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  5. Healthsource Midwest America, LLC

Healthsource Midwest America, LLC

Company Details

Name: Healthsource Midwest America, LLC
Jurisdiction: Minnesota
Legal type: Limited Liability Company (Domestic)
Status: Active / In Good Standing
Date formed: 15 Sep 2010 (14 years ago)
Company Number: 64d5fe7d-96d4-e011-a886-001ec94ffe7f
File Number: 3984610-2
Registered Office Address: 1090 Wildhurst Trail, Orono, MN 55364, USA
Principal Executive Office Address: 1090 WILDHURST TRL, MOUND, MN 55364–9639, USA
ZIP code: 55364
County: Hennepin County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
HEALTHSOURCE MIDWEST AMERICA, LLC 401(K) PLAN 2023 273540876 2024-07-30 HEALTHSOURCE MIDWEST AMERICA, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621310
Sponsor’s telephone number 6122812797
Plan sponsor’s address 1090 WILDHURST TRAIL, ORONO, MN, 55364
HEALTHSOURCE MIDWEST AMERICA, LLC 401(K) PLAN 2022 273540876 2023-07-25 HEALTHSOURCE MIDWEST AMERICA, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621310
Sponsor’s telephone number 6122812797
Plan sponsor’s address 1090 WILDHURST TRAIL, ORONO, MN, 55364
HEALTHSOURCE MIDWEST AMERICA, LLC 401(K) PLAN 2021 273540876 2022-07-20 HEALTHSOURCE MIDWEST AMERICA, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621310
Sponsor’s telephone number 6122812797
Plan sponsor’s address 1090 WILDHURST TRAIL, ORONO, MN, 55364
HEALTHSOURCE MIDWEST AMERICA, LLC 401(K) PLAN 2020 273540876 2021-08-02 HEALTHSOURCE MIDWEST AMERICA, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621310
Sponsor’s telephone number 6122812797
Plan sponsor’s address 1090 WILDHURST TRAIL, ORONO, MN, 55364
HEALTHSOURCE MIDWEST AMERICA, LLC 401(K) PLAN 2019 273540876 2020-07-15 HEALTHSOURCE MIDWEST AMERICA, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621310
Sponsor’s telephone number 6122812797
Plan sponsor’s address 7205 BUCKSKIN TR., CORCORAN, MN, 55340
HEALTHSOURCE MIDWEST AMERICA, LLC 401(K) PLAN 2018 273540876 2019-09-26 HEALTHSOURCE MIDWEST AMERICA, LLC 4
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621310
Sponsor’s telephone number 6122812797
Plan sponsor’s address 7205 BUCKSKIN TR., CORCORAN, MN, 55340

Signature of
Role Employer/plan sponsor
Date 2019-09-26
Name of individual signing COURTNEY PAULSEN
Valid signature Filed with authorized/valid electronic signature
HEALTHSOURCE MIDWEST AMERICA, LLC 401(K) PLAN 2018 273540876 2019-10-15 HEALTHSOURCE MIDWEST AMERICA, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621310
Sponsor’s telephone number 6122812797
Plan sponsor’s address 7205 BUCKSKIN TR., CORCORAN, MN, 55340
HEALTHSOURCE MIDWEST AMERICA, LLC 401(K) PLAN 2017 273540876 2018-05-31 HEALTHSOURCE MIDWEST AMERICA, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621310
Sponsor’s telephone number 6122812797
Plan sponsor’s address 7205 BUCKSKIN TRAIL, CORCORAN, MN, 55340

Signature of
Role Plan administrator
Date 2018-05-31
Name of individual signing COURTNEY MARIE PAULSEN
Valid signature Filed with authorized/valid electronic signature
HEALTHSOURCE MIDWEST AMERICA, LLC 401(K) PLAN 2016 273540876 2017-07-18 HEALTHSOURCE MIDWEST AMERICA, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621310
Sponsor’s telephone number 6122812797
Plan sponsor’s address 7205 BUCKSKIN TRAIL, CORCORAN, MN, 55340

Signature of
Role Plan administrator
Date 2017-07-18
Name of individual signing COURTNEY MARIE PAULSEN
Valid signature Filed with authorized/valid electronic signature
HEALTHSOURCE MIDWEST AMERICA, LLC 401(K) PLAN 2015 273540876 2017-07-18 HEALTHSOURCE MIDWEST AMERICA, LLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621310
Sponsor’s telephone number 6122812797
Plan sponsor’s address 7205 BUCKSKIN TRAIL, CORCORAN, MN, 55340

Signature of
Role Plan administrator
Date 2017-07-18
Name of individual signing COURTNEY MARIE PAULSEN
Valid signature Filed with authorized/valid electronic signature

Manager

Name Role Address
Casey Paulsen Manager 1090 WILDHURST TRL, MOUND, MN 55364–9639, USA

Agent

Name Role
Casey Lee Paulsen Agent

Filing

Filing Name Filing date
Registered Office and/or Agent - Limited Liability Company (Domestic) 2022-01-03
Conversion to 322C Due to Statute Mandate – Limited Liability Company (Domestic) 2018-01-01
Annual Reinstatement - Limited Liability Company (Domestic) 2014-05-06
Administrative Termination - Limited Liability Company (Domestic) 2014-04-21
Original Filing - Limited Liability Company (Domestic) 2010-09-15
Limited Liability Company (Domestic) Business Name (Business Name: Healthsource Midwest America, LLC) 2010-09-15

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Related by address

1090 Wildhurst Trail, Orono, MN 55364, USA

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Date of last update: 29 Dec 2024

Sources: Minnesota's Official State Website

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