MANN LAKE LTD. HEALTH AND DENTAL PLANS
|
2020
|
411570037
|
2021-08-02
|
MANN LAKE LTD.
|
332
|
|
File |
View Page
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
2012-01-01
|
Business code |
115110
|
Sponsor’s telephone number |
2186756688
|
Plan sponsor’s mailing address |
501 1ST ST S, HACKENSACK, MN, 564522526
|
Plan sponsor’s
address |
501 1ST ST S, HACKENSACK, MN, 564522526
|
Number of participants as of the end of the plan year
|
MANN LAKE LTD. VISION PLAN
|
2020
|
411570037
|
2021-08-02
|
MANN LAKE LTD.
|
255
|
|
File |
View Page
|
Three-digit plan number (PN) |
510
|
Effective date of plan |
2011-01-01
|
Business code |
115110
|
Sponsor’s telephone number |
2186756688
|
Plan sponsor’s mailing address |
501 1ST ST S, HACKENSACK, MN, 564522526
|
Plan sponsor’s
address |
501 1ST ST S, HACKENSACK, MN, 564522526
|
Number of participants as of the end of the plan year
|
MANN LAKE LTD. LTD PLAN
|
2020
|
411570037
|
2021-08-02
|
MANN LAKE LTD.
|
458
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2007-03-01
|
Business code |
115110
|
Sponsor’s telephone number |
2186756688
|
Plan sponsor’s mailing address |
501 1ST ST S, HACKENSACK, MN, 564522526
|
Plan sponsor’s
address |
501 1ST ST S, HACKENSACK, MN, 564522526
|
Number of participants as of the end of the plan year
|
MANN LAKE LTD. VOLUNTARY BENEFITS
|
2020
|
411570037
|
2021-08-02
|
MANN LAKE LTD.
|
264
|
|
File |
View Page
|
Three-digit plan number (PN) |
511
|
Effective date of plan |
2016-01-01
|
Business code |
115110
|
Sponsor’s telephone number |
2186756688
|
Plan sponsor’s mailing address |
501 1ST ST S, HACKENSACK, MN, 564522526
|
Plan sponsor’s
address |
501 1ST ST S, HACKENSACK, MN, 564522526
|
Number of participants as of the end of the plan year
|
MANN LAKE LTD. STD PLAN
|
2020
|
411570037
|
2021-08-02
|
MANN LAKE LTD.
|
240
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2017-01-01
|
Business code |
115110
|
Sponsor’s telephone number |
2186756688
|
Plan sponsor’s mailing address |
501 1ST ST S, HACKENSACK, MN, 564522526
|
Plan sponsor’s
address |
501 1ST ST S, HACKENSACK, MN, 564522526
|
Number of participants as of the end of the plan year
|
MANN LAKE LTD. LIFE INSURANCE PLAN
|
2020
|
411570037
|
2021-08-02
|
MANN LAKE LTD.
|
479
|
|
File |
View Page
|
Three-digit plan number (PN) |
506
|
Effective date of plan |
2011-01-01
|
Business code |
115110
|
Sponsor’s telephone number |
2186756688
|
Plan sponsor’s mailing address |
501 1ST ST S, HACKENSACK, MN, 564522526
|
Plan sponsor’s
address |
501 1ST ST S, HACKENSACK, MN, 564522526
|
Number of participants as of the end of the plan year
|
MANN LAKE LTD HEALTH AND DENTAL PLANS
|
2013
|
411570037
|
2014-07-31
|
MANN LAKE LTD
|
142
|
|
File |
View Page
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
2012-01-01
|
Business code |
115110
|
Sponsor’s telephone number |
2186757431
|
Plan sponsor’s mailing address |
501 1ST ST S, HACKENSACK, MN, 56452
|
Plan sponsor’s
address |
501 1ST ST S, HACKENSACK, MN, 56452
|
Number of participants as of the end of the plan year
Active participants |
231 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2014-07-31 |
Name of individual signing |
VICKI DUFNER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-07-31 |
Name of individual signing |
VICKI DUFNER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MANN LAKE LTD LIFE INSURANCE PLAN
|
2013
|
411570037
|
2014-07-31
|
MANN LAKE LTD
|
142
|
|
File |
View Page
|
Three-digit plan number (PN) |
506
|
Effective date of plan |
2011-01-01
|
Business code |
115110
|
Sponsor’s telephone number |
2186757431
|
Plan sponsor’s mailing address |
501 1ST ST. S., HACKENSACK, MN, 56452
|
Plan sponsor’s
address |
501 1ST ST. S., HACKENSACK, MN, 56452
|
Plan administrator’s name and address
Administrator’s EIN |
411570037 |
Plan administrator’s name |
MANN LAKE LTD |
Plan administrator’s
address |
501 1ST ST. S., HACKENSACK, MN, 56452 |
Administrator’s telephone number |
2186757431 |
Number of participants as of the end of the plan year
Active participants |
171 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2014-07-31 |
Name of individual signing |
VICKI DUFNER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-07-31 |
Name of individual signing |
VICKI DUFNER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MANN LAKE LTD LTD PLAN
|
2013
|
411570037
|
2014-07-31
|
MANN LAKE LTD
|
142
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2007-03-01
|
Business code |
115110
|
Sponsor’s telephone number |
2186757431
|
Plan sponsor’s mailing address |
501 1ST ST. S., HACKENSACK, MN, 56452
|
Plan sponsor’s
address |
501 1ST ST. S., HACKENSACK, MN, 56452
|
Plan administrator’s name and address
Administrator’s EIN |
411570037 |
Plan administrator’s name |
MANN LAKE LTD |
Plan administrator’s
address |
501 1ST ST. S., HACKENSACK, MN, 56452 |
Administrator’s telephone number |
2186757431 |
Number of participants as of the end of the plan year
Active participants |
176 |
Retired or separated participants receiving
benefits |
1 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2014-07-31 |
Name of individual signing |
VICKI DUFNER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-07-31 |
Name of individual signing |
VICKI DUFNER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MANN LAKE LTD HEALTH AND DENTAL PLANS
|
2012
|
411570037
|
2013-07-31
|
MANN LAKE LTD
|
116
|
|
File |
View Page
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
2012-01-01
|
Business code |
115110
|
Sponsor’s telephone number |
2186757431
|
Plan sponsor’s mailing address |
501 1ST ST S, HACKENSACK, MN, 56452
|
Plan sponsor’s
address |
501 1ST ST S, HACKENSACK, MN, 56452
|
Number of participants as of the end of the plan year
Active participants |
141 |
Retired or separated participants receiving
benefits |
1 |
Signature of
Role |
Plan administrator |
Date |
2013-07-31 |
Name of individual signing |
VICKI NATIONS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|