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UPPER MIDWEST ORGAN PROCUREMENT ORGANIZATION INC DBA LIFESOURCE GROUP SHORT TERM AND GROUP LONG TERM DISABILITY INSURANCE 401k Plan overview

Plan NameUPPER MIDWEST ORGAN PROCUREMENT ORGANIZATION INC DBA LIFESOURCE GROUP SHORT TERM AND GROUP LONG TERM DISABILITY INSURANCE
Plan identification number 504

UPPER MIDWEST ORGAN PROCUREMENT ORGANIZATION INC DBA LIFESOURCE GROUP SHORT TERM AND GROUP LONG TERM DISABILITY INSURANCE Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Temporary disability (accident and sickness)
  • Long-term disability cover

401k Sponsoring company profile

UPPER MIDWEST ORGAN PROCUREMENT ORGANIZATION INC. DBA LIFESO has sponsored the creation of one or more 401k plans.

Company Name:UPPER MIDWEST ORGAN PROCUREMENT ORGANIZATION INC. DBA LIFESO
Employer identification number (EIN):363584029
NAIC Classification:541990
NAIC Description:All Other Professional, Scientific, and Technical Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UPPER MIDWEST ORGAN PROCUREMENT ORGANIZATION INC DBA LIFESOURCE GROUP SHORT TERM AND GROUP LONG TERM DISABILITY INSURANCE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042014-07-01PETER FARSTAD
5042013-07-01PETER FARSTAD PETER FARSTAD2015-01-23
5042012-07-01PETER D. FARSTAD
5042011-07-01PETER D. FARSTAD
5042009-07-01PETER D. FARSTAD PETER D. FARSTAD2010-11-30

Plan Statistics for UPPER MIDWEST ORGAN PROCUREMENT ORGANIZATION INC DBA LIFESOURCE GROUP SHORT TERM AND GROUP LONG TERM DISABILITY INSURANCE

401k plan membership statisitcs for UPPER MIDWEST ORGAN PROCUREMENT ORGANIZATION INC DBA LIFESOURCE GROUP SHORT TERM AND GROUP LONG TERM DISABILITY INSURANCE

Measure Date Value
2014: UPPER MIDWEST ORGAN PROCUREMENT ORGANIZATION INC DBA LIFESOURCE GROUP SHORT TERM AND GROUP LONG TERM DISABILITY INSURANCE 2014 401k membership
Total participants, beginning-of-year2014-07-01120
Total number of active participants reported on line 7a of the Form 55002014-07-01120
Number of retired or separated participants receiving benefits2014-07-010
Number of other retired or separated participants entitled to future benefits2014-07-010
Total of all active and inactive participants2014-07-01120
2013: UPPER MIDWEST ORGAN PROCUREMENT ORGANIZATION INC DBA LIFESOURCE GROUP SHORT TERM AND GROUP LONG TERM DISABILITY INSURANCE 2013 401k membership
Total participants, beginning-of-year2013-07-01117
Total number of active participants reported on line 7a of the Form 55002013-07-01120
Total of all active and inactive participants2013-07-01120
Total participants2013-07-01120
2012: UPPER MIDWEST ORGAN PROCUREMENT ORGANIZATION INC DBA LIFESOURCE GROUP SHORT TERM AND GROUP LONG TERM DISABILITY INSURANCE 2012 401k membership
Total participants, beginning-of-year2012-07-01116
Total number of active participants reported on line 7a of the Form 55002012-07-01117
Number of retired or separated participants receiving benefits2012-07-010
Number of other retired or separated participants entitled to future benefits2012-07-010
Total of all active and inactive participants2012-07-01117
2011: UPPER MIDWEST ORGAN PROCUREMENT ORGANIZATION INC DBA LIFESOURCE GROUP SHORT TERM AND GROUP LONG TERM DISABILITY INSURANCE 2011 401k membership
Total participants, beginning-of-year2011-07-01117
Total number of active participants reported on line 7a of the Form 55002011-07-01112
Number of retired or separated participants receiving benefits2011-07-012
Number of other retired or separated participants entitled to future benefits2011-07-010
Total of all active and inactive participants2011-07-01114
2009: UPPER MIDWEST ORGAN PROCUREMENT ORGANIZATION INC DBA LIFESOURCE GROUP SHORT TERM AND GROUP LONG TERM DISABILITY INSURANCE 2009 401k membership
Total participants, beginning-of-year2009-07-01112
Total number of active participants reported on line 7a of the Form 55002009-07-01109
Number of retired or separated participants receiving benefits2009-07-010
Number of other retired or separated participants entitled to future benefits2009-07-010
Total of all active and inactive participants2009-07-01109

Form 5500 Responses for UPPER MIDWEST ORGAN PROCUREMENT ORGANIZATION INC DBA LIFESOURCE GROUP SHORT TERM AND GROUP LONG TERM DISABILITY INSURANCE

2014: UPPER MIDWEST ORGAN PROCUREMENT ORGANIZATION INC DBA LIFESOURCE GROUP SHORT TERM AND GROUP LONG TERM DISABILITY INSURANCE 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013: UPPER MIDWEST ORGAN PROCUREMENT ORGANIZATION INC DBA LIFESOURCE GROUP SHORT TERM AND GROUP LONG TERM DISABILITY INSURANCE 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – InsuranceYes
2012: UPPER MIDWEST ORGAN PROCUREMENT ORGANIZATION INC DBA LIFESOURCE GROUP SHORT TERM AND GROUP LONG TERM DISABILITY INSURANCE 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – InsuranceYes
2011: UPPER MIDWEST ORGAN PROCUREMENT ORGANIZATION INC DBA LIFESOURCE GROUP SHORT TERM AND GROUP LONG TERM DISABILITY INSURANCE 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – InsuranceYes
2009: UPPER MIDWEST ORGAN PROCUREMENT ORGANIZATION INC DBA LIFESOURCE GROUP SHORT TERM AND GROUP LONG TERM DISABILITY INSURANCE 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number865163
Policy instance 1
Insurance contract or identification number865163
Number of Individuals Covered120
Insurance policy start date2014-07-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
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 $10,436
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1009025
Policy instance 1
Insurance contract or identification number1009025
Number of Individuals Covered114
Insurance policy start date2013-07-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $5,135
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
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 $52,658
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,135
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameAON RISK SERVICES INC OF ILLINOIS
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number865163
Policy instance 2
Insurance contract or identification number865163
Number of Individuals Covered120
Insurance policy start date2014-01-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
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 $67,427
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH10999
Policy instance 1
Insurance contract or identification numberH10999
Number of Individuals Covered114
Insurance policy start date2012-07-01
Insurance policy end date2012-09-30
Total amount of commissions paid to insurance brokerUSD $4,797
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
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 $24,882
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,797
Insurance broker organization code?3
Insurance broker nameKIMBERLY A. THOMPSON
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1009025
Policy instance 2
Insurance contract or identification number1009025
Number of Individuals Covered119
Insurance policy start date2012-10-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $6,110
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
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 $76,398
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,110
Insurance broker organization code?3
Insurance broker nameKIMBERLY A. THOMPSON
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH10999
Policy instance 1
Insurance contract or identification numberH10999
Number of Individuals Covered114
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $8,627
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
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 $74,805
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract numberH10999
Policy instance 1
Insurance contract or identification numberH10999
Number of Individuals Covered117
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $9,625
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
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 $85,260
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,625
Insurance broker organization code?3
Insurance broker nameKIMBERLY A THOMPSON

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