HEALTH CARE PLAN
|
2018
|
410971937
|
2019-07-15
|
FREDRIKSON & BYRON, P.A.
|
476
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1992-01-01
|
Business code |
541110
|
Sponsor’s telephone number |
6124927599
|
Plan sponsor’s mailing address |
200 S 6TH ST STE 4000, MINNEAPOLIS, MN, 554021425
|
Plan sponsor’s
address |
200 S 6TH ST STE 4000, MINNEAPOLIS, MN, 554021425
|
Number of participants as of the end of the plan year
Active participants |
475 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2019-07-15 |
Name of individual signing |
SHELLEY CARTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HEALTH CARE PLAN
|
2016
|
410971937
|
2017-08-31
|
FREDRIKSON & BYRON, P.A.
|
462
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1992-01-01
|
Business code |
541110
|
Sponsor’s telephone number |
6124927599
|
Plan sponsor’s mailing address |
200 S 6TH ST, MINNEAPOLIS, MN, 554021403
|
Plan sponsor’s
address |
200 S 6TH ST, MINNEAPOLIS, MN, 554021403
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-08-31 |
Name of individual signing |
NANCY SCHULTZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-08-31 |
Name of individual signing |
NANCY SCHULTZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EMPLOYEE ASSISTANCE PROGRAM
|
2016
|
410971937
|
2017-08-31
|
FREDRIKSON & BYRON, P.A.
|
561
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
1979-07-07
|
Business code |
541110
|
Sponsor’s telephone number |
6124927599
|
Plan sponsor’s mailing address |
200 S 6TH ST, MINNEAPOLIS, MN, 554021403
|
Plan sponsor’s
address |
200 S 6TH ST, MINNEAPOLIS, MN, 554021403
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-08-31 |
Name of individual signing |
NANCY SCHULTZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-08-31 |
Name of individual signing |
NANCY SCHULTZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHORT TERM DISABILITY
|
2016
|
410971937
|
2017-08-31
|
FREDRIKSON & BYRON, P.A.
|
256
|
|
File |
View Page
|
Three-digit plan number (PN) |
506
|
Effective date of plan |
2005-01-01
|
Business code |
541110
|
Plan sponsor’s mailing address |
200 S 6TH ST STE 4000, MINNEAPOLIS, MN, 554021431
|
Plan sponsor’s
address |
200 S 6TH ST STE 4000, MINNEAPOLIS, MN, 554021431
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-08-31 |
Name of individual signing |
NANCY SCHULTZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-08-31 |
Name of individual signing |
NANCY SCHULTZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LONG TERM DISABILITY
|
2016
|
410971937
|
2017-08-31
|
FREDRIKSON & BYRON, P.A.
|
512
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2005-01-01
|
Business code |
541110
|
Plan sponsor’s mailing address |
200 S 6TH ST STE 4000, MINNEAPOLIS, MN, 554021431
|
Plan sponsor’s
address |
200 S 6TH ST STE 4000, MINNEAPOLIS, MN, 554021431
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-08-31 |
Name of individual signing |
NANCY SCHULTZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-08-31 |
Name of individual signing |
NANCY SCHULTZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP TERM LIFE INSURANCE
|
2016
|
410971937
|
2017-08-31
|
FREDRIKSON & BYRON, P.A.
|
520
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2005-01-01
|
Business code |
541110
|
Plan sponsor’s mailing address |
200 S 6TH ST STE 4000, MINNEAPOLIS, MN, 554021431
|
Plan sponsor’s
address |
200 S 6TH ST STE 4000, MINNEAPOLIS, MN, 554021431
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-08-31 |
Name of individual signing |
NANCY SCHULTZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-08-31 |
Name of individual signing |
NANCY SCHULTZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|