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ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 401k Plan overview

Plan NameROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN
Plan identification number 511

ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN Benefits

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

401k Sponsoring company profile

ROSENBOOM MACHINE & TOOL, INC has sponsored the creation of one or more 401k plans.

Company Name:ROSENBOOM MACHINE & TOOL, INC
Employer identification number (EIN):421258906
NAIC Classification:332900

Additional information about ROSENBOOM MACHINE & TOOL, INC

Jurisdiction of Incorporation: Iowa Secretary of State Business Entities
Incorporation Date: 1985-08-05
Company Identification Number: 103648
Legal Registered Office Address: 1530 WESTERN AVE

SHELDON
United States of America (USA)
51201

More information about ROSENBOOM MACHINE & TOOL, INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5112022-01-01
5112021-01-01
5112020-01-01
5112019-01-01
5112018-01-01VIVIAN ROSENBOOM
5112017-01-01VIVIAN ROSENBOOM
5112016-01-01VIVIAN ROSENBOOM
5112015-01-01VIVIAN ROSENBOOM
5112014-01-01VIVIAN ROSENBOOM
5112013-01-01VIVIAN ROSENBOOM
5112012-01-01VIVIAN ROSENBOOM
5112011-01-01VIVIAN ROSENBOOM
5112010-01-01VIVIAN ROSENBOOM
5112009-01-01VIVIAN ROSENBOOM2010-07-29

Plan Statistics for ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN

401k plan membership statisitcs for ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN

Measure Date Value
2022: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01140
Total number of active participants reported on line 7a of the Form 55002022-01-01129
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-01129
2021: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01150
Total number of active participants reported on line 7a of the Form 55002021-01-01140
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01140
2020: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01187
Total number of active participants reported on line 7a of the Form 55002020-01-01150
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01150
2019: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01197
Total number of active participants reported on line 7a of the Form 55002019-01-01187
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01187
2018: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01157
Total number of active participants reported on line 7a of the Form 55002018-01-01197
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01197
2017: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01151
Total number of active participants reported on line 7a of the Form 55002017-01-01157
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-01157
2016: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01158
Total number of active participants reported on line 7a of the Form 55002016-01-01151
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01151
2015: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01207
Total number of active participants reported on line 7a of the Form 55002015-01-01158
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-01158
2014: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01173
Total number of active participants reported on line 7a of the Form 55002014-01-01207
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01207
2013: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01135
Total number of active participants reported on line 7a of the Form 55002013-01-01173
Total of all active and inactive participants2013-01-01173
2012: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01105
Total number of active participants reported on line 7a of the Form 55002012-01-01135
Total of all active and inactive participants2012-01-01135
2011: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01181
Total number of active participants reported on line 7a of the Form 55002011-01-01105
Total of all active and inactive participants2011-01-01105
2010: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01127
Total number of active participants reported on line 7a of the Form 55002010-01-01181
Total of all active and inactive participants2010-01-01181
2009: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01127
Total of all active and inactive participants2009-01-010

Form 5500 Responses for ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN

2022: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY 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: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY 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: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY 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: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY 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: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY 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: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY 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: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: ROSENBOOM MACHINE & TOOL, INC. SECTION 125 PREMIUM ONLY PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract numberL01593
Policy instance 1
Insurance contract or identification numberL01593
Number of Individuals Covered129
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $81,753
Total amount of fees paid to insurance companyUSD $2,085
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,833,667
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $81,753
Amount paid for insurance broker fees2085
Additional information about fees paid to insurance brokerSERVICE FEES
Insurance broker organization code?3
COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 )
Policy contract numberL01593
Policy instance 1
Insurance contract or identification numberL01593
Number of Individuals Covered140
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $74,141
Total amount of fees paid to insurance companyUSD $5,917
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,853,205
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $40,809
Amount paid for insurance broker fees5917
Additional information about fees paid to insurance brokerSERVICE FEES
Insurance broker organization code?3
PARAMOUNT HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95189 )
Policy contract number031128 & CD0114
Policy instance 1
Insurance contract or identification number031128 & CD0114
Number of Individuals Covered150
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $66,806
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $66,806
Insurance broker organization code?3
PARAMOUNT HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95189 )
Policy contract number031128 & CD0114
Policy instance 1
Insurance contract or identification number031128 & CD0114
Number of Individuals Covered187
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $68,824
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $68,824
Insurance broker organization code?3
PARAMOUNT HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95189 )
Policy contract number031128 & CD0114
Policy instance 1
Insurance contract or identification number031128 & CD0114
Number of Individuals Covered197
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $67,499
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $67,499
Insurance broker organization code?4
PARAMOUNT HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95189 )
Policy contract number031128 & CD0114
Policy instance 1
Insurance contract or identification number031128 & CD0114
Number of Individuals Covered157
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $49,967
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,665,569
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $49,967
Insurance broker organization code?4
Insurance broker nameKAMINSKY & ASSOCIATES, INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00508664
Policy instance 2
Insurance contract or identification number00508664
Number of Individuals Covered182
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $3,591
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $106,078
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,591
Insurance broker nameKAMINSKY & ASSOCIATES
PARAMOUNT HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95189 )
Policy contract number030299 & CD0114
Policy instance 1
Insurance contract or identification number030299 & CD0114
Number of Individuals Covered158
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $52,449
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,748,305
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $52,449
Insurance broker nameKAMINSKY & ASSOCIATES, INC
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number503R83 & BP0330
Policy instance 2
Insurance contract or identification number503R83 & BP0330
Number of Individuals Covered213
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $5,625
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $98,542
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,625
Insurance broker nameKAMINSKY & ASSOCIATES
PARAMOUNT HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95189 )
Policy contract number030299 & CD0114
Policy instance 1
Insurance contract or identification number030299 & CD0114
Number of Individuals Covered207
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $52,707
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,756,906
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $52,707
Insurance broker nameKAMINSKY & ASSOCIATES, INC
NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 )
Policy contract number503R83
Policy instance 2
Insurance contract or identification number503R83
Number of Individuals Covered186
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $3,167
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $89,121
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,167
Insurance broker nameKAMINSKY & ASSOCIATES
PARAMOUNT HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95189 )
Policy contract number030299 & CD0114
Policy instance 1
Insurance contract or identification number030299 & CD0114
Number of Individuals Covered173
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $39,106
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,303,519
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $39,106
Insurance broker nameKAMINSKY & ASSOCIATES, INC
PARAMOUNT HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95189 )
Policy contract number030299 & CD0114
Policy instance 1
Insurance contract or identification number030299 & CD0114
Number of Individuals Covered135
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $26,778
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $892,600
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,778
Insurance broker nameKAMINSKY & ASSOCIATES, INC
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF1D0765
Policy instance 2
Insurance contract or identification numberF1D0765
Number of Individuals Covered119
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $3,167
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $66,949
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,167
Insurance broker nameKAMINSKY & ASSOCIATES INC
SUN LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 80926 )
Policy contract number212895
Policy instance 3
Insurance contract or identification number212895
Insurance policy start date2011-01-01
Insurance policy end date2011-04-01
Total amount of commissions paid to insurance brokerUSD $299
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $39,962
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF1D0765
Policy instance 2
Insurance contract or identification numberF1D0765
Number of Individuals Covered105
Insurance policy start date2011-04-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $2,488
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $41,904
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PARAMOUNT HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95189 )
Policy contract number030299 CD0114
Policy instance 1
Insurance contract or identification number030299 CD0114
Number of Individuals Covered100
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $19,967
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $665,581
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PARAMOUNT HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95189 )
Policy contract number
Policy instance 1
Number of Individuals Covered181
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of fees paid to insurance companyUSD $23,528
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees23528
Additional information about fees paid to insurance brokerCOMMISSIONS FEES
Insurance broker organization code?3
Insurance broker nameMICHAEL WONG

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