COBORN'S INCORPORATED SHORT-TERM DISABILITY PLAN
|
2016
|
410824910
|
2018-07-30
|
COBORN'S INCORPORATED
|
2546
|
|
File |
View Page
|
Three-digit plan number (PN) |
508
|
Effective date of plan |
2006-06-01
|
Business code |
445110
|
Sponsor’s telephone number |
3202524222
|
Plan sponsor’s mailing address |
PO BOX 6146, ST. CLOUD, MN, 56302
|
Plan sponsor’s
address |
1921 COBORN BLVD, ST. CLOUD, MN, 56301
|
Number of participants as of the end of the plan year
Active participants |
0 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2018-07-30 |
Name of individual signing |
SHEILA JOVANOVICH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
COBORN'S INCORPORATED LONG-TERM DISABILITY PLAN
|
2016
|
410824910
|
2017-07-31
|
COBORN'S INCORPORATED
|
2546
|
|
File |
View Page
|
Three-digit plan number (PN) |
507
|
Effective date of plan |
2006-06-01
|
Business code |
445110
|
Sponsor’s telephone number |
3202524222
|
Plan sponsor’s mailing address |
PO BOX 6146, ST. CLOUD, MN, 56302
|
Plan sponsor’s
address |
1921 COBORN BLVD, ST. CLOUD, MN, 56301
|
Number of participants as of the end of the plan year
Active participants |
2422 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2017-07-31 |
Name of individual signing |
SHEILA JOVANOVICH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
COBORN'S INCORPORATED LIFE INSURANCE PLAN
|
2016
|
410824910
|
2017-07-31
|
COBORN'S INCORPORATED
|
2553
|
|
File |
View Page
|
Three-digit plan number (PN) |
506
|
Effective date of plan |
2006-06-01
|
Business code |
445110
|
Sponsor’s telephone number |
3202524222
|
Plan sponsor’s mailing address |
PO BOX 6146, ST. CLOUD, MN, 56302
|
Plan sponsor’s
address |
1921 COBORN BLVD, ST. CLOUD, MN, 56301
|
Number of participants as of the end of the plan year
Active participants |
2422 |
Retired or separated participants receiving
benefits |
20 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2017-07-31 |
Name of individual signing |
SHEILA JOVANOVICH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
COBORN'S INCORPORATED HEALTH AND WELFARE PLAN
|
2016
|
410824910
|
2017-07-31
|
COBORN'S INCORPORATED
|
2122
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1985-12-01
|
Business code |
445110
|
Sponsor’s telephone number |
3202524222
|
Plan sponsor’s mailing address |
PO BOX 6146, ST. CLOUD, MN, 56302
|
Plan sponsor’s
address |
1921 COBORN BLVD, ST. CLOUD, MN, 56301
|
Number of participants as of the end of the plan year
Active participants |
1988 |
Retired or separated participants receiving
benefits |
30 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2017-07-31 |
Name of individual signing |
SHEILA JOVANOVICH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
COBORN'S INCORPORATED DENTAL PLAN
|
2016
|
410824910
|
2017-07-31
|
COBORN'S INCORPORATED
|
2116
|
|
File |
View Page
|
Three-digit plan number (PN) |
509
|
Effective date of plan |
2006-12-01
|
Business code |
445110
|
Sponsor’s telephone number |
3202524222
|
Plan sponsor’s mailing address |
PO BOX 6146, ST. CLOUD, MN, 56302
|
Plan sponsor’s
address |
1921 COBORN BLVD, ST. CLOUD, MN, 56301
|
Number of participants as of the end of the plan year
Active participants |
2060 |
Retired or separated participants receiving
benefits |
19 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2017-07-31 |
Name of individual signing |
SHEILA JOVANOVICH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
COBORN'S INCORPORATED SHORT-TERM DISABILITY PLAN
|
2016
|
410824910
|
2017-07-31
|
COBORN'S INCORPORATED
|
2546
|
|
Three-digit plan number (PN) |
508
|
Effective date of plan |
2006-06-01
|
Business code |
445110
|
Sponsor’s telephone number |
3202524222
|
Plan sponsor’s mailing address |
PO BOX 6146, ST. CLOUD, MN, 56302
|
Plan sponsor’s
address |
1921 COBORN BLVD, ST. CLOUD, MN, 56301
|
Number of participants as of the end of the plan year
Active participants |
2422 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2017-07-31 |
Name of individual signing |
SHEILA JOVANOVICH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
COBORN'S INC GROUP VISION CARE PLAN
|
2016
|
410824910
|
2017-07-31
|
COBORN'S INCORPORATED
|
1519
|
|
File |
View Page
|
Three-digit plan number (PN) |
526
|
Effective date of plan |
2015-01-01
|
Business code |
445110
|
Sponsor’s telephone number |
3202524222
|
Plan sponsor’s mailing address |
PO BOX 6146, ST. CLOUD, MN, 56302
|
Plan sponsor’s
address |
1921 COBORN BLVD, ST. CLOUD, MN, 56301
|
Number of participants as of the end of the plan year
Active participants |
1476 |
Retired or separated participants receiving
benefits |
19 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2017-07-31 |
Name of individual signing |
SHEILA JOVANOVICH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
COBORN'S INC FLEXIBLE BENEFIT PLAN
|
2016
|
410824910
|
2017-07-31
|
COBORN'S INCORPORATED
|
479
|
|
File |
View Page
|
Three-digit plan number (PN) |
525
|
Effective date of plan |
1994-03-01
|
Business code |
445110
|
Sponsor’s telephone number |
3202524222
|
Plan sponsor’s mailing address |
PO BOX 6146, ST. CLOUD, MN, 56302
|
Plan sponsor’s
address |
1921 COBORN BLVD, ST. CLOUD, MN, 56301
|
Number of participants as of the end of the plan year
Active participants |
455 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2017-07-31 |
Name of individual signing |
SHEILA JOVANOVICH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
COBORN'S INCORPORATED SHORT-TERM DISABILITY PLAN
|
2015
|
410824910
|
2016-10-10
|
COBORN'S INCORPORATED
|
2142
|
|
File |
View Page
|
Three-digit plan number (PN) |
508
|
Effective date of plan |
2006-06-01
|
Business code |
445110
|
Sponsor’s telephone number |
3202524222
|
Plan sponsor’s mailing address |
PO BOX 6146, ST. CLOUD, MN, 56302
|
Plan sponsor’s
address |
1921 COBORN BLVD, ST. CLOUD, MN, 56301
|
Number of participants as of the end of the plan year
Active participants |
2525 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2016-10-10 |
Name of individual signing |
SHEILA JOVANOVICH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
COBORN'S INCORPORATED LONG-TERM DISABILITY PLAN
|
2015
|
410824910
|
2016-10-10
|
COBORN'S INCORPORATED
|
2142
|
|
File |
View Page
|
Three-digit plan number (PN) |
507
|
Effective date of plan |
2006-06-01
|
Business code |
445110
|
Sponsor’s telephone number |
3202524222
|
Plan sponsor’s mailing address |
PO BOX 6146, ST. CLOUD, MN, 56302
|
Plan sponsor’s
address |
1921 COBORN BLVD, ST. CLOUD, MN, 56301
|
Number of participants as of the end of the plan year
Active participants |
2525 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2016-10-10 |
Name of individual signing |
SHEILA JOVANOVICH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|