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| Plan Name | VALLEY MEMORIAL HOMES CAFETERIA PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | VALLEY MEMORIAL HOMES |
| Employer identification number (EIN): | 450229071 |
| NAIC Classification: | 623000 |
| NAIC Description: | Nursing and Residential Care Facilities |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2018-01-01 | ||||
| 501 | 2017-01-01 | BARBARA J BARTA | GARTH RYDLAND | 2018-10-12 | |
| 501 | 2016-01-01 | BARBARA J BARTA | GARTH RYDLAND | 2017-07-19 | |
| 501 | 2015-01-01 | BARBARA J BARTA | GARTH RYDLAND | 2016-07-20 | |
| 501 | 2014-01-01 | BARBARA J BARTA | GARTH RYDLAND | 2015-07-27 | |
| 501 | 2013-01-01 | BARBARA J BARTA | GARTH RYDLAND | 2014-07-28 | |
| 501 | 2012-01-01 | BARBARA J BARTA | GREG HANSON | 2013-07-30 | |
| 501 | 2011-01-01 | BARBARA J BARTA | GREG HANSON | 2012-07-31 | |
| 501 | 2010-01-01 | BARBARA J BARTA | GREG HANSON | 2011-07-20 | |
| 501 | 2009-01-01 | BARBARA J BARTA | GREG HANSON | 2010-07-28 |
| 2018: VALLEY MEMORIAL HOMES CAFETERIA 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: VALLEY MEMORIAL HOMES CAFETERIA 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: VALLEY MEMORIAL HOMES CAFETERIA 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: VALLEY MEMORIAL HOMES CAFETERIA 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: VALLEY MEMORIAL HOMES CAFETERIA 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: VALLEY MEMORIAL HOMES CAFETERIA 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: VALLEY MEMORIAL HOMES CAFETERIA 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: VALLEY MEMORIAL HOMES CAFETERIA 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: VALLEY MEMORIAL HOMES CAFETERIA 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: VALLEY MEMORIAL HOMES CAFETERIA PLAN 2009 form 5500 responses | ||
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | This submission is the final filing | No |
| 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 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | KM05931960 |
| Policy instance | 4 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | TS05369145 |
| Policy instance | 3 |
| MEDICA (National Association of Insurance Commissioners NAIC id number: 12459 ) | |
| Policy contract number | 301734 |
| Policy instance | 2 |
| DELTA DENTAL OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 ) | |
| Policy contract number | 359443/629359 |
| Policy instance | 1 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | 0189118 |
| Policy instance | 2 |
| MEDICA (National Association of Insurance Commissioners NAIC id number: 12459 ) | |
| Policy contract number | 301734 |
| Policy instance | 3 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | 0189117 |
| Policy instance | 4 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | TS05369145 |
| Policy instance | 5 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | KM05931960 |
| Policy instance | 6 |
| DELTA DENTAL OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 ) | |
| Policy contract number | 359443/629359 |
| Policy instance | 1 |
| SANFORD HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95683 ) | |
| Policy contract number | HP040155 |
| Policy instance | 1 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 098989 |
| Policy instance | 2 |
| DELTA DENTAL PLAN OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 ) | |
| Policy contract number | 359443/271671 |
| Policy instance | 3 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 098989 |
| Policy instance | 2 |
| SANFORD HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95683 ) | |
| Policy contract number | HP040155 |
| Policy instance | 1 |
| DELTA DENTAL PLAN OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 ) | |
| Policy contract number | 359443/271671 |
| Policy instance | 3 |
| DELTA DENTAL PLAN OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 ) | |
| Policy contract number | 271671 |
| Policy instance | 3 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 098989 |
| Policy instance | 2 |
| BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 ) | |
| Policy contract number | 25521 |
| Policy instance | 1 |
| THE DENTAL SERVICE CORPORATION OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 47054 ) | |
| Policy contract number | 25521 |
| Policy instance | 2 |
| BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 ) | |
| Policy contract number | 25521 |
| Policy instance | 1 |
| LINCOLN MUTUAL LIFE & CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65641 ) | |
| Policy contract number | 2212000 |
| Policy instance | 3 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 098989 |
| Policy instance | 4 |
| LINCOLN MUTUAL LIFE & CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65641 ) | |
| Policy contract number | 2212000 |
| Policy instance | 3 |
| THE DENTAL SERVICE CORPORATION OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 47054 ) | |
| Policy contract number | 25521 |
| Policy instance | 2 |
| BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 ) | |
| Policy contract number | 25521 |
| Policy instance | 1 |
| BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 ) | |
| Policy contract number | 25521 |
| Policy instance | 1 |
| LINCOLN MUTUAL LIFE & CASUALTY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65641 ) | |
| Policy contract number | 2431400 |
| Policy instance | 3 |
| THE DENTAL SERVICE CORPORATION OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 47054 ) | |
| Policy contract number | 25521 |
| Policy instance | 2 |
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