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LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATE GROUP MEDICAL PLAN 401k Plan overview

Plan NameLAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATE GROUP MEDICAL PLAN
Plan identification number 501

LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATE GROUP MEDICAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)

401k Sponsoring company profile

LAKESHIRTS, INC. has sponsored the creation of one or more 401k plans.

Company Name:LAKESHIRTS, INC.
Employer identification number (EIN):411771405
NAIC Classification:315990
NAIC Description:Apparel Accessories and Other Apparel Manufacturing

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATE GROUP MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01KARA AHLES KARA AHLES2019-06-26
5012017-01-01
5012016-01-01 KARA AHLES2019-06-26
5012015-01-01
5012014-01-01KARA AHLES KARA AHLES2019-06-26
5012013-01-01KARA AHLES KARA AHLES2019-06-26
5012012-01-01KARA AHLES KARA AHLES2019-06-26
5012011-01-01KARA AHLES KARA AHLES2019-06-26

Plan Statistics for LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATE GROUP MEDICAL PLAN

401k plan membership statisitcs for LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATE GROUP MEDICAL PLAN

Measure Date Value
2021: LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATE GROUP MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01248
Total number of active participants reported on line 7a of the Form 55002021-01-01300
Total of all active and inactive participants2021-01-01300
Total participants2021-01-01300
2020: LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATE GROUP MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01360
Total number of active participants reported on line 7a of the Form 55002020-01-01248
Total of all active and inactive participants2020-01-01248
Total participants2020-01-01248
2019: LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATE GROUP MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01360
Total number of active participants reported on line 7a of the Form 55002019-01-01360
Total of all active and inactive participants2019-01-01360
Total participants2019-01-01360
2018: LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATE GROUP MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01333
Total number of active participants reported on line 7a of the Form 55002018-01-01360
Total of all active and inactive participants2018-01-01360
2017: LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATE GROUP MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01284
Total number of active participants reported on line 7a of the Form 55002017-01-01329
Number of retired or separated participants receiving benefits2017-01-011
Total of all active and inactive participants2017-01-01330
2016: LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATE GROUP MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01221
Total number of active participants reported on line 7a of the Form 55002016-01-01280
Number of retired or separated participants receiving benefits2016-01-011
Total of all active and inactive participants2016-01-01281
2015: LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATE GROUP MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01196
Total number of active participants reported on line 7a of the Form 55002015-01-01219
Total of all active and inactive participants2015-01-01219
2014: LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATE GROUP MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01174
Total number of active participants reported on line 7a of the Form 55002014-01-01189
Number of retired or separated participants receiving benefits2014-01-012
Total of all active and inactive participants2014-01-01191
2013: LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATE GROUP MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01184
Total number of active participants reported on line 7a of the Form 55002013-01-01175
Total of all active and inactive participants2013-01-01175
2012: LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATE GROUP MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01154
Total number of active participants reported on line 7a of the Form 55002012-01-01183
Total of all active and inactive participants2012-01-01183
2011: LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATE GROUP MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01150
Total number of active participants reported on line 7a of the Form 55002011-01-01153
Number of retired or separated participants receiving benefits2011-01-011
Total of all active and inactive participants2011-01-01154

Form 5500 Responses for LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATE GROUP MEDICAL PLAN

2021: LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATE GROUP MEDICAL PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATE GROUP MEDICAL PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATE GROUP MEDICAL PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATE GROUP MEDICAL PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATE GROUP MEDICAL PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATE GROUP MEDICAL PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATE GROUP MEDICAL PLAN 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 benefit arrangement – InsuranceYes
2014: LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATE GROUP MEDICAL PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATE GROUP MEDICAL PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATE GROUP MEDICAL PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: LAKESHIRTS INC/DOGHOUSE DYEWORKS INC AND AFFILIATE GROUP MEDICAL PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01First time form 5500 has been submittedYes
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MEDICA (National Association of Insurance Commissioners NAIC id number: 1259 )
Policy contract number147143
Policy instance 1
Insurance contract or identification number147143
Number of Individuals Covered300
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $63,027
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 BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $2,100,903
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $63,027
Amount paid for insurance broker fees0
Insurance broker organization code?3
MEDICA (National Association of Insurance Commissioners NAIC id number: 1259 )
Policy contract number147143
Policy instance 1
Insurance contract or identification number147143
Number of Individuals Covered348
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $58,129
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 BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $1,937,670
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $58,129
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerBROKER INCENTIVE PROGRAM
Insurance broker organization code?3
MEDICA (National Association of Insurance Commissioners NAIC id number: 1259 )
Policy contract number147143
Policy instance 1
Insurance contract or identification number147143
Number of Individuals Covered360
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $65,479
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 BenefitYes
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
Welfare Benefit Premiums Paid to CarrierUSD $2,182,643
Commission paid to Insurance BrokerUSD $65,479
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerBROKER INCENTIVE PROGRAM
Insurance broker organization code?3
MEDICA (National Association of Insurance Commissioners NAIC id number: 1259 )
Policy contract number147143
Policy instance 1
Insurance contract or identification number147143
Number of Individuals Covered450
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $50,663
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,689,267
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $50,663
Insurance broker organization code?3
MEDICA (National Association of Insurance Commissioners NAIC id number: 1259 )
Policy contract number147143
Policy instance 1
Insurance contract or identification number147143
Number of Individuals Covered366
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $28,447
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,320,765
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
MEDICA (National Association of Insurance Commissioners NAIC id number: 1259 )
Policy contract number147143
Policy instance 1
Insurance contract or identification number147143
Number of Individuals Covered217
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $20,570
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,028,477
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $20,570
Insurance broker organization code?3
MEDICA (National Association of Insurance Commissioners NAIC id number: 1259 )
Policy contract number147143
Policy instance 1
Insurance contract or identification number147143
Number of Individuals Covered225
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $17,823
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $891,142
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,823
Insurance broker organization code?3
MEDICA (National Association of Insurance Commissioners NAIC id number: 1259 )
Policy contract number147143
Policy instance 1
Insurance contract or identification number147143
Number of Individuals Covered192
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $16,909
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $845,431
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,909
Insurance broker organization code?3
HEALTHPARTNERS INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 44547 )
Policy contract number22660
Policy instance 1
Insurance contract or identification number22660
Number of Individuals Covered186
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $13,239
Total amount of fees paid to insurance companyUSD $4
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $601,859
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,239
Amount paid for insurance broker fees4
Additional information about fees paid to insurance brokerMARKETING ALLOWANCE
Insurance broker organization code?3

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