL BALANCE GROUP LLC

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

124209

Policy instance

Insurance contract or identification number	124209
Number of Individuals Covered	191
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $2,364
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
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 number

124209

Policy instance

Insurance contract or identification number	124209
Number of Individuals Covered	171
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $3,110
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Life Insurance Welfare Benefit	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,110
Insurance broker organization code?	3
Insurance broker name	STRATEGIC EMPLOYEE BENEFIT SVCS MN

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Company Name:	NORTH STAR MUTUAL INSURANCE COMPANY
Employer identification number (EIN):	410446480
NAIC Classification:	524150