BIG STONE THERAPIES, INC. DENTAL PLAN
|
2016
|
454119100
|
2017-06-23
|
BIG STONE THERAPIES, INC.
|
185
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2016-01-01
|
Business code |
621340
|
Sponsor’s telephone number |
3208394087
|
Plan sponsor’s mailing address |
309 WASHINGTON AVE, ORTONVILLE, MN, 562781357
|
Plan sponsor’s
address |
309 WASHINGTON AVE, ORTONVILLE, MN, 562781357
|
Number of participants as of the end of the plan year
Active participants |
222 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2017-06-23 |
Name of individual signing |
SUSAN STENSRUD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-06-23 |
Name of individual signing |
SUSAN STENSRUD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BIG STONE THERAPIES, INC. HEALTH PLAN
|
2016
|
454119100
|
2017-06-23
|
BIG STONE THERAPIES, INC.
|
162
|
|
File |
View Page
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
2016-01-01
|
Business code |
621340
|
Sponsor’s telephone number |
3208394087
|
Plan sponsor’s mailing address |
309 WASHINGTON AVE, ORTONVILLE, MN, 562781357
|
Plan sponsor’s
address |
309 WASHINGTON AVE, ORTONVILLE, MN, 562781357
|
Plan administrator’s name and address
Administrator’s EIN |
161264154 |
Plan administrator’s name |
MERETAIN HEALTH |
Plan administrator’s
address |
PO BOX 27337, LANSING, MI, 489097337 |
Administrator’s telephone number |
3208394087 |
Number of participants as of the end of the plan year
Active participants |
188 |
Retired or separated participants receiving
benefits |
4 |
Signature of
Role |
Plan administrator |
Date |
2017-06-23 |
Name of individual signing |
SUSAN STENSRUD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-06-23 |
Name of individual signing |
SUSAN STENSRUD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BIG STONE THERAPIES, INC. VISION PLAN
|
2016
|
454119100
|
2017-06-23
|
BIG STONE THERAPIES, INC.
|
107
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2016-01-01
|
Business code |
621340
|
Sponsor’s telephone number |
3208394087
|
Plan sponsor’s mailing address |
309 WASHINGTON AVE, ORTONVILLE, MN, 562781357
|
Plan sponsor’s
address |
309 WASHINGTON AVE, ORTONVILLE, MN, 562781357
|
Number of participants as of the end of the plan year
Active participants |
134 |
Retired or separated participants receiving
benefits |
1 |
Signature of
Role |
Plan administrator |
Date |
2017-06-23 |
Name of individual signing |
SUSAN STENSRUD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-06-23 |
Name of individual signing |
SUSAN STENSRUD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BIG STONE THERAPIES INC
|
2015
|
454119100
|
2016-07-31
|
BIG STONE THERAPIES, INC.
|
161
|
|
File |
View Page
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
2015-01-01
|
Business code |
621340
|
Sponsor’s telephone number |
3208394087
|
Plan sponsor’s mailing address |
309 WASHINGTON AVE, ORTONVILLE, MN, 562781357
|
Plan sponsor’s
address |
309 WASHINGTON AVE, ORTONVILLE, MN, 562781357
|
Plan administrator’s name and address
Administrator’s EIN |
161264154 |
Plan administrator’s name |
MERITAIN HEALTH |
Plan administrator’s
address |
PO BOX 27337, LANSING, MI, 489097337 |
Administrator’s telephone number |
3208394087 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-07-31 |
Name of individual signing |
HEATHER ZINTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-07-31 |
Name of individual signing |
HEATHER ZINTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BIG STONE THERAPIES, INC. DENTAL PLAN
|
2015
|
454119100
|
2016-07-31
|
BIG STONE THERAPIES, INC.
|
181
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2015-01-01
|
Business code |
621340
|
Sponsor’s telephone number |
3208394087
|
Plan sponsor’s mailing address |
309 WASHINGTON AVE, ORTONVILLE, MN, 562781357
|
Plan sponsor’s
address |
309 WASHINGTON AVE, ORTONVILLE, MN, 562781357
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-07-31 |
Name of individual signing |
HEATHER ZINTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-07-31 |
Name of individual signing |
HEATHER ZINTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BIG STONE THERAPIES, INC. VISION PLAN
|
2015
|
454119100
|
2016-07-31
|
BIG STONE THERAPIES, INC.
|
94
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2015-01-01
|
Business code |
621340
|
Sponsor’s telephone number |
3208394087
|
Plan sponsor’s mailing address |
309 WASHINGTON AVE, ORTONVILLE, MN, 562781357
|
Plan sponsor’s
address |
309 WASHINGTON AVE, ORTONVILLE, MN, 562781357
|
Number of participants as of the end of the plan year
Active participants |
106 |
Retired or separated participants receiving
benefits |
1 |
Signature of
Role |
Plan administrator |
Date |
2016-07-31 |
Name of individual signing |
HEATHER ZINTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-07-31 |
Name of individual signing |
HEATHER ZINTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BIG STONE THERAPIES, INC. DENTAL PLAN
|
2014
|
454119100
|
2015-07-31
|
BIG STONE THERAPIES, INC.
|
162
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2014-01-01
|
Business code |
621340
|
Sponsor’s telephone number |
3208394087
|
Plan sponsor’s mailing address |
309 WASHINGTON AVE, ORTONVILLE, MN, 56278
|
Plan sponsor’s
address |
309 WASHINGTON AVE, ORTONVILLE, MN, 56278
|
Number of participants as of the end of the plan year
Active participants |
180 |
Retired or separated participants receiving
benefits |
1 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-07-31 |
Name of individual signing |
HEATHER ZINTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-07-31 |
Name of individual signing |
HEATHER ZINTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BIG STONE THERAPIES, INC. VISION PLAN
|
2014
|
454119100
|
2015-07-31
|
BIG STONE THERAPIES, INC.
|
79
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2014-01-01
|
Business code |
621340
|
Sponsor’s telephone number |
3208394087
|
Plan sponsor’s mailing address |
309 WASHINGTON AVE, ORTONVILLE, MN, 56278
|
Plan sponsor’s
address |
309 WASHINGTON AVE, ORTONVILLE, MN, 56278
|
Number of participants as of the end of the plan year
Active participants |
93 |
Retired or separated participants receiving
benefits |
1 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-07-31 |
Name of individual signing |
HEATHER ZINTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-07-31 |
Name of individual signing |
HEATHER ZINTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BIG STONE THERAPIES, INC. HEALTH PLAN
|
2014
|
454119100
|
2015-07-31
|
BIG STONE THERAPIES, INC.
|
160
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2014-01-01
|
Business code |
621340
|
Sponsor’s telephone number |
3208394087
|
Plan sponsor’s mailing address |
309 WASHINGTON AVE, ORTONVILLE, MN, 56278
|
Plan sponsor’s
address |
309 WASHINGTON AVE, ORTONVILLE, MN, 56278
|
Number of participants as of the end of the plan year
Active participants |
161 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-07-31 |
Name of individual signing |
HEATHER ZINTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-07-31 |
Name of individual signing |
HEATHER ZINTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|