401k Plan data: MINNESOTA CHAMBER BUSINESS SERVICE GROUP INSURANCE TRUST plan

MINNESOTA CHAMBER BUSINESS SERVICE GROUP INSURANCE TRUST 401k Plan overview

Plan Name	MINNESOTA CHAMBER BUSINESS SERVICE GROUP INSURANCE TRUST
Plan identification number	509

MINNESOTA CHAMBER BUSINESS SERVICE GROUP INSURANCE TRUST Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance

401k Sponsoring company profile

SJ ELECTRO SYSTEMS, LLC has sponsored the creation of one or more 401k plans.

Company Name: SJ ELECTRO SYSTEMS, LLC

Employer identification number (EIN): 411297816

NAIC Classification: 335900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MINNESOTA CHAMBER BUSINESS SERVICE GROUP INSURANCE TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
509 2021-01-01 TAUNIA SUCKERT 2022-07-13
509 2021-01-01
509 2020-01-01

Plan Statistics for MINNESOTA CHAMBER BUSINESS SERVICE GROUP INSURANCE TRUST

401k plan membership statisitcs for MINNESOTA CHAMBER BUSINESS SERVICE GROUP INSURANCE TRUST

Measure Date Value
2021: MINNESOTA CHAMBER BUSINESS SERVICE GROUP INSURANCE TRUST 2021 401k membership
Total participants, beginning-of-year 2021-01-01 398
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 0
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 0
Total of all active and inactive participants 2021-01-01 0
Number of employers contributing to the scheme 2021-01-01 0
2020: MINNESOTA CHAMBER BUSINESS SERVICE GROUP INSURANCE TRUST 2020 401k membership
Total participants, beginning-of-year 2020-01-01 362
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 398
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 398

Measure	Date	Value
2021: MINNESOTA CHAMBER BUSINESS SERVICE GROUP INSURANCE TRUST 2021 401k membership
Total participants, beginning-of-year	2021-01-01	398
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	0
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	0
Number of employers contributing to the scheme	2021-01-01	0
2020: MINNESOTA CHAMBER BUSINESS SERVICE GROUP INSURANCE TRUST 2020 401k membership
Total participants, beginning-of-year	2020-01-01	362
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	398
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	398

Form 5500 Responses for MINNESOTA CHAMBER BUSINESS SERVICE GROUP INSURANCE TRUST

2021: MINNESOTA CHAMBER BUSINESS SERVICE GROUP INSURANCE TRUST 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	Yes
2021-01-01	This submission is the final filing	Yes
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2020: MINNESOTA CHAMBER BUSINESS SERVICE GROUP INSURANCE TRUST 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	First time form 5500 has been submitted	Yes
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

165380

Policy instance

Insurance contract or identification number	165380
Number of Individuals Covered	398
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $7,111
Total amount of fees paid to insurance company	USD $0
Life Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $5,845
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3

STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 )

Policy contract number

165380

Policy instance

Insurance contract or identification number	165380
Number of Individuals Covered	393
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $6,693
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Broker	USD $5,608
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	N/A
Insurance broker organization code?	3

Potentially related plans

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Company Name:	SJ ELECTRO SYSTEMS, LLC
Employer identification number (EIN):	411297816
NAIC Classification:	335900

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
509	2021-01-01	TAUNIA SUCKERT	2022-07-13
509	2021-01-01
509	2020-01-01