401k Plan data: MTU ONSITE ENERGY CORP HEALTH AND DENTAL PLAN plan

MTU ONSITE ENERGY CORP HEALTH AND DENTAL PLAN 401k Plan overview

Plan Name	MTU ONSITE ENERGY CORP HEALTH AND DENTAL PLAN
Plan identification number	502

MTU ONSITE ENERGY CORP HEALTH AND DENTAL PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Long-term disability cover Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

MTU ONSITE ENERGY CORPORATION has sponsored the creation of one or more 401k plans.

Company Name: MTU ONSITE ENERGY CORPORATION

Employer identification number (EIN): 410720890

NAIC Classification: 335900

Additional information about MTU ONSITE ENERGY CORPORATION

Jurisdiction of Incorporation: Oregon Secretary of State Corporations Division

Incorporation Date: 2017-01-13

Company Identification Number: 128332392

Legal Registered Office Address: 5305 RIVER RD N

KEIZER
United States of America (USA)
97303

More information about MTU ONSITE ENERGY CORPORATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MTU ONSITE ENERGY CORP HEALTH AND DENTAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2017-01-01 DIANA STOLL DIANA STOLL 2018-10-15
502 2016-01-01 DIANA STOLL DIANA STOLL 2017-10-16
502 2015-01-01 DIANA STOLL DIANA STOLL 2016-10-17
502 2014-01-01 DIANA STOLL DIANA STOLL 2015-10-15
502 2013-01-01 DIANA STOLL DIANA STOLL 2014-10-15
502 2012-01-01 DIANA STOLL
502 2011-01-01 DIANA STOLL
502 2009-01-01 DIANA STOLL

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
502	2017-01-01	DIANA STOLL	DIANA STOLL	2018-10-15
502	2016-01-01	DIANA STOLL	DIANA STOLL	2017-10-16
502	2015-01-01	DIANA STOLL	DIANA STOLL	2016-10-17
502	2014-01-01	DIANA STOLL	DIANA STOLL	2015-10-15
502	2013-01-01	DIANA STOLL	DIANA STOLL	2014-10-15
502	2012-01-01	DIANA STOLL
502	2011-01-01	DIANA STOLL
502	2009-01-01	DIANA STOLL

Plan Statistics for MTU ONSITE ENERGY CORP HEALTH AND DENTAL PLAN

401k plan membership statisitcs for MTU ONSITE ENERGY CORP HEALTH AND DENTAL PLAN

Measure Date Value
2017: MTU ONSITE ENERGY CORP HEALTH AND DENTAL PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 285
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 280
Number of retired or separated participants receiving benefits 2017-01-01 5
Number of other retired or separated participants entitled to future benefits 2017-01-01 3
Total of all active and inactive participants 2017-01-01 288
2016: MTU ONSITE ENERGY CORP HEALTH AND DENTAL PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 294
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 281
Number of retired or separated participants receiving benefits 2016-01-01 4
Number of other retired or separated participants entitled to future benefits 2016-01-01 2
Total of all active and inactive participants 2016-01-01 287
2015: MTU ONSITE ENERGY CORP HEALTH AND DENTAL PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 343
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 325
Total of all active and inactive participants 2015-01-01 325
2014: MTU ONSITE ENERGY CORP HEALTH AND DENTAL PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 324
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 315
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 315
2013: MTU ONSITE ENERGY CORP HEALTH AND DENTAL PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 326
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 325
Number of retired or separated participants receiving benefits 2013-01-01 1
Number of other retired or separated participants entitled to future benefits 2013-01-01 1
Total of all active and inactive participants 2013-01-01 327
2012: MTU ONSITE ENERGY CORP HEALTH AND DENTAL PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 318
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 324
Number of retired or separated participants receiving benefits 2012-01-01 1
Number of other retired or separated participants entitled to future benefits 2012-01-01 3
Total of all active and inactive participants 2012-01-01 328
2011: MTU ONSITE ENERGY CORP HEALTH AND DENTAL PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 292
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 314
Number of retired or separated participants receiving benefits 2011-01-01 4
Total of all active and inactive participants 2011-01-01 318
2009: MTU ONSITE ENERGY CORP HEALTH AND DENTAL PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 389
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 350
Number of retired or separated participants receiving benefits 2009-01-01 24
Number of other retired or separated participants entitled to future benefits 2009-01-01 3
Total of all active and inactive participants 2009-01-01 377

Measure	Date	Value
2017: MTU ONSITE ENERGY CORP HEALTH AND DENTAL PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	285
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	280
Number of retired or separated participants receiving benefits	2017-01-01	5
Number of other retired or separated participants entitled to future benefits	2017-01-01	3
Total of all active and inactive participants	2017-01-01	288
2016: MTU ONSITE ENERGY CORP HEALTH AND DENTAL PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	294
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	281
Number of retired or separated participants receiving benefits	2016-01-01	4
Number of other retired or separated participants entitled to future benefits	2016-01-01	2
Total of all active and inactive participants	2016-01-01	287
2015: MTU ONSITE ENERGY CORP HEALTH AND DENTAL PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	343
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	325
Total of all active and inactive participants	2015-01-01	325
2014: MTU ONSITE ENERGY CORP HEALTH AND DENTAL PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	324
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	315
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	315
2013: MTU ONSITE ENERGY CORP HEALTH AND DENTAL PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	326
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	325
Number of retired or separated participants receiving benefits	2013-01-01	1
Number of other retired or separated participants entitled to future benefits	2013-01-01	1
Total of all active and inactive participants	2013-01-01	327
2012: MTU ONSITE ENERGY CORP HEALTH AND DENTAL PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	318
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	324
Number of retired or separated participants receiving benefits	2012-01-01	1
Number of other retired or separated participants entitled to future benefits	2012-01-01	3
Total of all active and inactive participants	2012-01-01	328
2011: MTU ONSITE ENERGY CORP HEALTH AND DENTAL PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	292
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	314
Number of retired or separated participants receiving benefits	2011-01-01	4
Total of all active and inactive participants	2011-01-01	318
2009: MTU ONSITE ENERGY CORP HEALTH AND DENTAL PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	389
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	350
Number of retired or separated participants receiving benefits	2009-01-01	24
Number of other retired or separated participants entitled to future benefits	2009-01-01	3
Total of all active and inactive participants	2009-01-01	377

Form 5500 Responses for MTU ONSITE ENERGY CORP HEALTH AND DENTAL PLAN

2017: MTU ONSITE ENERGY CORP HEALTH AND DENTAL 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 funding arrangement – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: MTU ONSITE ENERGY CORP HEALTH AND DENTAL 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 funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: MTU ONSITE ENERGY CORP HEALTH AND DENTAL 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 funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: MTU ONSITE ENERGY CORP HEALTH AND DENTAL 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 funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: MTU ONSITE ENERGY CORP HEALTH AND DENTAL 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 funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: MTU ONSITE ENERGY CORP HEALTH AND DENTAL 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 funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: MTU ONSITE ENERGY CORP HEALTH AND DENTAL PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	Yes
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: MTU ONSITE ENERGY CORP HEALTH AND DENTAL 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 funding arrangement – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

DELTA DENTAL PLAN OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

0000000695

Policy instance

Insurance contract or identification number	0000000695
Number of Individuals Covered	268
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $4,155
Total amount of fees paid to insurance company	USD $0
Dental 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 $2,500
Insurance broker organization code?	3
Insurance broker name	BROWN & BROWN OF MN INC.

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )

Policy contract number

30005778

Policy instance

Insurance contract or identification number	30005778
Number of Individuals Covered	268
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $3,245
Total amount of fees paid to insurance company	USD $0
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $64,892
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,663
Insurance broker organization code?	3
Insurance broker name	BROWN & BROWN OF MN INC.

BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )

Policy contract number

EP295

Policy instance

Insurance contract or identification number	EP295
Number of Individuals Covered	711
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $10,693
Total amount of fees paid to insurance company	USD $0
Welfare Benefit Premiums Paid to Carrier	USD $372,835
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $10,693
Insurance broker organization code?	3
Insurance broker name	FEDSON INSURANCE SERVICES INC.

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Company Name:	MTU ONSITE ENERGY CORPORATION
Employer identification number (EIN):	410720890
NAIC Classification:	335900

Jurisdiction of Incorporation:	Oregon Secretary of State Corporations Division
Incorporation Date:	2017-01-13
Company Identification Number:	128332392
Legal Registered Office Address:	5305 RIVER RD N KEIZER United States of America (USA) 97303