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| Plan Name | POLARIS EMPLOYEE BENEFITS PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | POLARIS ENGINEERING, INC. |
| Employer identification number (EIN): | 721390948 |
| NAIC Classification: | 237100 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2023-10-01 | CONNIE NODIER | |||
| 501 | 2022-10-01 | ||||
| 501 | 2022-10-01 | CONNIE NODIER | |||
| 501 | 2021-10-01 | ||||
| 501 | 2021-10-01 | CONNIE NODIER | |||
| 501 | 2020-10-01 |
| 2022: POLARIS EMPLOYEE BENEFITS PLAN 2022 form 5500 responses | ||
|---|---|---|
| 2022-10-01 | Type of plan entity | Single employer plan |
| 2022-10-01 | Submission has been amended | No |
| 2022-10-01 | This submission is the final filing | No |
| 2022-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-10-01 | Plan is a collectively bargained plan | No |
| 2022-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: POLARIS EMPLOYEE BENEFITS PLAN 2021 form 5500 responses | ||
| 2021-10-01 | Type of plan entity | Single employer plan |
| 2021-10-01 | Submission has been amended | No |
| 2021-10-01 | This submission is the final filing | No |
| 2021-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-10-01 | Plan is a collectively bargained plan | No |
| 2021-10-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: POLARIS EMPLOYEE BENEFITS PLAN 2020 form 5500 responses | ||
| 2020-10-01 | Type of plan entity | Single employer plan |
| 2020-10-01 | First time form 5500 has been submitted | Yes |
| 2020-10-01 | Submission has been amended | No |
| 2020-10-01 | This submission is the final filing | No |
| 2020-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-10-01 | Plan is a collectively bargained plan | No |
| 2020-10-01 | Plan funding arrangement – Insurance | Yes |
| 2020-10-01 | Plan benefit arrangement – Insurance | Yes |
| NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 ) | |
| Policy contract number | 660660 |
| Policy instance | 12 |
| BLUE CROSS AND BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 ) | |
| Policy contract number | 78250ERC |
| Policy instance | 1 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | 136-421039 |
| Policy instance | 2 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | 136-421039 |
| Policy instance | 3 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | GL 149766 |
| Policy instance | 4 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | GL 160391 |
| Policy instance | 5 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | VAI 826914 |
| Policy instance | 6 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | VAR 208507 |
| Policy instance | 7 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | VCI 801738 |
| Policy instance | 8 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | VPL 301062 |
| Policy instance | 9 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | VPS 325970 |
| Policy instance | 10 |
| NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 ) | |
| Policy contract number | 660660 |
| Policy instance | 11 |
| NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 ) | |
| Policy contract number | 660660 |
| Policy instance | 11 |
| NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 ) | |
| Policy contract number | 660660 |
| Policy instance | 10 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | VPS 325970 |
| Policy instance | 9 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | VPL 301062 |
| Policy instance | 8 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | VCI 801738 |
| Policy instance | 7 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | VAR 208507 |
| Policy instance | 6 |
| BLUE CROSS AND BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 ) | |
| Policy contract number | 78250ERC |
| Policy instance | 1 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | 136421039 |
| Policy instance | 2 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | GL 149766 |
| Policy instance | 3 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | GL 160391 |
| Policy instance | 4 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | VAI 826914 |
| Policy instance | 5 |
| NORTHWESTERN MUTUAL (National Association of Insurance Commissioners NAIC id number: 67091 ) | |
| Policy contract number | 660660 |
| Policy instance | 2 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | 136-421039 |
| Policy instance | 3 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | GL 149766 |
| Policy instance | 4 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | GL 160391 |
| Policy instance | 5 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | VAI 826914 |
| Policy instance | 6 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | VAR 208507 |
| Policy instance | 7 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | VCI 801738 |
| Policy instance | 8 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | VPL 301062 |
| Policy instance | 9 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 ) | |
| Policy contract number | VPS 325970 |
| Policy instance | 10 |
| BLUE CROSS BLUE SHIELD OF LOUISIANA (National Association of Insurance Commissioners NAIC id number: 81200 ) | |
| Policy contract number | 78250ERC |
| Policy instance | 1 |
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