ROSENBOOM MACHINE & TOOL, INC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan ROSENBOOM MACHINE & TOOL INC. EMPLOYEE MEDICAL & DENTAL BENEFIT PLAN
401k plan membership statisitcs for ROSENBOOM MACHINE & TOOL INC. EMPLOYEE MEDICAL & DENTAL BENEFIT PLAN
| Measure | Date | Value |
|---|
| 2022: ROSENBOOM MACHINE & TOOL INC. EMPLOYEE MEDICAL & DENTAL BENEFIT PLAN 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 492 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 511 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 511 |
| 2021: ROSENBOOM MACHINE & TOOL INC. EMPLOYEE MEDICAL & DENTAL BENEFIT PLAN 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 497 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 492 |
| 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 | 492 |
| 2020: ROSENBOOM MACHINE & TOOL INC. EMPLOYEE MEDICAL & DENTAL BENEFIT PLAN 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 529 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 497 |
| 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 | 497 |
| 2019: ROSENBOOM MACHINE & TOOL INC. EMPLOYEE MEDICAL & DENTAL BENEFIT PLAN 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 513 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 529 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 529 |
| 2018: ROSENBOOM MACHINE & TOOL INC. EMPLOYEE MEDICAL & DENTAL BENEFIT PLAN 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 513 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 513 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 513 |
| 2017: ROSENBOOM MACHINE & TOOL INC. EMPLOYEE MEDICAL & DENTAL BENEFIT PLAN 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 499 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 513 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
| Total of all active and inactive participants | 2017-01-01 | 513 |
| 2016: ROSENBOOM MACHINE & TOOL INC. EMPLOYEE MEDICAL & DENTAL BENEFIT PLAN 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 520 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 499 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
| Total of all active and inactive participants | 2016-01-01 | 499 |
| 2015: ROSENBOOM MACHINE & TOOL INC. EMPLOYEE MEDICAL & DENTAL BENEFIT PLAN 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 536 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 520 |
| Number of retired or separated participants receiving benefits | 2015-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-01-01 | 0 |
| Total of all active and inactive participants | 2015-01-01 | 520 |
| 2014: ROSENBOOM MACHINE & TOOL INC. EMPLOYEE MEDICAL & DENTAL BENEFIT PLAN 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 547 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 536 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2014-01-01 | 0 |
| Total of all active and inactive participants | 2014-01-01 | 536 |
| 2013: ROSENBOOM MACHINE & TOOL INC. EMPLOYEE MEDICAL & DENTAL BENEFIT PLAN 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 505 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 547 |
| Total of all active and inactive participants | 2013-01-01 | 547 |
| 2012: ROSENBOOM MACHINE & TOOL INC. EMPLOYEE MEDICAL & DENTAL BENEFIT PLAN 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 461 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 505 |
| Total of all active and inactive participants | 2012-01-01 | 505 |
| 2011: ROSENBOOM MACHINE & TOOL INC. EMPLOYEE MEDICAL & DENTAL BENEFIT PLAN 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 367 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 461 |
| Total of all active and inactive participants | 2011-01-01 | 461 |
| 2010: ROSENBOOM MACHINE & TOOL INC. EMPLOYEE MEDICAL & DENTAL BENEFIT PLAN 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 325 |
| Total of all active and inactive participants | 2010-01-01 | 0 |
| 2009: ROSENBOOM MACHINE & TOOL INC. EMPLOYEE MEDICAL & DENTAL BENEFIT PLAN 2009 401k membership |
|---|
| Total participants, beginning-of-year | 2009-01-01 | 505 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 325 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 0 |
| Total of all active and inactive participants | 2009-01-01 | 325 |
| 2022: ROSENBOOM MACHINE & TOOL INC. EMPLOYEE MEDICAL & DENTAL BENEFIT PLAN 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: ROSENBOOM MACHINE & TOOL INC. EMPLOYEE MEDICAL & DENTAL BENEFIT PLAN 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: ROSENBOOM MACHINE & TOOL INC. EMPLOYEE MEDICAL & DENTAL BENEFIT PLAN 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: ROSENBOOM MACHINE & TOOL INC. EMPLOYEE MEDICAL & DENTAL BENEFIT PLAN 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: ROSENBOOM MACHINE & TOOL INC. EMPLOYEE MEDICAL & DENTAL BENEFIT PLAN 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: ROSENBOOM MACHINE & TOOL INC. EMPLOYEE MEDICAL & DENTAL BENEFIT PLAN 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: ROSENBOOM MACHINE & TOOL INC. EMPLOYEE MEDICAL & DENTAL BENEFIT PLAN 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: ROSENBOOM MACHINE & TOOL INC. EMPLOYEE MEDICAL & DENTAL BENEFIT PLAN 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: ROSENBOOM MACHINE & TOOL INC. EMPLOYEE MEDICAL & DENTAL BENEFIT PLAN 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: ROSENBOOM MACHINE & TOOL INC. EMPLOYEE MEDICAL & DENTAL BENEFIT PLAN 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: ROSENBOOM MACHINE & TOOL INC. EMPLOYEE MEDICAL & DENTAL BENEFIT PLAN 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: ROSENBOOM MACHINE & TOOL INC. EMPLOYEE MEDICAL & DENTAL BENEFIT PLAN 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2010: ROSENBOOM MACHINE & TOOL INC. EMPLOYEE MEDICAL & DENTAL BENEFIT PLAN 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: ROSENBOOM MACHINE & TOOL INC. EMPLOYEE MEDICAL & DENTAL BENEFIT PLAN 2009 form 5500 responses |
|---|
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | Submission has been amended | Yes |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | 706 |
| Policy instance | 2 |
| Insurance contract or identification number | 706 | | Number of Individuals Covered | 500 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 60128 ) |
| Policy contract number | 706 |
| Policy instance | 1 |
| Insurance contract or identification number | 706 | | Number of Individuals Covered | 511 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Total amount of commissions paid to insurance broker | USD $23,968 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $23,968 | | Insurance broker organization code? | 3 |
|
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | 706 |
| Policy instance | 2 |
| Insurance contract or identification number | 706 | | Number of Individuals Covered | 474 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 60128 ) |
| Policy contract number | 706 |
| Policy instance | 1 |
| Insurance contract or identification number | 706 | | Number of Individuals Covered | 492 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Total amount of commissions paid to insurance broker | USD $21,892 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $21,892 | | Insurance broker organization code? | 3 |
|
| WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 60128 ) |
| Policy contract number | 706 |
| Policy instance | 1 |
| Insurance contract or identification number | 706 | | Number of Individuals Covered | 497 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $24,502 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $24,502 | | Insurance broker organization code? | 3 |
|
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | 706 |
| Policy instance | 2 |
| Insurance contract or identification number | 706 | | Number of Individuals Covered | 472 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | 706 |
| Policy instance | 2 |
| Insurance contract or identification number | 706 | | Number of Individuals Covered | 496 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 60128 ) |
| Policy contract number | 706 |
| Policy instance | 1 |
| Insurance contract or identification number | 706 | | Number of Individuals Covered | 529 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $27,124 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $27,124 | | Insurance broker organization code? | 3 |
|
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | 706 |
| Policy instance | 2 |
| Insurance contract or identification number | 706 | | Number of Individuals Covered | 487 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Insurance broker organization code? | 3 |
|
| WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 60128 ) |
| Policy contract number | 706 |
| Policy instance | 1 |
| Insurance contract or identification number | 706 | | Number of Individuals Covered | 513 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $26,720 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $26,720 | | Insurance broker organization code? | 3 |
|
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | 706 |
| Policy instance | 2 |
| Insurance contract or identification number | 706 | | Number of Individuals Covered | 472 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 60128 ) |
| Policy contract number | 706 |
| Policy instance | 1 |
| Insurance contract or identification number | 706 | | Number of Individuals Covered | 513 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $30,145 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $30,145 | | Insurance broker organization code? | 3 | | Insurance broker name | N/A |
|
| WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 60128 ) |
| Policy contract number | 706 |
| Policy instance | 1 |
| Insurance contract or identification number | 706 | | Number of Individuals Covered | 520 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | 706 |
| Policy instance | 2 |
| Insurance contract or identification number | 706 | | Number of Individuals Covered | 480 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | 706 |
| Policy instance | 2 |
| Insurance contract or identification number | 706 | | Number of Individuals Covered | 491 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 60128 ) |
| Policy contract number | 706 |
| Policy instance | 1 |
| Insurance contract or identification number | 706 | | Number of Individuals Covered | 536 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Health Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | 24400 |
| Policy instance | 1 |
| Insurance contract or identification number | 24400 | | Number of Individuals Covered | 547 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $611,815 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | 24400 |
| Policy instance | 1 |
| Insurance contract or identification number | 24400 | | Number of Individuals Covered | 505 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2012-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $340,651 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | 24400 |
| Policy instance | 1 |
| Insurance contract or identification number | 24400 | | Number of Individuals Covered | 461 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $258,704 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| WELLMARK BLUE CROSS BLUE SHIELD OF SOUTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 88848 ) |
| Policy contract number | 24400 |
| Policy instance | 1 |
| Insurance contract or identification number | 24400 | | Number of Individuals Covered | 367 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Welfare Benefit Premiums Paid to Carrier | USD $203,048 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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