IMPRESSIONS INCORPORATED FLEXIBLE BENEFIT PLAN
|
2020
|
410916667
|
2021-07-28
|
IMPRESSIONS INCORPORATED
|
215
|
|
File |
View Page
|
Three-digit plan number (PN) |
507
|
Effective date of plan |
1991-10-01
|
Business code |
322200
|
Sponsor’s telephone number |
6516461050
|
Plan sponsor’s mailing address |
1050 WESTGATE DR, SAINT PAUL, MN, 551141067
|
Plan sponsor’s
address |
1050 WESTGATE DR, SAINT PAUL, MN, 551141067
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-07-28 |
Name of individual signing |
SUE SUTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-07-28 |
Name of individual signing |
SUE SUTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
IMPRESSIONS INCORPORATED GROUP LIFE & ACCIDENT & SICKNESS PLAN
|
2020
|
410916667
|
2021-07-28
|
IMPRESSIONS INCORPORATED
|
245
|
|
File |
View Page
|
Three-digit plan number (PN) |
511
|
Effective date of plan |
1989-01-01
|
Business code |
322200
|
Sponsor’s telephone number |
6516461050
|
Plan sponsor’s mailing address |
1050 WESTGATE DR, SAINT PAUL, MN, 551141067
|
Plan sponsor’s
address |
1050 WESTGATE DR, SAINT PAUL, MN, 551141067
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-07-28 |
Name of individual signing |
SUE SUTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-07-28 |
Name of individual signing |
SUE SUTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
IMPRESSIONS INCORPORATED GROUP DENTAL PLAN
|
2020
|
410916667
|
2021-03-04
|
IMPRESSIONS INCORPORATED
|
202
|
|
File |
View Page
|
Three-digit plan number (PN) |
510
|
Effective date of plan |
1997-01-01
|
Business code |
322200
|
Sponsor’s telephone number |
6516461050
|
Plan sponsor’s mailing address |
1050 WESTGATE DR, SAINT PAUL, MN, 551141067
|
Plan sponsor’s
address |
1050 WESTGATE DR, SAINT PAUL, MN, 551141067
|
Plan administrator’s name and address
Administrator’s EIN |
410916667 |
Plan administrator’s name |
IMPRESSIONS INCORPORATED |
Plan administrator’s
address |
1050 WESTGATE DR, SAINT PAUL, MN, 551141067 |
Administrator’s telephone number |
6516461050 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-03-04 |
Name of individual signing |
STEVEN HOLUPCHINSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-03-04 |
Name of individual signing |
STEVEN HOLUPCHINSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
IMPRESSIONS INCORPORATED FLEXIBLE BENEFIT PLAN
|
2019
|
410916667
|
2020-04-29
|
IMPRESSIONS INCORPORATED
|
224
|
|
File |
View Page
|
Three-digit plan number (PN) |
507
|
Effective date of plan |
1991-10-01
|
Business code |
322200
|
Sponsor’s telephone number |
6516461050
|
Plan sponsor’s mailing address |
1050 WESTGATE DR, SAINT PAUL, MN, 551141067
|
Plan sponsor’s
address |
1050 WESTGATE DR, SAINT PAUL, MN, 551141067
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2020-04-29 |
Name of individual signing |
STEVEN HOLUPCHINSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-04-29 |
Name of individual signing |
STEVEN HOLUPCHINSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
IMPRESSIONS INCORPORATED GROUP DENTAL PLAN
|
2019
|
410916667
|
2020-04-29
|
IMPRESSIONS INCORPORATED
|
210
|
|
File |
View Page
|
Three-digit plan number (PN) |
510
|
Effective date of plan |
1997-01-01
|
Business code |
322200
|
Sponsor’s telephone number |
6516461050
|
Plan sponsor’s mailing address |
1050 WESTGATE DR, SAINT PAUL, MN, 551141067
|
Plan sponsor’s
address |
1050 WESTGATE DR, SAINT PAUL, MN, 551141067
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2020-04-29 |
Name of individual signing |
STEVEN HOLUPCHINSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-04-29 |
Name of individual signing |
STEVEN HOLUPCHINSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
IMPRESSIONS INCORPORATED GROUP LIFE & ACCIDENT & SICKNESS PLAN
|
2019
|
410916667
|
2020-04-28
|
IMPRESSIONS INCORPORATED
|
256
|
|
File |
View Page
|
Three-digit plan number (PN) |
511
|
Effective date of plan |
1989-01-01
|
Business code |
322200
|
Sponsor’s telephone number |
6516461050
|
Plan sponsor’s mailing address |
1050 WESTGATE DR, SAINT PAUL, MN, 551141067
|
Plan sponsor’s
address |
1050 WESTGATE DR, SAINT PAUL, MN, 551141067
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2020-04-28 |
Name of individual signing |
STEVEN HOLUPCHINSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-04-28 |
Name of individual signing |
STEVEN HOLUPCHINSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
IMPRESSIONS INCORPORATED MEDICAL PLAN
|
2018
|
410916667
|
2020-04-28
|
IMPRESSIONS INCORPORATED
|
208
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1999-11-01
|
Business code |
322200
|
Sponsor’s telephone number |
6516461050
|
Plan sponsor’s mailing address |
1050 WESTGATE DR, SAINT PAUL, MN, 551141067
|
Plan sponsor’s
address |
1050 WESTGATE DR, SAINT PAUL, MN, 551141067
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2020-04-28 |
Name of individual signing |
STEVEN HOLUPCHINSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-04-28 |
Name of individual signing |
STEVEN HOLUPCHINSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
IMPRESSIONS INC. MEDICAL PLAN
|
2018
|
410916667
|
2019-05-17
|
IMPRESSIONS INCORPORATED
|
201
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1999-11-01
|
Business code |
322200
|
Sponsor’s telephone number |
6516461050
|
Plan sponsor’s mailing address |
1050 WESTGATE DR, SAINT PAUL, MN, 551141067
|
Plan sponsor’s
address |
1050 WESTGATE DR, SAINT PAUL, MN, 551141067
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-05-17 |
Name of individual signing |
STEVEN HOLUPCHINSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-05-17 |
Name of individual signing |
STEVEN HOLUPCHINSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
IMPRESSIONS INCORPORATED GROUP DENTAL PLAN
|
2018
|
410916667
|
2019-05-20
|
IMPRESSIONS INCORPORATED
|
192
|
|
File |
View Page
|
Three-digit plan number (PN) |
510
|
Effective date of plan |
2018-12-31
|
Business code |
322200
|
Sponsor’s telephone number |
6516461050
|
Plan sponsor’s mailing address |
1050 WESTGATE DR, SAINT PAUL, MN, 551141067
|
Plan sponsor’s
address |
1050 WESTGATE DR, SAINT PAUL, MN, 551141067
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-05-20 |
Name of individual signing |
STEVEN HOLUPCHINSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-05-20 |
Name of individual signing |
STEVEN HOLUPCHINSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
IMPRESSIONS INCORPORATED FLEXIBLE BENEFIT PLAN
|
2018
|
410916667
|
2019-05-20
|
IMPRESSIONS INCORPORATED
|
224
|
|
File |
View Page
|
Three-digit plan number (PN) |
507
|
Effective date of plan |
1991-10-01
|
Business code |
322200
|
Sponsor’s telephone number |
6516461050
|
Plan sponsor’s mailing address |
1050 WESTGATE DR, SAINT PAUL, MN, 551141067
|
Plan sponsor’s
address |
1050 WESTGATE DR, SAINT PAUL, MN, 551141067
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-05-20 |
Name of individual signing |
STEVEN HOLUPCHINSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-05-20 |
Name of individual signing |
STEVEN HOLUPCHINSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|