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Plan Name | NORTHWEST DOOR LLC MEDICAL AND DENTAL PLAN |
Plan identification number | 501 |
401k Plan Type | Welfare Benefit |
Plan Features/Benefits |
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Company Name: | HORMANN NORTHWEST DOOR, LLC |
Employer identification number (EIN): | 474725688 |
NAIC Classification: | 423990 |
NAIC Description: | Other Miscellaneous Durable Goods Merchant Wholesalers |
Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
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501 | 2017-03-01 | ||||
501 | 2016-03-01 | ||||
501 | 2015-09-01 | PATTI HIGH |
Measure | Date | Value |
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2017: NORTHWEST DOOR LLC MEDICAL AND DENTAL PLAN 2017 401k membership | ||
Total participants, beginning-of-year | 2017-03-01 | 286 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-03-01 | 0 |
Number of retired or separated participants receiving benefits | 2017-03-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2017-03-01 | 0 |
Total of all active and inactive participants | 2017-03-01 | 0 |
2016: NORTHWEST DOOR LLC MEDICAL AND DENTAL PLAN 2016 401k membership | ||
Total participants, beginning-of-year | 2016-03-01 | 238 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-03-01 | 277 |
Number of retired or separated participants receiving benefits | 2016-03-01 | 1 |
Number of other retired or separated participants entitled to future benefits | 2016-03-01 | 8 |
Total of all active and inactive participants | 2016-03-01 | 286 |
2015: NORTHWEST DOOR LLC MEDICAL AND DENTAL PLAN 2015 401k membership | ||
Total participants, beginning-of-year | 2015-09-01 | 207 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-09-01 | 220 |
Number of retired or separated participants receiving benefits | 2015-09-01 | 3 |
Number of other retired or separated participants entitled to future benefits | 2015-09-01 | 0 |
Total of all active and inactive participants | 2015-09-01 | 223 |
2017: NORTHWEST DOOR LLC MEDICAL AND DENTAL PLAN 2017 form 5500 responses | ||
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2017-03-01 | Type of plan entity | Single employer plan |
2017-03-01 | This submission is the final filing | Yes |
2017-03-01 | Plan funding arrangement – Insurance | Yes |
2017-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2017-03-01 | Plan benefit arrangement – Insurance | Yes |
2017-03-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2016: NORTHWEST DOOR LLC MEDICAL AND DENTAL PLAN 2016 form 5500 responses | ||
2016-03-01 | Type of plan entity | Single employer plan |
2016-03-01 | Submission has been amended | No |
2016-03-01 | This submission is the final filing | No |
2016-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-03-01 | Plan is a collectively bargained plan | No |
2016-03-01 | Plan funding arrangement – Insurance | Yes |
2016-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2016-03-01 | Plan benefit arrangement – Insurance | Yes |
2016-03-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
2015: NORTHWEST DOOR LLC MEDICAL AND DENTAL PLAN 2015 form 5500 responses | ||
2015-09-01 | Type of plan entity | Single employer plan |
2015-09-01 | First time form 5500 has been submitted | Yes |
2015-09-01 | Submission has been amended | No |
2015-09-01 | This submission is the final filing | No |
2015-09-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
2015-09-01 | Plan is a collectively bargained plan | No |
2015-09-01 | Plan funding arrangement – Insurance | Yes |
2015-09-01 | Plan benefit arrangement – Insurance | Yes |
DELTA DENTAL OF ILLINOIS (National Association of Insurance Commissioners NAIC id number: 47589 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy contract number | 11481 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 12516 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy contract number | 30074926 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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UNITED BEHAVIORAL HEALTH DBA OPTUM (National Association of Insurance Commissioners NAIC id number: 79413 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy contract number | 1304815 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy instance | 3 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy contract number | 901881 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy instance | 4 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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REGENCE BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 53902 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy contract number | 10019053 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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