401k Plan data: MOUNTAIN STATES LITHOGRAPHING, LLC SELF FUNDED MEDICAL REIMBURSEMENT PLAN plan

MOUNTAIN STATES LITHOGRAPHING, LLC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 401k Plan overview

Plan Name	MOUNTAIN STATES LITHOGRAPHING, LLC SELF FUNDED MEDICAL REIMBURSEMENT PLAN
Plan identification number	501

MOUNTAIN STATES LITHOGRAPHING, LLC SELF FUNDED MEDICAL REIMBURSEMENT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision)

401k Sponsoring company profile

MOUNTAIN STATES LITHOGRAPHING, LLC has sponsored the creation of one or more 401k plans.

Company Name: MOUNTAIN STATES LITHOGRAPHING, LLC

Employer identification number (EIN): 464729456

NAIC Classification: 323100

Additional information about MOUNTAIN STATES LITHOGRAPHING, LLC

Jurisdiction of Incorporation: Wyoming Corporations Division

Incorporation Date: 2014-01-31

Company Identification Number: 000658255

Legal Registered Office Address: 133 S. McKinley Street
P O Box 1389
Casper
United States of America (USA)
82602

More information about MOUNTAIN STATES LITHOGRAPHING, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MOUNTAIN STATES LITHOGRAPHING, LLC SELF FUNDED MEDICAL REIMBURSEMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2019-07-01
501 2018-07-01
501 2016-07-01 TAMMY J LITTAU
501 2015-07-01 TAMMY J LITTAU
501 2014-07-01 TAMMY J LITTAU

Plan Statistics for MOUNTAIN STATES LITHOGRAPHING, LLC SELF FUNDED MEDICAL REIMBURSEMENT PLAN

401k plan membership statisitcs for MOUNTAIN STATES LITHOGRAPHING, LLC SELF FUNDED MEDICAL REIMBURSEMENT PLAN

Measure Date Value
2019: MOUNTAIN STATES LITHOGRAPHING, LLC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-07-01 0
Total number of active participants reported on line 7a of the Form 5500 2019-07-01 0
Number of retired or separated participants receiving benefits 2019-07-01 0
Number of other retired or separated participants entitled to future benefits 2019-07-01 0
Total of all active and inactive participants 2019-07-01 0
2018: MOUNTAIN STATES LITHOGRAPHING, LLC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2018 401k membership
Total participants, beginning-of-year 2018-07-01 10
Total number of active participants reported on line 7a of the Form 5500 2018-07-01 10
Number of retired or separated participants receiving benefits 2018-07-01 0
Number of other retired or separated participants entitled to future benefits 2018-07-01 0
Total of all active and inactive participants 2018-07-01 10
2016: MOUNTAIN STATES LITHOGRAPHING, LLC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-07-01 0
Total number of active participants reported on line 7a of the Form 5500 2016-07-01 0
Number of retired or separated participants receiving benefits 2016-07-01 0
Number of other retired or separated participants entitled to future benefits 2016-07-01 0
Total of all active and inactive participants 2016-07-01 0
2015: MOUNTAIN STATES LITHOGRAPHING, LLC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2015 401k membership
Total participants, beginning-of-year 2015-07-01 12
Total number of active participants reported on line 7a of the Form 5500 2015-07-01 11
Number of retired or separated participants receiving benefits 2015-07-01 0
Number of other retired or separated participants entitled to future benefits 2015-07-01 0
Total of all active and inactive participants 2015-07-01 11
2014: MOUNTAIN STATES LITHOGRAPHING, LLC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2014 401k membership
Total participants, beginning-of-year 2014-07-01 11
Total number of active participants reported on line 7a of the Form 5500 2014-07-01 12
Number of retired or separated participants receiving benefits 2014-07-01 0
Number of other retired or separated participants entitled to future benefits 2014-07-01 0
Total of all active and inactive participants 2014-07-01 12

Measure	Date	Value
2019: MOUNTAIN STATES LITHOGRAPHING, LLC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-07-01	0
Total number of active participants reported on line 7a of the Form 5500	2019-07-01	0
Number of retired or separated participants receiving benefits	2019-07-01	0
Number of other retired or separated participants entitled to future benefits	2019-07-01	0
Total of all active and inactive participants	2019-07-01	0
2018: MOUNTAIN STATES LITHOGRAPHING, LLC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2018 401k membership
Total participants, beginning-of-year	2018-07-01	10
Total number of active participants reported on line 7a of the Form 5500	2018-07-01	10
Number of retired or separated participants receiving benefits	2018-07-01	0
Number of other retired or separated participants entitled to future benefits	2018-07-01	0
Total of all active and inactive participants	2018-07-01	10
2016: MOUNTAIN STATES LITHOGRAPHING, LLC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-07-01	0
Total number of active participants reported on line 7a of the Form 5500	2016-07-01	0
Number of retired or separated participants receiving benefits	2016-07-01	0
Number of other retired or separated participants entitled to future benefits	2016-07-01	0
Total of all active and inactive participants	2016-07-01	0
2015: MOUNTAIN STATES LITHOGRAPHING, LLC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2015 401k membership
Total participants, beginning-of-year	2015-07-01	12
Total number of active participants reported on line 7a of the Form 5500	2015-07-01	11
Number of retired or separated participants receiving benefits	2015-07-01	0
Number of other retired or separated participants entitled to future benefits	2015-07-01	0
Total of all active and inactive participants	2015-07-01	11
2014: MOUNTAIN STATES LITHOGRAPHING, LLC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2014 401k membership
Total participants, beginning-of-year	2014-07-01	11
Total number of active participants reported on line 7a of the Form 5500	2014-07-01	12
Number of retired or separated participants receiving benefits	2014-07-01	0
Number of other retired or separated participants entitled to future benefits	2014-07-01	0
Total of all active and inactive participants	2014-07-01	12

Financial Data on MOUNTAIN STATES LITHOGRAPHING, LLC SELF FUNDED MEDICAL REIMBURSEMENT PLAN

Measure	Date	Value
2020 : MOUNTAIN STATES LITHOGRAPHING, LLC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2020 401k financial data
Total income from all sources	2020-06-30	$3,633
Expenses. Total of all expenses incurred	2020-06-30	$3,968
Benefits paid (including direct rollovers)	2020-06-30	$3,622
Total plan assets at end of year	2020-06-30	$0
Total plan assets at beginning of year	2020-06-30	$335
Value of fidelity bond covering the plan	2020-06-30	$50,000
Other income received	2020-06-30	$4
Net income (gross income less expenses)	2020-06-30	$-335
Net plan assets at end of year (total assets less liabilities)	2020-06-30	$0
Net plan assets at beginning of year (total assets less liabilities)	2020-06-30	$335
Total contributions received or receivable from employer(s)	2020-06-30	$3,629
Expenses. Administrative service providers (salaries,fees and commissions)	2020-06-30	$346
2019 : MOUNTAIN STATES LITHOGRAPHING, LLC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2019 401k financial data
Total income from all sources	2019-06-30	$99,447
Expenses. Total of all expenses incurred	2019-06-30	$99,112
Benefits paid (including direct rollovers)	2019-06-30	$91,990
Total plan assets at end of year	2019-06-30	$335
Total plan assets at beginning of year	2019-06-30	$0
Value of fidelity bond covering the plan	2019-06-30	$50,000
Total contributions received or receivable from participants	2019-06-30	$5,746
Other income received	2019-06-30	$35
Net income (gross income less expenses)	2019-06-30	$335
Net plan assets at end of year (total assets less liabilities)	2019-06-30	$335
Net plan assets at beginning of year (total assets less liabilities)	2019-06-30	$0
Total contributions received or receivable from employer(s)	2019-06-30	$93,666
Expenses. Administrative service providers (salaries,fees and commissions)	2019-06-30	$7,122
2017 : MOUNTAIN STATES LITHOGRAPHING, LLC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2017 401k financial data
Transfers to/from the plan	2017-06-30	$-17,360
Total income from all sources	2017-06-30	$1,665
Expenses. Total of all expenses incurred	2017-06-30	$4,903
Benefits paid (including direct rollovers)	2017-06-30	$4,574
Total plan assets at end of year	2017-06-30	$0
Total plan assets at beginning of year	2017-06-30	$20,598
Value of fidelity bond covering the plan	2017-06-30	$50,000
Other income received	2017-06-30	$10
Net income (gross income less expenses)	2017-06-30	$-3,238
Net plan assets at end of year (total assets less liabilities)	2017-06-30	$0
Net plan assets at beginning of year (total assets less liabilities)	2017-06-30	$20,598
Total contributions received or receivable from employer(s)	2017-06-30	$1,655
Expenses. Administrative service providers (salaries,fees and commissions)	2017-06-30	$329
2016 : MOUNTAIN STATES LITHOGRAPHING, LLC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2016 401k financial data
Total income from all sources	2016-06-30	$30,295
Expenses. Total of all expenses incurred	2016-06-30	$37,804
Benefits paid (including direct rollovers)	2016-06-30	$31,698
Total plan assets at end of year	2016-06-30	$20,598
Total plan assets at beginning of year	2016-06-30	$28,107
Value of fidelity bond covering the plan	2016-06-30	$50,000
Total contributions received or receivable from participants	2016-06-30	$5,985
Other income received	2016-06-30	$46
Net income (gross income less expenses)	2016-06-30	$-7,509
Net plan assets at end of year (total assets less liabilities)	2016-06-30	$20,598
Net plan assets at beginning of year (total assets less liabilities)	2016-06-30	$28,107
Total contributions received or receivable from employer(s)	2016-06-30	$24,264
Expenses. Administrative service providers (salaries,fees and commissions)	2016-06-30	$6,106
2015 : MOUNTAIN STATES LITHOGRAPHING, LLC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2015 401k financial data
Total income from all sources	2015-06-30	$42,903
Expenses. Total of all expenses incurred	2015-06-30	$14,796
Benefits paid (including direct rollovers)	2015-06-30	$10,051
Total plan assets at end of year	2015-06-30	$28,107
Total plan assets at beginning of year	2015-06-30	$0
Other income received	2015-06-30	$8
Net income (gross income less expenses)	2015-06-30	$28,107
Net plan assets at end of year (total assets less liabilities)	2015-06-30	$28,107
Net plan assets at beginning of year (total assets less liabilities)	2015-06-30	$0
Total contributions received or receivable from employer(s)	2015-06-30	$42,895
Expenses. Administrative service providers (salaries,fees and commissions)	2015-06-30	$4,745

Form 5500 Responses for MOUNTAIN STATES LITHOGRAPHING, LLC SELF FUNDED MEDICAL REIMBURSEMENT PLAN

2019: MOUNTAIN STATES LITHOGRAPHING, LLC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2019 form 5500 responses
2019-07-01	Type of plan entity	Single employer plan
2019-07-01	This submission is the final filing	Yes
2019-07-01	Plan funding arrangement – Trust	Yes
2019-07-01	Plan benefit arrangement - Trust	Yes
2018: MOUNTAIN STATES LITHOGRAPHING, LLC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2018 form 5500 responses
2018-07-01	Type of plan entity	Single employer plan
2018-07-01	First time form 5500 has been submitted	Yes
2018-07-01	Plan funding arrangement – Trust	Yes
2018-07-01	Plan benefit arrangement - Trust	Yes
2016: MOUNTAIN STATES LITHOGRAPHING, LLC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2016 form 5500 responses
2016-07-01	Type of plan entity	Single employer plan
2016-07-01	This submission is the final filing	Yes
2016-07-01	Plan funding arrangement – Trust	Yes
2016-07-01	Plan benefit arrangement - Trust	Yes
2015: MOUNTAIN STATES LITHOGRAPHING, LLC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2015 form 5500 responses
2015-07-01	Type of plan entity	Single employer plan
2015-07-01	Plan funding arrangement – Trust	Yes
2015-07-01	Plan benefit arrangement - Trust	Yes
2014: MOUNTAIN STATES LITHOGRAPHING, LLC SELF FUNDED MEDICAL REIMBURSEMENT PLAN 2014 form 5500 responses
2014-07-01	Type of plan entity	Single employer plan
2014-07-01	First time form 5500 has been submitted	Yes
2014-07-01	Plan funding arrangement – Trust	Yes
2014-07-01	Plan benefit arrangement - Trust	Yes

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Company Name:	MOUNTAIN STATES LITHOGRAPHING, LLC
Employer identification number (EIN):	464729456
NAIC Classification:	323100

Jurisdiction of Incorporation:	Wyoming Corporations Division
Incorporation Date:	2014-01-31
Company Identification Number:	000658255
Legal Registered Office Address:	133 S. McKinley Street P O Box 1389 Casper United States of America (USA) 82602