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UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 401k Plan overview

Plan NameUPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K)
Plan identification number 001

UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

UPPER SIOUX COMMUNITY has sponsored the creation of one or more 401k plans.

Company Name:UPPER SIOUX COMMUNITY
Employer identification number (EIN):410916290
NAIC Classification:921000

Form 5500 Filing Information

Submission information for form 5500 for 401k plan UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K)

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01KEVIN L. JENSVOLD2023-10-16 KEVIN L. JENSVOLD2023-10-16
0012021-01-01KEVIN L. JENSVOLD2022-10-21 KEVIN L. JENSVOLD2022-10-21
0012020-01-01KEVIN L. JENSVOLD2021-07-19 KEVIN L. JENSVOLD2021-07-19
0012019-01-01KEVIN L. JENSVOLD2020-06-15 KEVIN L. JENSVOLD2020-06-15
0012018-01-01KEVIN L. JENSVOLD2019-10-02 KEVIN L. JENSVOLD2019-10-02
0012017-01-01
0012016-01-01
0012015-01-01
0012014-01-01KEVIN L. JENSVOLD
0012013-01-01PEGGY MILLER
0012012-01-01TRAVIS STENBERG
0012011-01-01TRAVIS STENBERG
0012010-01-01ANN LEE
0012009-01-01ANN LEE

Plan Statistics for UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K)

401k plan membership statisitcs for UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K)

Measure Date Value
2022: UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2022 401k membership
Total participants, beginning-of-year2022-01-01313
Total number of active participants reported on line 7a of the Form 55002022-01-01257
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-0135
Total of all active and inactive participants2022-01-01292
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-01292
Number of participants with account balances2022-01-01201
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-0110
2021: UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2021 401k membership
Total participants, beginning-of-year2021-01-01321
Total number of active participants reported on line 7a of the Form 55002021-01-01263
Number of retired or separated participants receiving benefits2021-01-014
Number of other retired or separated participants entitled to future benefits2021-01-0127
Total of all active and inactive participants2021-01-01294
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-01294
Number of participants with account balances2021-01-01101
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2020 401k membership
Total participants, beginning-of-year2020-01-01343
Total number of active participants reported on line 7a of the Form 55002020-01-01291
Number of retired or separated participants receiving benefits2020-01-012
Number of other retired or separated participants entitled to future benefits2020-01-0119
Total of all active and inactive participants2020-01-01312
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-01312
Number of participants with account balances2020-01-0197
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2019 401k membership
Total participants, beginning-of-year2019-01-01325
Total number of active participants reported on line 7a of the Form 55002019-01-01300
Number of retired or separated participants receiving benefits2019-01-012
Number of other retired or separated participants entitled to future benefits2019-01-019
Total of all active and inactive participants2019-01-01311
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-01311
Number of participants with account balances2019-01-0188
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2018 401k membership
Total participants, beginning-of-year2018-01-01319
Total number of active participants reported on line 7a of the Form 55002018-01-01302
Number of retired or separated participants receiving benefits2018-01-011
Number of other retired or separated participants entitled to future benefits2018-01-0110
Total of all active and inactive participants2018-01-01313
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-01313
Number of participants with account balances2018-01-0183
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2017 401k membership
Total participants, beginning-of-year2017-01-01337
Total number of active participants reported on line 7a of the Form 55002017-01-01297
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-0111
Total of all active and inactive participants2017-01-01308
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-01308
Number of participants with account balances2017-01-0177
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2016 401k membership
Total participants, beginning-of-year2016-01-01339
Total number of active participants reported on line 7a of the Form 55002016-01-01313
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-0110
Total of all active and inactive participants2016-01-01323
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01323
Number of participants with account balances2016-01-0177
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2015 401k membership
Total participants, beginning-of-year2015-01-01333
Total number of active participants reported on line 7a of the Form 55002015-01-01303
Number of retired or separated participants receiving benefits2015-01-011
Number of other retired or separated participants entitled to future benefits2015-01-0112
Total of all active and inactive participants2015-01-01316
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-01316
Number of participants with account balances2015-01-0179
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2014 401k membership
Total participants, beginning-of-year2014-01-01348
Total number of active participants reported on line 7a of the Form 55002014-01-01307
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-0114
Total of all active and inactive participants2014-01-01321
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-01321
Number of participants with account balances2014-01-0176
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2013 401k membership
Total participants, beginning-of-year2013-01-01342
Total number of active participants reported on line 7a of the Form 55002013-01-01319
Number of retired or separated participants receiving benefits2013-01-011
Number of other retired or separated participants entitled to future benefits2013-01-0111
Total of all active and inactive participants2013-01-01331
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-01331
Number of participants with account balances2013-01-0175
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2012 401k membership
Total participants, beginning-of-year2012-01-01350
Total number of active participants reported on line 7a of the Form 55002012-01-01323
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-0110
Total of all active and inactive participants2012-01-01333
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-01333
Number of participants with account balances2012-01-0169
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2011 401k membership
Total participants, beginning-of-year2011-01-01334
Total number of active participants reported on line 7a of the Form 55002011-01-01305
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-015
Total of all active and inactive participants2011-01-01310
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01310
Number of participants with account balances2011-01-0171
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2010 401k membership
Total participants, beginning-of-year2010-01-01356
Total number of active participants reported on line 7a of the Form 55002010-01-01309
Number of retired or separated participants receiving benefits2010-01-011
Number of other retired or separated participants entitled to future benefits2010-01-015
Total of all active and inactive participants2010-01-01315
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-01315
Number of participants with account balances2010-01-0176
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2009 401k membership
Total participants, beginning-of-year2009-01-01314
Total number of active participants reported on line 7a of the Form 55002009-01-01322
Number of retired or separated participants receiving benefits2009-01-012
Number of other retired or separated participants entitled to future benefits2009-01-0116
Total of all active and inactive participants2009-01-01340
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01340
Number of participants with account balances2009-01-0188
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K)

Measure Date Value
2022 : UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2022 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$8,388
Total income from all sources (including contributions)2022-12-31$287,665
Total of all expenses incurred2022-12-31$195,708
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$148,659
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$754,373
Value of total assets at end of year2022-12-31$3,131,044
Value of total assets at beginning of year2022-12-31$3,030,699
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$47,049
Total interest from all sources2022-12-31$3,891
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$400,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$543,523
Participant contributions at end of year2022-12-31$65,223
Participant contributions at beginning of year2022-12-31$75,187
Participant contributions at end of year2022-12-31$10,018
Participant contributions at beginning of year2022-12-31$3,817
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$2,171
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2022-12-31$8,388
Administrative expenses (other) incurred2022-12-31$47,049
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$91,957
Value of net assets at end of year (total assets less liabilities)2022-12-31$3,122,656
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$3,030,699
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in pooled separate accounts at end of year2022-12-31$3,051,284
Value of interest in pooled separate accounts at beginning of year2022-12-31$2,951,353
Interest on participant loans2022-12-31$3,891
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$345
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$342
Net investment gain/loss from pooled separate accounts2022-12-31$-470,599
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31No
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$208,679
Employer contributions (assets) at end of year2022-12-31$4,174
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$148,659
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31SCHECHTER DOKKEN KANTER CPAS
Accountancy firm EIN2022-12-31411680240
2021 : UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2021 401k financial data
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total income from all sources (including contributions)2021-12-31$540,169
Total of all expenses incurred2021-12-31$125,384
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$74,184
Value of total corrective distributions2021-12-31$5,376
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$218,033
Value of total assets at end of year2021-12-31$3,030,699
Value of total assets at beginning of year2021-12-31$2,615,914
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$45,824
Total interest from all sources2021-12-31$5,973
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$300,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$218,033
Participant contributions at end of year2021-12-31$75,187
Participant contributions at beginning of year2021-12-31$93,543
Participant contributions at end of year2021-12-31$3,817
Participant contributions at beginning of year2021-12-31$4,037
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$414,785
Value of net assets at end of year (total assets less liabilities)2021-12-31$3,030,699
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$2,615,914
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Investment advisory and management fees2021-12-31$39,763
Value of interest in pooled separate accounts at end of year2021-12-31$2,951,353
Value of interest in pooled separate accounts at beginning of year2021-12-31$2,515,010
Interest on participant loans2021-12-31$5,973
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$342
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$3,324
Net investment gain/loss from pooled separate accounts2021-12-31$316,163
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31No
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$74,184
Contract administrator fees2021-12-31$6,061
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31SCHECHTER DOKKEN KANTER CPAS
Accountancy firm EIN2021-12-31411680240
2020 : UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2020 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$152
Total income from all sources (including contributions)2020-12-31$549,897
Total of all expenses incurred2020-12-31$170,777
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$128,142
Value of total corrective distributions2020-12-31$6,434
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$246,200
Value of total assets at end of year2020-12-31$2,615,914
Value of total assets at beginning of year2020-12-31$2,236,946
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$36,201
Total interest from all sources2020-12-31$6,943
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$300,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$196,200
Participant contributions at end of year2020-12-31$93,543
Participant contributions at beginning of year2020-12-31$91,716
Participant contributions at end of year2020-12-31$4,037
Participant contributions at beginning of year2020-12-31$753
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$50,000
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$152
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$379,120
Value of net assets at end of year (total assets less liabilities)2020-12-31$2,615,914
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$2,236,794
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Investment advisory and management fees2020-12-31$29,800
Value of interest in pooled separate accounts at end of year2020-12-31$2,515,010
Value of interest in pooled separate accounts at beginning of year2020-12-31$2,141,353
Interest on participant loans2020-12-31$6,943
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$3,324
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$3,124
Net investment gain/loss from pooled separate accounts2020-12-31$296,754
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31No
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$128,142
Contract administrator fees2020-12-31$6,401
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31SCHECHTER DOKKEN KANTER CPAS
Accountancy firm EIN2020-12-31910950793
2019 : UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2019 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$152
Total income from all sources (including contributions)2019-12-31$546,542
Total of all expenses incurred2019-12-31$67,156
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$32,818
Value of total corrective distributions2019-12-31$2,361
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$183,191
Value of total assets at end of year2019-12-31$2,236,946
Value of total assets at beginning of year2019-12-31$1,757,408
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$31,977
Total interest from all sources2019-12-31$8,075
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$250,000
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$181,627
Participant contributions at end of year2019-12-31$91,716
Participant contributions at beginning of year2019-12-31$112,149
Participant contributions at end of year2019-12-31$753
Participant contributions at beginning of year2019-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$1,564
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$152
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$479,386
Value of net assets at end of year (total assets less liabilities)2019-12-31$2,236,794
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$1,757,408
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Investment advisory and management fees2019-12-31$26,349
Value of interest in pooled separate accounts at end of year2019-12-31$2,141,353
Value of interest in pooled separate accounts at beginning of year2019-12-31$1,642,220
Interest on participant loans2019-12-31$8,075
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$3,124
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$3,039
Net investment gain/loss from pooled separate accounts2019-12-31$355,276
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$32,818
Contract administrator fees2019-12-31$5,628
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31VRS, PC
Accountancy firm EIN2019-12-31460414067
2018 : UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$61,972
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$95,353
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$56,948
Expenses. Certain deemed distributions of participant loans2018-12-31$2,086
Value of total corrective distributions2018-12-31$6,080
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$163,349
Value of total assets at end of year2018-12-31$1,757,408
Value of total assets at beginning of year2018-12-31$1,790,789
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$30,239
Total interest from all sources2018-12-31$7,188
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$250,000
If this is an individual account plan, was there a blackout period2018-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$163,349
Participant contributions at end of year2018-12-31$112,149
Participant contributions at beginning of year2018-12-31$90,807
Participant contributions at end of year2018-12-31$0
Participant contributions at beginning of year2018-12-31$2,240
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Value of net income/loss2018-12-31$-33,381
Value of net assets at end of year (total assets less liabilities)2018-12-31$1,757,408
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$1,790,789
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Investment advisory and management fees2018-12-31$30,239
Value of interest in pooled separate accounts at end of year2018-12-31$1,642,220
Value of interest in pooled separate accounts at beginning of year2018-12-31$1,693,469
Interest on participant loans2018-12-31$7,188
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$3,039
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$4,273
Net investment gain/loss from pooled separate accounts2018-12-31$-108,565
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31No
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$56,948
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31No
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31VRS, PC
Accountancy firm EIN2018-12-31460414067
2017 : UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total income from all sources (including contributions)2017-12-31$382,847
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$217,148
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$184,470
Value of total corrective distributions2017-12-31$5,113
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$135,427
Value of total assets at end of year2017-12-31$1,790,789
Value of total assets at beginning of year2017-12-31$1,625,090
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$27,565
Total interest from all sources2017-12-31$4,600
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$250,000
If this is an individual account plan, was there a blackout period2017-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$135,353
Participant contributions at end of year2017-12-31$90,807
Participant contributions at beginning of year2017-12-31$88,448
Participant contributions at end of year2017-12-31$2,240
Participant contributions at beginning of year2017-12-31$2,375
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$74
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$165,699
Value of net assets at end of year (total assets less liabilities)2017-12-31$1,790,789
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$1,625,090
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Investment advisory and management fees2017-12-31$27,565
Value of interest in pooled separate accounts at end of year2017-12-31$1,693,469
Value of interest in pooled separate accounts at beginning of year2017-12-31$1,530,043
Interest on participant loans2017-12-31$4,600
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$4,273
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$4,224
Net investment gain/loss from pooled separate accounts2017-12-31$242,820
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31Yes
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$184,470
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31No
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31VRS, PC
Accountancy firm EIN2017-12-31460414067
2016 : UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2016 401k financial data
Total unrealized appreciation/depreciation of assets2016-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2016-12-31$0
Total income from all sources (including contributions)2016-12-31$215,378
Total loss/gain on sale of assets2016-12-31$0
Total of all expenses incurred2016-12-31$30,621
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2016-12-31$23,223
Value of total corrective distributions2016-12-31$4,420
Total contributions o plan (from employers,participants, others, non cash contrinutions)2016-12-31$123,175
Value of total assets at end of year2016-12-31$1,625,090
Value of total assets at beginning of year2016-12-31$1,440,333
Total of administrative expenses incurred including professional, contract, advisory and management fees2016-12-31$2,978
Total interest from all sources2016-12-31$4,984
Total dividends received (eg from common stock, registered investment company shares)2016-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2016-12-31No
Was this plan covered by a fidelity bond2016-12-31Yes
Value of fidelity bond cover2016-12-31$250,000
If this is an individual account plan, was there a blackout period2016-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-12-31$0
Were there any nonexempt tranactions with any party-in-interest2016-12-31No
Contributions received from participants2016-12-31$123,175
Participant contributions at end of year2016-12-31$88,448
Participant contributions at beginning of year2016-12-31$99,454
Participant contributions at end of year2016-12-31$2,375
Participant contributions at beginning of year2016-12-31$2,451
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Value of net income/loss2016-12-31$184,757
Value of net assets at end of year (total assets less liabilities)2016-12-31$1,625,090
Value of net assets at beginning of year (total assets less liabilities)2016-12-31$1,440,333
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2016-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2016-12-31No
Were any leases to which the plan was party in default or uncollectible2016-12-31No
Investment advisory and management fees2016-12-31$2,978
Value of interest in pooled separate accounts at end of year2016-12-31$1,530,043
Value of interest in pooled separate accounts at beginning of year2016-12-31$1,338,428
Interest on participant loans2016-12-31$4,984
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2016-12-31$4,224
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2016-12-31$0
Net investment gain/loss from pooled separate accounts2016-12-31$87,219
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2016-12-31No
Was there a failure to transmit to the plan any participant contributions2016-12-31Yes
Has the plan failed to provide any benefit when due under the plan2016-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2016-12-31$23,223
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32016-12-31No
Did the plan have assets held for investment2016-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2016-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2016-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2016-12-31Yes
Opinion of an independent qualified public accountant for this plan2016-12-31Disclaimer
Accountancy firm name2016-12-31VILHAUER RAML & SNYDER PC
Accountancy firm EIN2016-12-31460414067
2015 : UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2015 401k financial data
Total unrealized appreciation/depreciation of assets2015-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2015-12-31$0
Total income from all sources (including contributions)2015-12-31$91,074
Total loss/gain on sale of assets2015-12-31$0
Total of all expenses incurred2015-12-31$43,818
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2015-12-31$35,570
Value of total corrective distributions2015-12-31$5,079
Total contributions o plan (from employers,participants, others, non cash contrinutions)2015-12-31$114,687
Value of total assets at end of year2015-12-31$1,440,333
Value of total assets at beginning of year2015-12-31$1,393,077
Total of administrative expenses incurred including professional, contract, advisory and management fees2015-12-31$3,169
Total interest from all sources2015-12-31$5,218
Total dividends received (eg from common stock, registered investment company shares)2015-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2015-12-31No
Was this plan covered by a fidelity bond2015-12-31Yes
Value of fidelity bond cover2015-12-31$250,000
If this is an individual account plan, was there a blackout period2015-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-12-31$0
Were there any nonexempt tranactions with any party-in-interest2015-12-31No
Contributions received from participants2015-12-31$114,687
Participant contributions at end of year2015-12-31$99,454
Participant contributions at beginning of year2015-12-31$99,063
Participant contributions at end of year2015-12-31$2,451
Participant contributions at beginning of year2015-12-31$410
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Value of net income/loss2015-12-31$47,256
Value of net assets at end of year (total assets less liabilities)2015-12-31$1,440,333
Value of net assets at beginning of year (total assets less liabilities)2015-12-31$1,393,077
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2015-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2015-12-31No
Were any leases to which the plan was party in default or uncollectible2015-12-31No
Value of interest in pooled separate accounts at end of year2015-12-31$1,338,428
Value of interest in pooled separate accounts at beginning of year2015-12-31$1,293,604
Interest on participant loans2015-12-31$5,218
Net investment gain/loss from pooled separate accounts2015-12-31$-28,831
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2015-12-31No
Was there a failure to transmit to the plan any participant contributions2015-12-31No
Has the plan failed to provide any benefit when due under the plan2015-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2015-12-31$35,570
Contract administrator fees2015-12-31$3,169
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32015-12-31Yes
Did the plan have assets held for investment2015-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2015-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2015-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2015-12-31Yes
Opinion of an independent qualified public accountant for this plan2015-12-31Disclaimer
Accountancy firm name2015-12-31VILHAUER RAML & SNYDER PC
Accountancy firm EIN2015-12-31460414067
2014 : UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2014 401k financial data
Total unrealized appreciation/depreciation of assets2014-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2014-12-31$0
Total income from all sources (including contributions)2014-12-31$195,888
Total loss/gain on sale of assets2014-12-31$0
Total of all expenses incurred2014-12-31$63,563
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2014-12-31$58,298
Value of total corrective distributions2014-12-31$2,234
Total contributions o plan (from employers,participants, others, non cash contrinutions)2014-12-31$113,081
Value of total assets at end of year2014-12-31$1,393,077
Value of total assets at beginning of year2014-12-31$1,260,752
Total of administrative expenses incurred including professional, contract, advisory and management fees2014-12-31$3,031
Total interest from all sources2014-12-31$4,060
Total dividends received (eg from common stock, registered investment company shares)2014-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2014-12-31No
Was this plan covered by a fidelity bond2014-12-31Yes
Value of fidelity bond cover2014-12-31$1,000,000
If this is an individual account plan, was there a blackout period2014-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-12-31$0
Were there any nonexempt tranactions with any party-in-interest2014-12-31No
Contributions received from participants2014-12-31$113,081
Participant contributions at end of year2014-12-31$99,063
Participant contributions at beginning of year2014-12-31$57,646
Participant contributions at end of year2014-12-31$410
Participant contributions at beginning of year2014-12-31$374
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Value of net income/loss2014-12-31$132,325
Value of net assets at end of year (total assets less liabilities)2014-12-31$1,393,077
Value of net assets at beginning of year (total assets less liabilities)2014-12-31$1,260,752
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2014-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2014-12-31No
Were any leases to which the plan was party in default or uncollectible2014-12-31No
Value of interest in pooled separate accounts at end of year2014-12-31$1,293,604
Value of interest in pooled separate accounts at beginning of year2014-12-31$1,202,732
Interest on participant loans2014-12-31$4,060
Net investment gain/loss from pooled separate accounts2014-12-31$78,747
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2014-12-31No
Was there a failure to transmit to the plan any participant contributions2014-12-31No
Has the plan failed to provide any benefit when due under the plan2014-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2014-12-31$58,298
Contract administrator fees2014-12-31$3,031
Did the plan have assets held for investment2014-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2014-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2014-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2014-12-31Yes
Opinion of an independent qualified public accountant for this plan2014-12-31Disclaimer
Accountancy firm name2014-12-31VILHAUER RAML & SNYDER PC
Accountancy firm EIN2014-12-31460414067
2013 : UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2013 401k financial data
Total unrealized appreciation/depreciation of assets2013-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2013-12-31$0
Total income from all sources (including contributions)2013-12-31$407,947
Total loss/gain on sale of assets2013-12-31$0
Total of all expenses incurred2013-12-31$146,141
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2013-12-31$129,584
Value of total corrective distributions2013-12-31$2,189
Total contributions o plan (from employers,participants, others, non cash contrinutions)2013-12-31$145,357
Value of total assets at end of year2013-12-31$1,260,752
Value of total assets at beginning of year2013-12-31$998,946
Total of administrative expenses incurred including professional, contract, advisory and management fees2013-12-31$14,368
Total interest from all sources2013-12-31$2,388
Total dividends received (eg from common stock, registered investment company shares)2013-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2013-12-31No
Was this plan covered by a fidelity bond2013-12-31Yes
Value of fidelity bond cover2013-12-31$1,000,000
If this is an individual account plan, was there a blackout period2013-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-12-31$0
Were there any nonexempt tranactions with any party-in-interest2013-12-31No
Contributions received from participants2013-12-31$103,785
Participant contributions at end of year2013-12-31$57,646
Participant contributions at beginning of year2013-12-31$50,309
Participant contributions at end of year2013-12-31$374
Participant contributions at beginning of year2013-12-31$405
Income. Received or receivable in cash from other sources (including rollovers)2013-12-31$41,572
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2013-12-31$1,762
Administrative expenses (other) incurred2013-12-31$11,818
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Value of net income/loss2013-12-31$261,806
Value of net assets at end of year (total assets less liabilities)2013-12-31$1,260,752
Value of net assets at beginning of year (total assets less liabilities)2013-12-31$998,946
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2013-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2013-12-31No
Were any leases to which the plan was party in default or uncollectible2013-12-31No
Value of interest in pooled separate accounts at end of year2013-12-31$1,202,732
Value of interest in pooled separate accounts at beginning of year2013-12-31$948,232
Interest on participant loans2013-12-31$2,388
Net investment gain/loss from pooled separate accounts2013-12-31$260,202
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2013-12-31No
Was there a failure to transmit to the plan any participant contributions2013-12-31No
Has the plan failed to provide any benefit when due under the plan2013-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2013-12-31$127,822
Contract administrator fees2013-12-31$2,550
Did the plan have assets held for investment2013-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2013-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2013-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2013-12-31Yes
Opinion of an independent qualified public accountant for this plan2013-12-31Disclaimer
Accountancy firm name2013-12-31VILHAUER RAML & SNYDER PC
Accountancy firm EIN2013-12-31460414067
2012 : UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2012 401k financial data
Total unrealized appreciation/depreciation of assets2012-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2012-12-31$0
Total income from all sources (including contributions)2012-12-31$253,918
Total loss/gain on sale of assets2012-12-31$0
Total of all expenses incurred2012-12-31$198,000
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-12-31$181,268
Expenses. Certain deemed distributions of participant loans2012-12-31$2,759
Value of total corrective distributions2012-12-31$769
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-12-31$113,710
Value of total assets at end of year2012-12-31$998,946
Value of total assets at beginning of year2012-12-31$943,028
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-12-31$13,204
Total interest from all sources2012-12-31$2,236
Total dividends received (eg from common stock, registered investment company shares)2012-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31Yes
Value of fidelity bond cover2012-12-31$1,000,000
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Contributions received from participants2012-12-31$106,816
Participant contributions at end of year2012-12-31$50,309
Participant contributions at beginning of year2012-12-31$33,854
Participant contributions at end of year2012-12-31$405
Participant contributions at beginning of year2012-12-31$342
Income. Received or receivable in cash from other sources (including rollovers)2012-12-31$6,894
Administrative expenses (other) incurred2012-12-31$10,803
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Value of net income/loss2012-12-31$55,918
Value of net assets at end of year (total assets less liabilities)2012-12-31$998,946
Value of net assets at beginning of year (total assets less liabilities)2012-12-31$943,028
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Value of interest in pooled separate accounts at end of year2012-12-31$948,232
Value of interest in pooled separate accounts at beginning of year2012-12-31$908,832
Interest on participant loans2012-12-31$2,236
Net investment gain/loss from pooled separate accounts2012-12-31$137,972
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-12-31$181,268
Contract administrator fees2012-12-31$2,401
Did the plan have assets held for investment2012-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-12-31Yes
Opinion of an independent qualified public accountant for this plan2012-12-31Disclaimer
Accountancy firm name2012-12-31VILHAUER, RAML & SYNDER P.C.
Accountancy firm EIN2012-12-31460414067
2011 : UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2011 401k financial data
Total unrealized appreciation/depreciation of assets2011-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total income from all sources (including contributions)2011-12-31$105,070
Total loss/gain on sale of assets2011-12-31$0
Total of all expenses incurred2011-12-31$77,003
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$62,931
Expenses. Certain deemed distributions of participant loans2011-12-31$1,749
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$117,570
Value of total assets at end of year2011-12-31$943,028
Value of total assets at beginning of year2011-12-31$914,961
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$12,323
Total interest from all sources2011-12-31$1,712
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$1,000,000
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$112,790
Participant contributions at end of year2011-12-31$33,854
Participant contributions at beginning of year2011-12-31$24,741
Participant contributions at end of year2011-12-31$342
Participant contributions at beginning of year2011-12-31$515
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$4,780
Administrative expenses (other) incurred2011-12-31$10,166
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$28,067
Value of net assets at end of year (total assets less liabilities)2011-12-31$943,028
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$914,961
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in pooled separate accounts at end of year2011-12-31$908,832
Value of interest in pooled separate accounts at beginning of year2011-12-31$889,705
Interest on participant loans2011-12-31$1,712
Net investment gain/loss from pooled separate accounts2011-12-31$-14,212
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$62,931
Contract administrator fees2011-12-31$2,157
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31VILHAUER, RAML & SYNDER P.C.
Accountancy firm EIN2011-12-31460414067
2010 : UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2010 401k financial data
Total unrealized appreciation/depreciation of assets2010-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total income from all sources (including contributions)2010-12-31$225,398
Total loss/gain on sale of assets2010-12-31$0
Total of all expenses incurred2010-12-31$93,166
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$72,985
Expenses. Certain deemed distributions of participant loans2010-12-31$11,243
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$126,384
Value of total assets at end of year2010-12-31$914,961
Value of total assets at beginning of year2010-12-31$782,729
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$8,938
Total interest from all sources2010-12-31$1,792
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Administrative expenses professional fees incurred2010-12-31$8,938
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$1,000,000
If this is an individual account plan, was there a blackout period2010-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$126,384
Participant contributions at end of year2010-12-31$24,741
Participant contributions at beginning of year2010-12-31$38,031
Participant contributions at end of year2010-12-31$515
Participant contributions at beginning of year2010-12-31$1,696
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$132,232
Value of net assets at end of year (total assets less liabilities)2010-12-31$914,961
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$782,729
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in pooled separate accounts at end of year2010-12-31$889,705
Value of interest in pooled separate accounts at beginning of year2010-12-31$743,002
Interest on participant loans2010-12-31$1,792
Net investment gain/loss from pooled separate accounts2010-12-31$97,222
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$72,985
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31HANSON VILHAUER AND RAML P.C.
Accountancy firm EIN2010-12-31460414067
2009 : UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K)

2022: UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedYes
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes
2016: UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement - TrustYes
2015: UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement - TrustYes
2014: UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement - TrustYes
2013: UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement - TrustYes
2012: UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement - TrustYes
2011: UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement - TrustYes
2010: UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement - TrustYes
2009: UPPER SIOUX COMMUNITY/PRAIRIE'S EDGE CASINO RESORT 401(K) 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-CP-HH6L
Policy instance 1
Insurance contract or identification numberGAP-CP-HH6L
Number of Individuals Covered201
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of fees paid to insurance companyUSD $2
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Insurance broker organization code?3
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-CP-HH6L
Policy instance 1
Insurance contract or identification numberGAP-CP-HH6L
Number of Individuals Covered101
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $5
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Insurance broker organization code?3
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-CP-HH6L
Policy instance 1
Insurance contract or identification numberGAP-CP-HH6L
Number of Individuals Covered97
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $19
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Commission paid to Insurance BrokerUSD $19
Insurance broker organization code?3
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-CP-HH6L
Policy instance 1
Insurance contract or identification numberGAP-CP-HH6L
Number of Individuals Covered88
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $18
Are there contracts with unallocated funds for contracts of type guaranteed investment?Yes
Commission paid to Insurance BrokerUSD $18
Insurance broker organization code?3
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-CP-HH6L
Policy instance 1
Insurance contract or identification numberGAP-CP-HH6L
Number of Individuals Covered83
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $21
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
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?Yes
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 BenefitNo
Long Term Disability Insurance Welfare BenefitNo
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $21
Insurance broker organization code?3
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-CP-HH6L
Policy instance 1
Insurance contract or identification numberGAP-CP-HH6L
Number of Individuals Covered77
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $13
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
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 BenefitNo
Long Term Disability Insurance Welfare BenefitNo
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13
Insurance broker organization code?3
Insurance broker nameUBS FINANACIAL SERVICES, INC.
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-54-U973
Policy instance 1
Insurance contract or identification numberGAP-54-U973
Number of Individuals Covered79
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $5,192
Total amount of fees paid to insurance companyUSD $938
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 BenefitNo
Long Term Disability Insurance Welfare BenefitNo
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,192
Amount paid for insurance broker fees938
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameUBS FINANACIAL SERVICES, INC.
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-54-U973
Policy instance 1
Insurance contract or identification numberGAP-54-U973
Number of Individuals Covered76
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $7,410
Total amount of fees paid to insurance companyUSD $1,249
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 BenefitNo
Long Term Disability Insurance Welfare BenefitNo
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
Commission paid to Insurance BrokerUSD $7,410
Amount paid for insurance broker fees1249
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker nameUBS FINANACIAL SERVICES, INC.
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-54-U973
Policy instance 1
Insurance contract or identification numberGAP-54-U973
Number of Individuals Covered75
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $6,420
Total amount of fees paid to insurance companyUSD $1,020
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 BenefitNo
Long Term Disability Insurance Welfare BenefitNo
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
Commission paid to Insurance BrokerUSD $6,420
Insurance broker organization code?3
Amount paid for insurance broker fees1020
Additional information about fees paid to insurance brokerTPA COMPENSATION
Insurance broker nameBILLINGS AND COMPANY, INC.
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-54-U973
Policy instance 1
Insurance contract or identification numberGAP-54-U973
Number of Individuals Covered69
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $5,798
Total amount of fees paid to insurance companyUSD $871
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 BenefitNo
Long Term Disability Insurance Welfare BenefitNo
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
Commission paid to Insurance BrokerUSD $5,798
Insurance broker organization code?3
Amount paid for insurance broker fees871
Insurance broker nameBILLINGS AND COMPANY, INC.
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-54-U973
Policy instance 1
Insurance contract or identification numberGAP-54-U973
Number of Individuals Covered71
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $5,501
Total amount of fees paid to insurance companyUSD $792
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 BenefitNo
Long Term Disability Insurance Welfare BenefitNo
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
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract numberGAP-54-U973
Policy instance 1
Insurance contract or identification numberGAP-54-U973
Number of Individuals Covered356
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $4,641
Total amount of fees paid to insurance companyUSD $524
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 BenefitNo
Long Term Disability Insurance Welfare BenefitNo
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
Commission paid to Insurance BrokerUSD $4,641
Amount paid for insurance broker fees524
Insurance broker organization code?3
Insurance broker nameUBS FINANACIAL SERVICES, INC.

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