GEMINI INC LIFE INSURANCE
|
2018
|
410854683
|
2019-06-25
|
GEMINI INCORPORATED
|
579
|
|
File |
View Page
|
Three-digit plan number (PN) |
526
|
Effective date of plan |
1969-01-01
|
Business code |
326100
|
Sponsor’s telephone number |
5072633957
|
Plan sponsor’s mailing address |
103 MENSING WAY, CANNON FALLS, MN, 550091143
|
Plan sponsor’s
address |
103 MENSING WAY, CANNON FALLS, MN, 550091143
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-06-25 |
Name of individual signing |
PHILIP JACOBSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-06-25 |
Name of individual signing |
PHILIP JACOBSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GEMINI INC MEDICAL PLAN
|
2018
|
410854683
|
2019-06-20
|
GEMINI INCORPORATED
|
511
|
|
File |
View Page
|
Three-digit plan number (PN) |
528
|
Effective date of plan |
1969-01-01
|
Business code |
326100
|
Sponsor’s telephone number |
5072633957
|
Plan sponsor’s mailing address |
103 MENSING WAY, CANNON FALLS, MN, 550091143
|
Plan sponsor’s
address |
103 MENSING WAY, CANNON FALLS, MN, 550091143
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-06-20 |
Name of individual signing |
PHILIP JACOBSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-06-20 |
Name of individual signing |
PHILIP JACOBSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GEMINI INC. DENTAL PLAN
|
2018
|
410854683
|
2019-06-20
|
GEMINI INCORPORATED
|
505
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1989-01-01
|
Business code |
326100
|
Sponsor’s telephone number |
5072633957
|
Plan sponsor’s mailing address |
103 MENSING WAY, CANNON FALLS, MN, 550091143
|
Plan sponsor’s
address |
103 MENSING WAY, CANNON FALLS, MN, 550091143
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-06-20 |
Name of individual signing |
PHILIP JACOBSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-06-20 |
Name of individual signing |
PHILIP JACOBSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GEMINI INCORPORATED VISION PLAN
|
2018
|
410854683
|
2019-06-20
|
GEMINI INCORPORATED
|
349
|
|
File |
View Page
|
Three-digit plan number (PN) |
530
|
Effective date of plan |
2018-01-01
|
Business code |
326100
|
Sponsor’s telephone number |
5072633957
|
Plan sponsor’s mailing address |
103 MENSING WAY, CANNON FALLS, MN, 550091143
|
Plan sponsor’s
address |
103 MENSING WAY, CANNON FALLS, MN, 550091143
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-06-20 |
Name of individual signing |
PHILIP JACOBSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-06-20 |
Name of individual signing |
PHILIP JACOBSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GEMINI INCORPORATED FLEXIBLE SPENDING ACCOUNT PLAN
|
2018
|
410854683
|
2019-06-20
|
GEMINI INCORPORATED
|
247
|
|
File |
View Page
|
Three-digit plan number (PN) |
525
|
Effective date of plan |
1990-08-01
|
Business code |
326100
|
Sponsor’s telephone number |
5072633957
|
Plan sponsor’s mailing address |
103 MENSING WAY, CANNON FALLS, MN, 550091143
|
Plan sponsor’s
address |
103 MENSING WAY, CANNON FALLS, MN, 550091143
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-06-20 |
Name of individual signing |
PHILIP JACOBSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-06-20 |
Name of individual signing |
PHILIP JACOBSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GEMINI INC LTD
|
2018
|
410854683
|
2019-06-20
|
GEMINI INCORPORATED
|
469
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
1996-10-01
|
Business code |
326100
|
Sponsor’s telephone number |
5072633957
|
Plan sponsor’s mailing address |
103 MENSING WAY, CANNON FALLS, MN, 550091143
|
Plan sponsor’s
address |
103 MENSING WAY, CANNON FALLS, MN, 550091143
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-06-20 |
Name of individual signing |
PHILIP JACOBSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-06-20 |
Name of individual signing |
PHILIP JACOBSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GEMINI INC LIFE INSURANCE
|
2018
|
410854683
|
2019-06-20
|
GEMINI INCORPORATED
|
579
|
|
Three-digit plan number (PN) |
526
|
Effective date of plan |
1969-01-01
|
Business code |
326100
|
Sponsor’s telephone number |
5072633957
|
Plan sponsor’s mailing address |
103 MENSING WAY, CANNON FALLS, MN, 550091143
|
Plan sponsor’s
address |
103 MENSING WAY, CANNON FALLS, MN, 550091143
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-06-20 |
Name of individual signing |
PHILIP JACOBSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-06-20 |
Name of individual signing |
PHILIP JACOBSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GEMINI INC LIFE INSURANCE
|
2017
|
410854683
|
2018-06-01
|
GEMINI INCORPORATED
|
570
|
|
File |
View Page
|
Three-digit plan number (PN) |
526
|
Effective date of plan |
1969-01-01
|
Business code |
326100
|
Sponsor’s telephone number |
5072633957
|
Plan sponsor’s mailing address |
103 MENSING WAY, CANNON FALLS, MN, 550091143
|
Plan sponsor’s
address |
103 MENSING WAY, CANNON FALLS, MN, 550091143
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2018-05-31 |
Name of individual signing |
PHILIP JACOBSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-05-31 |
Name of individual signing |
PHILIP JACOBSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GEMINI INCORPORATED FLEXIBLE SPENDING ACCOUNT PLAN
|
2017
|
410854683
|
2018-06-01
|
GEMINI INCORPORATED
|
202
|
|
File |
View Page
|
Three-digit plan number (PN) |
525
|
Effective date of plan |
1990-08-01
|
Business code |
326100
|
Sponsor’s telephone number |
5072633957
|
Plan sponsor’s mailing address |
103 MENSING WAY, CANNON FALLS, MN, 550091143
|
Plan sponsor’s
address |
103 MENSING WAY, CANNON FALLS, MN, 550091143
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2018-05-31 |
Name of individual signing |
PHILIP JACOBSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-05-31 |
Name of individual signing |
PHILIP JACOBSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GEMINI INC MEDICAL PLAN
|
2017
|
410854683
|
2018-06-01
|
GEMINI INCORPORATED
|
488
|
|
File |
View Page
|
Three-digit plan number (PN) |
528
|
Effective date of plan |
1969-01-01
|
Business code |
326100
|
Sponsor’s telephone number |
5072633957
|
Plan sponsor’s mailing address |
103 MENSING WAY, CANNON FALLS, MN, 550091143
|
Plan sponsor’s
address |
103 MENSING WAY, CANNON FALLS, MN, 550091143
|
Number of participants as of the end of the plan year
Active participants |
509 |
Retired or separated participants receiving
benefits |
2 |
Signature of
Role |
Plan administrator |
Date |
2018-05-31 |
Name of individual signing |
PHILIP JACOBSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-05-31 |
Name of individual signing |
PHILIP JACOBSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|