SPARBOE FARMS HEALTH PLAN
|
2021
|
411226123
|
2022-09-15
|
SPARBOE FARMS INC
|
277
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2021-07-01
|
Business code |
112900
|
Sponsor’s telephone number |
3205939639
|
Plan sponsor’s mailing address |
23577 MN HWY 22, PO BOX 309, LITCHFIELD, MN, 553550309
|
Plan sponsor’s
address |
23577 MN HWY 22, PO BOX 309, LITCHFIELD, MN, 553550309
|
Number of participants as of the end of the plan year
Active participants |
206 |
Retired or separated participants receiving
benefits |
4 |
Signature of
Role |
Plan administrator |
Date |
2022-09-15 |
Name of individual signing |
NITA NURMI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-09-15 |
Name of individual signing |
NITA NURMI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SPARBOE FARMS INC GROUP TERM LIFE, VOLUNTARY LIFE, LTD, ADD, STD
|
2020
|
411226123
|
2021-10-14
|
SPARBOE FARMS, INC.
|
281
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2020-07-01
|
Business code |
112900
|
Sponsor’s telephone number |
3205939639
|
Plan sponsor’s mailing address |
23577 MN HWY 22, PO BOX 309, LITCHFIELD, MN, 553550309
|
Plan sponsor’s
address |
23577 MN HWY 22, PO BOX 309, LITCHFIELD, MN, 55355
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-10-14 |
Name of individual signing |
NITA NURMI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-10-14 |
Name of individual signing |
NITA NURMI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SPARBOE FARMS INC GROUP TERM LIFE, VOLUNTARY LIFE, LTD, ADD, STD
|
2020
|
411226123
|
2021-09-30
|
SPARBOE FARMS, INC.
|
281
|
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2020-07-01
|
Business code |
112900
|
Sponsor’s telephone number |
3205939639
|
Plan sponsor’s mailing address |
23577 MN HWY 22, PO BOX 309, LITCHFIELD, MN, 553550309
|
Plan sponsor’s
address |
23577 MN HWY 22, PO BOX 309, LITCHFIELD, MN, 55355
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-09-30 |
Name of individual signing |
NITA NURMI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-09-30 |
Name of individual signing |
NITA NURMI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SPARBOE FARMS INC HEALTH PLAN
|
2020
|
411226123
|
2021-10-01
|
SPARBOE FARMS INC
|
317
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2020-07-01
|
Business code |
112900
|
Sponsor’s telephone number |
3205939639
|
Plan sponsor’s mailing address |
23577 MN HWY 22, PO BOX 309, LITCHFIELD, MN, 553550309
|
Plan sponsor’s
address |
23577 MN HWY 22, PO BOX 309, LITCHFIELD, MN, 553550309
|
Number of participants as of the end of the plan year
Active participants |
277 |
Retired or separated participants receiving
benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2021-10-01 |
Name of individual signing |
NITA NURMI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-10-01 |
Name of individual signing |
NITA NURMI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SPARBOE FARMS INC GROUP TERM LIFE, VOLUNTARY LIFE, LTD, ADD, STD
|
2019
|
411226123
|
2020-10-16
|
SPARBOE FARMS, INC.
|
315
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2019-07-01
|
Business code |
112900
|
Sponsor’s telephone number |
3205939639
|
Plan sponsor’s mailing address |
23577 MN HWY 22, PO BOX 309, LITCHFIELD, MN, 553550309
|
Plan sponsor’s
address |
23577 MN HWY 22, PO BOX 309, LITCHFIELD, MN, 553550309
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2020-10-16 |
Name of individual signing |
NITA NURMI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-10-16 |
Name of individual signing |
NITA NURMI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SPARBOE FARMS INC HEALTH PLAN
|
2019
|
411226123
|
2020-10-16
|
SPARBOE FARMS INC
|
388
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2019-07-01
|
Business code |
112900
|
Sponsor’s telephone number |
3205939639
|
Plan sponsor’s mailing address |
23577 MN HWY 22, PO BOX 309, LITCHFIELD, MN, 553550309
|
Plan sponsor’s
address |
23577 MN HWY 22, PO BOX 309, LITCHFIELD, MN, 553550309
|
Number of participants as of the end of the plan year
Active participants |
317 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2020-10-16 |
Name of individual signing |
NITA NURMI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-10-16 |
Name of individual signing |
NITA NURMI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SPARBOE FARMS INC GROUP TERM LIFE, VOLUNTARY LIFE, LTD, ADD, STD
|
2018
|
411226123
|
2020-10-16
|
SPARBOE FARMS INC
|
569
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2017-07-01
|
Business code |
112900
|
Sponsor’s telephone number |
3205939639
|
Plan sponsor’s mailing address |
23577 MN HWY 22, PO BOX 309, LITCHFIELD, MN, 553550309
|
Plan sponsor’s
address |
23577 MN HWY 22, PO BOX 309, LITCHFIELD, MN, 553550309
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2020-10-16 |
Name of individual signing |
NITA NURMI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-10-16 |
Name of individual signing |
NITA NURMI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SPARBOE FARMS INC GROUP TERM LIFE, VOLUNTARY LIFE, LTD, ADD, STD
|
2018
|
411126123
|
2019-10-29
|
SPARBOE FARMS INC
|
569
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2017-07-01
|
Business code |
112900
|
Sponsor’s telephone number |
3205939639
|
Plan sponsor’s mailing address |
23577 MN HWY 22, PO BOX 309, LITCHFIELD, MN, 553550309
|
Plan sponsor’s
address |
23577 MN HWY 22, PO BOX 309, LITCHFIELD, MN, 553550309
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-10-29 |
Name of individual signing |
NITA NURMI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-10-29 |
Name of individual signing |
NITA NURMI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SPARBOE FARMS INC HEALTH PLAN
|
2018
|
411226123
|
2019-10-29
|
SPARBOE FARMS INC
|
599
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2018-07-01
|
Business code |
112900
|
Sponsor’s telephone number |
3205939639
|
Plan sponsor’s mailing address |
23577 MN HWY 22, PO BOX 309, LITCHFIELD, MN, 553550309
|
Plan sponsor’s
address |
23577 MN HWY 22, PO BOX 309, LITCHFIELD, MN, 553550309
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-10-29 |
Name of individual signing |
NITA NURMI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-10-29 |
Name of individual signing |
NITA NURMI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SPARBOE FARMS INC GROUP TERM LIFE, VOLUNTARY LIFE, LTD, ADD, STD
|
2017
|
411126123
|
2018-12-31
|
SPARBOE FARMS INC
|
462
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2017-07-01
|
Business code |
112900
|
Sponsor’s telephone number |
3205939639
|
Plan sponsor’s mailing address |
23577 MN HWY 22, PO BOX 309, LITCHFIELD, MN, 553550309
|
Plan sponsor’s
address |
23577 MN HWY 22, PO BOX 309, LITCHFIELD, MN, 553550309
|
Number of participants as of the end of the plan year
Active participants |
566 |
Retired or separated participants receiving
benefits |
3 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2018-12-31 |
Name of individual signing |
NITA NURMI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-12-31 |
Name of individual signing |
NITA NURMI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|