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THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 401k Plan overview

Plan NameTHE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN
Plan identification number 501

THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

THE LUTHERAN HOME has sponsored the creation of one or more 401k plans.

Company Name:THE LUTHERAN HOME
Employer identification number (EIN):410706147
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-09-01JODI FOSTER2023-02-27
5012020-09-01BETH WADSLEY2022-01-22
5012019-09-01BETH WADSLEY2021-02-23
5012018-09-01BETH WADSLEY2020-01-17
5012017-09-01
5012016-09-01
5012015-09-01BETH WADSLEY BETH WADSLEY2017-03-15
5012014-09-01BETH WADSLEY BETH WADSLEY2016-03-04
5012013-09-01BETH WADSLEY
5012012-09-01BETH WADSLEY
5012011-09-01BETH WADSLEY
5012010-09-01BETH WADSLEY
5012009-09-01BETH WADSLEY
5012008-10-01BETH WADSLEY
5012007-10-01BETH WADSLEY
5012006-10-01BETH WADSLEY
5012005-09-01BETH WADSLEY
5012004-09-01BETH WADSLEY
5012003-09-01BETH WADSLEY
5012002-09-01BETH WADSLEY
5012001-09-01BETH WADSLEY
5012000-09-01BETH WADSLEY
5011999-09-01BETH WADSLEY
5011998-09-01BETH WADSLEY
5011997-09-01BETH WADSLEY
5011996-09-01BETH WADSLEY

Plan Statistics for THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN

401k plan membership statisitcs for THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN

Measure Date Value
2021: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2021 401k membership
Total participants, beginning-of-year2021-09-01110
Total number of active participants reported on line 7a of the Form 55002021-09-0174
Number of retired or separated participants receiving benefits2021-09-010
Number of other retired or separated participants entitled to future benefits2021-09-010
Total of all active and inactive participants2021-09-0174
Number of employers contributing to the scheme2021-09-010
2020: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2020 401k membership
Total participants, beginning-of-year2020-09-01123
Total number of active participants reported on line 7a of the Form 55002020-09-01110
Number of retired or separated participants receiving benefits2020-09-012
Number of other retired or separated participants entitled to future benefits2020-09-010
Total of all active and inactive participants2020-09-01112
Number of employers contributing to the scheme2020-09-010
2019: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2019 401k membership
Total participants, beginning-of-year2019-09-01112
Total number of active participants reported on line 7a of the Form 55002019-09-0181
Number of retired or separated participants receiving benefits2019-09-010
Number of other retired or separated participants entitled to future benefits2019-09-010
Total of all active and inactive participants2019-09-0181
Number of employers contributing to the scheme2019-09-010
2018: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2018 401k membership
Total participants, beginning-of-year2018-09-01114
Total number of active participants reported on line 7a of the Form 55002018-09-01112
Number of retired or separated participants receiving benefits2018-09-010
Number of other retired or separated participants entitled to future benefits2018-09-010
Total of all active and inactive participants2018-09-01112
Number of employers contributing to the scheme2018-09-010
2017: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year2017-09-01152
Total number of active participants reported on line 7a of the Form 55002017-09-01114
Number of retired or separated participants receiving benefits2017-09-010
Number of other retired or separated participants entitled to future benefits2017-09-010
Total of all active and inactive participants2017-09-01114
Number of employers contributing to the scheme2017-09-010
2016: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2016 401k membership
Total participants, beginning-of-year2016-09-01117
Total number of active participants reported on line 7a of the Form 55002016-09-01152
Number of retired or separated participants receiving benefits2016-09-010
Number of other retired or separated participants entitled to future benefits2016-09-010
Total of all active and inactive participants2016-09-01152
2015: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2015 401k membership
Total participants, beginning-of-year2015-09-01125
Total number of active participants reported on line 7a of the Form 55002015-09-01137
Total of all active and inactive participants2015-09-01137
Total participants2015-09-01137
2014: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2014 401k membership
Total participants, beginning-of-year2014-09-01121
Total number of active participants reported on line 7a of the Form 55002014-09-01125
Number of retired or separated participants receiving benefits2014-09-010
Number of other retired or separated participants entitled to future benefits2014-09-010
Total of all active and inactive participants2014-09-01125
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-09-010
Total participants2014-09-01125
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-09-010
2013: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2013 401k membership
Total participants, beginning-of-year2013-09-01122
Total number of active participants reported on line 7a of the Form 55002013-09-01121
Number of retired or separated participants receiving benefits2013-09-010
Number of other retired or separated participants entitled to future benefits2013-09-010
Total of all active and inactive participants2013-09-01121
2012: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2012 401k membership
Total participants, beginning-of-year2012-09-01127
Total number of active participants reported on line 7a of the Form 55002012-09-01122
Number of retired or separated participants receiving benefits2012-09-010
Number of other retired or separated participants entitled to future benefits2012-09-010
Total of all active and inactive participants2012-09-01122
2011: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2011 401k membership
Total participants, beginning-of-year2011-09-01148
Total number of active participants reported on line 7a of the Form 55002011-09-01127
Number of retired or separated participants receiving benefits2011-09-010
Number of other retired or separated participants entitled to future benefits2011-09-010
Total of all active and inactive participants2011-09-01127
2010: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2010 401k membership
Total participants, beginning-of-year2010-09-01154
Total number of active participants reported on line 7a of the Form 55002010-09-01148
Number of retired or separated participants receiving benefits2010-09-010
Number of other retired or separated participants entitled to future benefits2010-09-010
Total of all active and inactive participants2010-09-01148
2009: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2009 401k membership
Total participants, beginning-of-year2009-09-01180
Total number of active participants reported on line 7a of the Form 55002009-09-01154
Number of retired or separated participants receiving benefits2009-09-010
Number of other retired or separated participants entitled to future benefits2009-09-010
Total of all active and inactive participants2009-09-01154
2008: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2008 401k membership
Total participants, beginning-of-year2008-10-01180
Total number of active participants reported on line 7a of the Form 55002008-10-01180
Number of retired or separated participants receiving benefits2008-10-010
Number of other retired or separated participants entitled to future benefits2008-10-010
Total of all active and inactive participants2008-10-01180
2007: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2007 401k membership
Total participants, beginning-of-year2007-10-01180
Total number of active participants reported on line 7a of the Form 55002007-10-01180
Number of retired or separated participants receiving benefits2007-10-010
Number of other retired or separated participants entitled to future benefits2007-10-010
Total of all active and inactive participants2007-10-01180
2006: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2006 401k membership
Total participants, beginning-of-year2006-10-01169
Total number of active participants reported on line 7a of the Form 55002006-10-01180
Number of retired or separated participants receiving benefits2006-10-010
Number of other retired or separated participants entitled to future benefits2006-10-010
Total of all active and inactive participants2006-10-01180
2005: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2005 401k membership
Total participants, beginning-of-year2005-09-01169
Total number of active participants reported on line 7a of the Form 55002005-09-01169
Number of retired or separated participants receiving benefits2005-09-010
Number of other retired or separated participants entitled to future benefits2005-09-010
Total of all active and inactive participants2005-09-01169
2004: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2004 401k membership
Total participants, beginning-of-year2004-09-01216
Total number of active participants reported on line 7a of the Form 55002004-09-01169
Number of retired or separated participants receiving benefits2004-09-010
Number of other retired or separated participants entitled to future benefits2004-09-010
Total of all active and inactive participants2004-09-01169
2003: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2003 401k membership
Total participants, beginning-of-year2003-09-01140
Total number of active participants reported on line 7a of the Form 55002003-09-01216
Number of retired or separated participants receiving benefits2003-09-010
Number of other retired or separated participants entitled to future benefits2003-09-010
Total of all active and inactive participants2003-09-01216
2002: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2002 401k membership
Total participants, beginning-of-year2002-09-01180
Total number of active participants reported on line 7a of the Form 55002002-09-01140
Number of retired or separated participants receiving benefits2002-09-010
Number of other retired or separated participants entitled to future benefits2002-09-010
Total of all active and inactive participants2002-09-01140
2001: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2001 401k membership
Total participants, beginning-of-year2001-09-01301
Total number of active participants reported on line 7a of the Form 55002001-09-01180
Number of retired or separated participants receiving benefits2001-09-010
Number of other retired or separated participants entitled to future benefits2001-09-010
Total of all active and inactive participants2001-09-01180
2000: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2000 401k membership
Total participants, beginning-of-year2000-09-01301
Total number of active participants reported on line 7a of the Form 55002000-09-01301
Number of retired or separated participants receiving benefits2000-09-010
Number of other retired or separated participants entitled to future benefits2000-09-010
Total of all active and inactive participants2000-09-01301
1999: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 1999 401k membership
Total participants, beginning-of-year1999-09-01301
Total number of active participants reported on line 7a of the Form 55001999-09-01301
Number of retired or separated participants receiving benefits1999-09-010
Number of other retired or separated participants entitled to future benefits1999-09-010
Total of all active and inactive participants1999-09-01301
1998: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 1998 401k membership
Total participants, beginning-of-year1998-09-01142
Total number of active participants reported on line 7a of the Form 55001998-09-01301
Number of retired or separated participants receiving benefits1998-09-010
Number of other retired or separated participants entitled to future benefits1998-09-010
Total of all active and inactive participants1998-09-01301
1997: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 1997 401k membership
Total participants, beginning-of-year1997-09-01136
Total number of active participants reported on line 7a of the Form 55001997-09-01142
Number of retired or separated participants receiving benefits1997-09-010
Number of other retired or separated participants entitled to future benefits1997-09-010
Total of all active and inactive participants1997-09-01142
1996: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 1996 401k membership
Total participants, beginning-of-year1996-09-01136
Total number of active participants reported on line 7a of the Form 55001996-09-01136
Number of retired or separated participants receiving benefits1996-09-010
Number of other retired or separated participants entitled to future benefits1996-09-010
Total of all active and inactive participants1996-09-01136

Form 5500 Responses for THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN

2021: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2021 form 5500 responses
2021-09-01Type of plan entitySingle employer plan
2021-09-01Plan funding arrangement – InsuranceYes
2021-09-01Plan benefit arrangement – InsuranceYes
2020: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2020 form 5500 responses
2020-09-01Type of plan entitySingle employer plan
2020-09-01Plan funding arrangement – InsuranceYes
2020-09-01Plan benefit arrangement – InsuranceYes
2019: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2019 form 5500 responses
2019-09-01Type of plan entitySingle employer plan
2019-09-01Plan funding arrangement – InsuranceYes
2019-09-01Plan benefit arrangement – InsuranceYes
2018: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2018 form 5500 responses
2018-09-01Type of plan entitySingle employer plan
2018-09-01Plan funding arrangement – InsuranceYes
2018-09-01Plan benefit arrangement – InsuranceYes
2017: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2017 form 5500 responses
2017-09-01Type of plan entitySingle employer plan
2017-09-01Plan funding arrangement – InsuranceYes
2017-09-01Plan benefit arrangement – InsuranceYes
2016: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2016 form 5500 responses
2016-09-01Type of plan entitySingle employer plan
2016-09-01Submission has been amendedNo
2016-09-01This submission is the final filingNo
2016-09-01This return/report is a short plan year return/report (less than 12 months)No
2016-09-01Plan is a collectively bargained planNo
2016-09-01Plan funding arrangement – InsuranceYes
2016-09-01Plan benefit arrangement – InsuranceYes
2015: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2015 form 5500 responses
2015-09-01Type of plan entitySingle employer plan
2015-09-01Submission has been amendedNo
2015-09-01This submission is the final filingNo
2015-09-01This return/report is a short plan year return/report (less than 12 months)No
2015-09-01Plan is a collectively bargained planNo
2015-09-01Plan funding arrangement – InsuranceYes
2015-09-01Plan benefit arrangement – InsuranceYes
2014: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2014 form 5500 responses
2014-09-01Type of plan entitySingle employer plan
2014-09-01Submission has been amendedNo
2014-09-01This submission is the final filingNo
2014-09-01This return/report is a short plan year return/report (less than 12 months)No
2014-09-01Plan is a collectively bargained planNo
2014-09-01Plan funding arrangement – InsuranceYes
2014-09-01Plan benefit arrangement – InsuranceYes
2013: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2013 form 5500 responses
2013-09-01Type of plan entitySingle employer plan
2013-09-01Submission has been amendedNo
2013-09-01This submission is the final filingNo
2013-09-01This return/report is a short plan year return/report (less than 12 months)No
2013-09-01Plan is a collectively bargained planNo
2013-09-01Plan funding arrangement – InsuranceYes
2013-09-01Plan benefit arrangement – InsuranceYes
2012: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2012 form 5500 responses
2012-09-01Type of plan entitySingle employer plan
2012-09-01Submission has been amendedNo
2012-09-01This submission is the final filingNo
2012-09-01This return/report is a short plan year return/report (less than 12 months)No
2012-09-01Plan is a collectively bargained planNo
2012-09-01Plan funding arrangement – InsuranceYes
2012-09-01Plan benefit arrangement – InsuranceYes
2011: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2011 form 5500 responses
2011-09-01Type of plan entitySingle employer plan
2011-09-01Submission has been amendedNo
2011-09-01This submission is the final filingNo
2011-09-01This return/report is a short plan year return/report (less than 12 months)No
2011-09-01Plan is a collectively bargained planNo
2011-09-01Plan funding arrangement – InsuranceYes
2011-09-01Plan benefit arrangement – InsuranceYes
2010: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2010 form 5500 responses
2010-09-01Type of plan entitySingle employer plan
2010-09-01Submission has been amendedNo
2010-09-01This submission is the final filingNo
2010-09-01This return/report is a short plan year return/report (less than 12 months)No
2010-09-01Plan is a collectively bargained planNo
2010-09-01Plan funding arrangement – InsuranceYes
2010-09-01Plan benefit arrangement – InsuranceYes
2009: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2009 form 5500 responses
2009-09-01Type of plan entitySingle employer plan
2009-09-01Submission has been amendedNo
2009-09-01This submission is the final filingNo
2009-09-01This return/report is a short plan year return/report (less than 12 months)No
2009-09-01Plan is a collectively bargained planNo
2009-09-01Plan funding arrangement – InsuranceYes
2009-09-01Plan benefit arrangement – InsuranceYes
2008: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2008 form 5500 responses
2008-10-01Type of plan entitySingle employer plan
2008-10-01Submission has been amendedNo
2008-10-01This submission is the final filingNo
2008-10-01This return/report is a short plan year return/report (less than 12 months)Yes
2008-10-01Plan is a collectively bargained planNo
2008-10-01Plan funding arrangement – InsuranceYes
2008-10-01Plan benefit arrangement – InsuranceYes
2007: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2007 form 5500 responses
2007-10-01Type of plan entitySingle employer plan
2007-10-01Submission has been amendedNo
2007-10-01This submission is the final filingNo
2007-10-01This return/report is a short plan year return/report (less than 12 months)No
2007-10-01Plan is a collectively bargained planNo
2007-10-01Plan funding arrangement – InsuranceYes
2007-10-01Plan benefit arrangement – InsuranceYes
2006: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2006 form 5500 responses
2006-10-01Type of plan entitySingle employer plan
2006-10-01Submission has been amendedNo
2006-10-01This submission is the final filingNo
2006-10-01This return/report is a short plan year return/report (less than 12 months)No
2006-10-01Plan is a collectively bargained planNo
2006-10-01Plan funding arrangement – InsuranceYes
2006-10-01Plan benefit arrangement – InsuranceYes
2005: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2005 form 5500 responses
2005-09-01Type of plan entitySingle employer plan
2005-09-01Submission has been amendedNo
2005-09-01This submission is the final filingNo
2005-09-01This return/report is a short plan year return/report (less than 12 months)No
2005-09-01Plan is a collectively bargained planNo
2005-09-01Plan funding arrangement – General assets of the sponsorYes
2005-09-01Plan benefit arrangement – General assets of the sponsorYes
2004: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2004 form 5500 responses
2004-09-01Type of plan entitySingle employer plan
2004-09-01Submission has been amendedNo
2004-09-01This submission is the final filingNo
2004-09-01This return/report is a short plan year return/report (less than 12 months)No
2004-09-01Plan is a collectively bargained planNo
2004-09-01Plan funding arrangement – General assets of the sponsorYes
2004-09-01Plan benefit arrangement – General assets of the sponsorYes
2003: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2003 form 5500 responses
2003-09-01Type of plan entitySingle employer plan
2003-09-01Submission has been amendedNo
2003-09-01This submission is the final filingNo
2003-09-01This return/report is a short plan year return/report (less than 12 months)No
2003-09-01Plan is a collectively bargained planNo
2003-09-01Plan funding arrangement – General assets of the sponsorYes
2003-09-01Plan benefit arrangement – General assets of the sponsorYes
2002: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2002 form 5500 responses
2002-09-01Type of plan entitySingle employer plan
2002-09-01Submission has been amendedNo
2002-09-01This submission is the final filingNo
2002-09-01This return/report is a short plan year return/report (less than 12 months)No
2002-09-01Plan is a collectively bargained planNo
2002-09-01Plan funding arrangement – General assets of the sponsorYes
2002-09-01Plan benefit arrangement – General assets of the sponsorYes
2001: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2001 form 5500 responses
2001-09-01Type of plan entitySingle employer plan
2001-09-01Submission has been amendedNo
2001-09-01This submission is the final filingNo
2001-09-01This return/report is a short plan year return/report (less than 12 months)No
2001-09-01Plan is a collectively bargained planNo
2001-09-01Plan funding arrangement – General assets of the sponsorYes
2001-09-01Plan benefit arrangement – General assets of the sponsorYes
2000: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 2000 form 5500 responses
2000-09-01Type of plan entitySingle employer plan
2000-09-01Submission has been amendedNo
2000-09-01This submission is the final filingNo
2000-09-01This return/report is a short plan year return/report (less than 12 months)No
2000-09-01Plan is a collectively bargained planNo
2000-09-01Plan funding arrangement – General assets of the sponsorYes
2000-09-01Plan benefit arrangement – General assets of the sponsorYes
1999: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 1999 form 5500 responses
1999-09-01Type of plan entitySingle employer plan
1999-09-01Submission has been amendedNo
1999-09-01This submission is the final filingNo
1999-09-01This return/report is a short plan year return/report (less than 12 months)No
1999-09-01Plan is a collectively bargained planNo
1999-09-01Plan funding arrangement – General assets of the sponsorYes
1999-09-01Plan benefit arrangement – General assets of the sponsorYes
1998: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 1998 form 5500 responses
1998-09-01Type of plan entitySingle employer plan
1998-09-01Submission has been amendedNo
1998-09-01This submission is the final filingNo
1998-09-01This return/report is a short plan year return/report (less than 12 months)No
1998-09-01Plan is a collectively bargained planNo
1998-09-01Plan funding arrangement – General assets of the sponsorYes
1998-09-01Plan benefit arrangement – General assets of the sponsorYes
1997: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 1997 form 5500 responses
1997-09-01Type of plan entitySingle employer plan
1997-09-01Submission has been amendedNo
1997-09-01This submission is the final filingNo
1997-09-01This return/report is a short plan year return/report (less than 12 months)No
1997-09-01Plan is a collectively bargained planNo
1997-09-01Plan funding arrangement – General assets of the sponsorYes
1997-09-01Plan benefit arrangement – General assets of the sponsorYes
1996: THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN 1996 form 5500 responses
1996-09-01Type of plan entitySingle employer plan
1996-09-01First time form 5500 has been submittedYes
1996-09-01Submission has been amendedNo
1996-09-01This submission is the final filingNo
1996-09-01This return/report is a short plan year return/report (less than 12 months)No
1996-09-01Plan is a collectively bargained planNo
1996-09-01Plan funding arrangement – General assets of the sponsorYes
1996-09-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number918522
Policy instance 1
Insurance contract or identification number918522
Number of Individuals Covered174
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $32,293
Total amount of fees paid to insurance companyUSD $5,364
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,272,331
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $32,293
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerBONUS
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number918522
Policy instance 1
Insurance contract or identification number918522
Number of Individuals Covered216
Insurance policy start date2020-09-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $39,389
Total amount of fees paid to insurance companyUSD $8,301
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,432,321
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $39,389
Amount paid for insurance broker fees8301
Additional information about fees paid to insurance brokerBONUS
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number918522
Policy instance 1
Insurance contract or identification number918522
Number of Individuals Covered191
Insurance policy start date2019-09-01
Insurance policy end date2020-08-31
Total amount of commissions paid to insurance brokerUSD $37,697
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,370,783
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $37,697
Amount paid for insurance broker fees0
Insurance broker organization code?3
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract number10192577
Policy instance 1
Insurance contract or identification number10192577
Number of Individuals Covered198
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $40,670
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,334,490
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $40,670
Amount paid for insurance broker fees0
Insurance broker organization code?3
HMO MINNESOTA DBA BLUE PLUS (National Association of Insurance Commissioners NAIC id number: 95649 )
Policy contract number10192577
Policy instance 1
Insurance contract or identification number10192577
Number of Individuals Covered118
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $37,084
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,214,808
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract numberAJ204
Policy instance 1
Insurance contract or identification numberAJ204
Number of Individuals Covered299
Insurance policy start date2015-09-01
Insurance policy end date2016-08-31
Total amount of commissions paid to insurance brokerUSD $36,445
Total amount of fees paid to insurance companyUSD $2,566
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,446,208
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,445
Amount paid for insurance broker fees2566
Additional information about fees paid to insurance brokerBROKER INCENTIVE
Insurance broker organization code?3
Insurance broker nameHANRATTY AND ASSOCIATES INC
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract numberAJ204
Policy instance 1
Insurance contract or identification numberAJ204
Number of Individuals Covered292
Insurance policy start date2014-09-01
Insurance policy end date2015-08-31
Total amount of commissions paid to insurance brokerUSD $46,042
Total amount of fees paid to insurance companyUSD $4,662
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,553,836
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $46,042
Amount paid for insurance broker fees4662
Additional information about fees paid to insurance brokerBROKER INCENTIVE
Insurance broker organization code?3
Insurance broker nameHANRATTY AND ASSOCIATES, INC
HEALTHPARTNERS INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 44547 )
Policy contract number27268
Policy instance 1
Insurance contract or identification number27268
Number of Individuals Covered278
Insurance policy start date2013-09-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $36,262
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,373,940
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21,205
Insurance broker organization code?3
Insurance broker nameJON TERRY
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract numberCN789
Policy instance 1
Insurance contract or identification numberCN789
Number of Individuals Covered304
Insurance policy start date2012-09-01
Insurance policy end date2013-08-31
Total amount of commissions paid to insurance brokerUSD $34,834
Total amount of fees paid to insurance companyUSD $536
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,268,578
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,834
Amount paid for insurance broker fees536
Additional information about fees paid to insurance brokerBROKER INCENTIVE
Insurance broker organization code?3
Insurance broker nameHANRATTY AND ASSOCIATES, INC.
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract numberCN789
Policy instance 1
Insurance contract or identification numberCN789
Number of Individuals Covered301
Insurance policy start date2011-09-01
Insurance policy end date2012-08-31
Total amount of commissions paid to insurance brokerUSD $34,481
Total amount of fees paid to insurance companyUSD $1,895
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,253,414
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract numberCN789
Policy instance 1
Insurance contract or identification numberCN789
Number of Individuals Covered335
Insurance policy start date2010-09-01
Insurance policy end date2011-08-31
Total amount of commissions paid to insurance brokerUSD $33,018
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,300,418
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $33,018
Insurance broker organization code?3
Insurance broker nameHANRATTY AND ASSOCIATES, INC.
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract numberCN789
Policy instance 1
Insurance contract or identification numberCN789
Number of Individuals Covered344
Insurance policy start date2009-09-01
Insurance policy end date2010-08-31
Total amount of commissions paid to insurance brokerUSD $36,501
Total amount of fees paid to insurance companyUSD $419
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,323,750
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,501
Amount paid for insurance broker fees419
Additional information about fees paid to insurance brokerBROKER INCENTIVE
Insurance broker organization code?3
Insurance broker nameHANRATTY AND ASSOCIATES, INC.
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract numberCN344
Policy instance 1
Insurance contract or identification numberCN344
Number of Individuals Covered379
Insurance policy start date2006-10-01
Insurance policy end date2007-09-30
Total amount of commissions paid to insurance brokerUSD $36,137
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,204,862
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,137
Insurance broker organization code?3
Insurance broker nameHANRATTY AND ASSOCIATES, INC.

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