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BLUE STONE THERAPY, INC. LIFE PLAN 401k Plan overview

Plan NameBLUE STONE THERAPY, INC. LIFE PLAN
Plan identification number 504

BLUE STONE THERAPY, INC. LIFE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

BLUE STONE THERAPY, INC. has sponsored the creation of one or more 401k plans.

Company Name:BLUE STONE THERAPY, INC.
Employer identification number (EIN):841787423
NAIC Classification:541990
NAIC Description:All Other Professional, Scientific, and Technical Services

Additional information about BLUE STONE THERAPY, INC.

Jurisdiction of Incorporation: Iowa Secretary of State Business Entities
Incorporation Date: 2019-05-10
Company Identification Number: 601278
Legal Registered Office Address: 4319 NW URBANDALE DR

URBANDALE
United States of America (USA)
50322

More information about BLUE STONE THERAPY, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BLUE STONE THERAPY, INC. LIFE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042022-01-01DOUG JOHNSON2024-01-02
5042021-01-01DOUG JOHNSON2024-01-02
5042020-01-01DOUG JOHNSON2024-01-27
5042020-01-01DOUG JOHNSON2024-01-27

Plan Statistics for BLUE STONE THERAPY, INC. LIFE PLAN

401k plan membership statisitcs for BLUE STONE THERAPY, INC. LIFE PLAN

Measure Date Value
2022: BLUE STONE THERAPY, INC. LIFE PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01192
Total number of active participants reported on line 7a of the Form 55002022-01-01223
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01223
Number of employers contributing to the scheme2022-01-010
2021: BLUE STONE THERAPY, INC. LIFE PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01187
Total number of active participants reported on line 7a of the Form 55002021-01-01192
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01192
Number of employers contributing to the scheme2021-01-010
2020: BLUE STONE THERAPY, INC. LIFE PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01100
Total participants, beginning-of-year2020-01-01100
Total number of active participants reported on line 7a of the Form 55002020-01-01187
Total number of active participants reported on line 7a of the Form 55002020-01-01187
Number of retired or separated participants receiving benefits2020-01-010
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01187
Total of all active and inactive participants2020-01-01187
Number of employers contributing to the scheme2020-01-010
Number of employers contributing to the scheme2020-01-010

Form 5500 Responses for BLUE STONE THERAPY, INC. LIFE PLAN

2022: BLUE STONE THERAPY, INC. LIFE PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: BLUE STONE THERAPY, INC. LIFE PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: BLUE STONE THERAPY, INC. LIFE PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Type of plan entitySingle employer plan
2020-01-01First time form 5500 has been submittedYes
2020-01-01First time form 5500 has been submittedYes
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10260520
Policy instance 1
Insurance contract or identification number10260520
Number of Individuals Covered223
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $762
Total amount of fees paid to insurance companyUSD $439
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $5,077
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $762
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerOVERRIDES
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10260520
Policy instance 1
Insurance contract or identification number10260520
Number of Individuals Covered192
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $688
Total amount of fees paid to insurance companyUSD $263
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $4,586
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $449
Amount paid for insurance broker fees34
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10260520
Policy instance 1
Insurance contract or identification number10260520
Number of Individuals Covered187
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $481
Total amount of fees paid to insurance companyUSD $329
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $3,207
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $481
Amount paid for insurance broker fees169
Additional information about fees paid to insurance brokerFEES, BROKER BONUS
Insurance broker organization code?3

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