401k Plan data: NORTH STAR MUTUAL INSURANCE COMPANY LONG TERM DISABILITY PLAN plan

NORTH STAR MUTUAL INSURANCE COMPANY LONG TERM DISABILITY PLAN 401k Plan overview

Plan Name	NORTH STAR MUTUAL INSURANCE COMPANY LONG TERM DISABILITY PLAN
Plan identification number	503

NORTH STAR MUTUAL INSURANCE COMPANY LONG TERM DISABILITY PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Long-term disability cover

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 LONG TERM DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2018-01-01
503 2017-01-01
503 2016-01-01
503 2015-01-01
503 2014-01-01
503 2013-01-01
503 2012-01-01 MELINDA SCHMIDT
503 2011-01-01 MELINDA SCHMIDT
503 2009-01-01 MELINDA SCHMIDT

Plan Statistics for NORTH STAR MUTUAL INSURANCE COMPANY LONG TERM DISABILITY PLAN

401k plan membership statisitcs for NORTH STAR MUTUAL INSURANCE COMPANY LONG TERM DISABILITY PLAN

Measure Date Value
2018: NORTH STAR MUTUAL INSURANCE COMPANY LONG TERM DISABILITY PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 248
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 LONG TERM DISABILITY PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 243
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 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 248
2016: NORTH STAR MUTUAL INSURANCE COMPANY LONG TERM DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 242
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 243
Total of all active and inactive participants 2016-01-01 243
2015: NORTH STAR MUTUAL INSURANCE COMPANY LONG TERM DISABILITY 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
Total of all active and inactive participants 2015-01-01 242
2014: NORTH STAR MUTUAL INSURANCE COMPANY LONG TERM DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 217
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 225
Number of retired or separated participants receiving benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 225
2013: NORTH STAR MUTUAL INSURANCE COMPANY LONG TERM DISABILITY PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 203
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 216
Number of retired or separated participants receiving benefits 2013-01-01 1
Total of all active and inactive participants 2013-01-01 217
2012: NORTH STAR MUTUAL INSURANCE COMPANY LONG TERM DISABILITY 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 retired or separated participants receiving benefits 2012-01-01 1
Total of all active and inactive participants 2012-01-01 203
2011: NORTH STAR MUTUAL INSURANCE COMPANY LONG TERM DISABILITY 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 0
Total of all active and inactive participants 2011-01-01 190
2009: NORTH STAR MUTUAL INSURANCE COMPANY LONG TERM DISABILITY PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 160
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 166
Total of all active and inactive participants 2009-01-01 166

Measure	Date	Value
2018: NORTH STAR MUTUAL INSURANCE COMPANY LONG TERM DISABILITY PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	248
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 LONG TERM DISABILITY PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	243
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	0
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	248
2016: NORTH STAR MUTUAL INSURANCE COMPANY LONG TERM DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	242
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	243
Total of all active and inactive participants	2016-01-01	243
2015: NORTH STAR MUTUAL INSURANCE COMPANY LONG TERM DISABILITY 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
Total of all active and inactive participants	2015-01-01	242
2014: NORTH STAR MUTUAL INSURANCE COMPANY LONG TERM DISABILITY PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	217
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	225
Number of retired or separated participants receiving benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	225
2013: NORTH STAR MUTUAL INSURANCE COMPANY LONG TERM DISABILITY PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	203
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	216
Number of retired or separated participants receiving benefits	2013-01-01	1
Total of all active and inactive participants	2013-01-01	217
2012: NORTH STAR MUTUAL INSURANCE COMPANY LONG TERM DISABILITY 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 retired or separated participants receiving benefits	2012-01-01	1
Total of all active and inactive participants	2012-01-01	203
2011: NORTH STAR MUTUAL INSURANCE COMPANY LONG TERM DISABILITY 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	0
Total of all active and inactive participants	2011-01-01	190
2009: NORTH STAR MUTUAL INSURANCE COMPANY LONG TERM DISABILITY PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	160
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	166
Total of all active and inactive participants	2009-01-01	166

Form 5500 Responses for NORTH STAR MUTUAL INSURANCE COMPANY LONG TERM DISABILITY PLAN

2018: NORTH STAR MUTUAL INSURANCE COMPANY LONG TERM DISABILITY 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 LONG TERM DISABILITY 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 LONG TERM DISABILITY 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 LONG TERM DISABILITY 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 LONG TERM DISABILITY 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 LONG TERM DISABILITY 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 LONG TERM DISABILITY 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 LONG TERM DISABILITY 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
2009: NORTH STAR MUTUAL INSURANCE COMPANY LONG TERM DISABILITY 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 $4,272
Total amount of fees paid to insurance company	USD $0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $42,412
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,272
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 $4,012
Total amount of fees paid to insurance company	USD $1,259
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $36,753
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,184
Insurance broker organization code?	3
Amount paid for insurance broker fees	1259
Insurance broker name	GALLAGHER BENEFIT SERVICES 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	242
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $3,547
Total amount of fees paid to insurance company	USD $0
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $27,496
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,020
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 $3,382
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
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $25,010
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,382
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 $3,276
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
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $23,966
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,276
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 $3,169
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
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $22,291
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,917
Insurance broker organization code?	3
Insurance broker name	FINANCIAL BALANCE GROUP LLC

NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )

Policy contract number

651040

Policy instance

Insurance contract or identification number	651040
Number of Individuals Covered	190
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $3,438
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
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $36,404
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 )

Policy contract number

651040

Policy instance

Insurance contract or identification number	651040
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 $3,293
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
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $33,173
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,964
Insurance broker organization code?	3
Insurance broker name	JOE HASLING

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