THE LUTHERAN HOME ASSOCIATION VISION BENEFITS PLAN
|
2015
|
410706147
|
2017-06-12
|
THE LUTHERAN HOME ASSOCIATION
|
177
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2015-09-01
|
Business code |
623000
|
Sponsor’s telephone number |
9528736000
|
Plan sponsor’s mailing address |
337 S MERIDIAN ST, BELLE PLAINE, MN, 560111919
|
Plan sponsor’s
address |
337 S MERIDIAN ST, BELLE PLAINE, MN, 560111919
|
Number of participants as of the end of the plan year
Active participants |
185 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2017-06-12 |
Name of individual signing |
BETH WADSLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-06-12 |
Name of individual signing |
BETH WADSLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE LUTHERAN HOME ASSOCIATION GROUP DENTAL PLAN
|
2015
|
410706147
|
2017-03-17
|
THE LUTHERAN HOME ASSOCIATION
|
143
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1996-11-01
|
Business code |
623000
|
Sponsor’s telephone number |
9528736000
|
Plan sponsor’s mailing address |
337 S MERIDIAN ST, BELLE PLAINE, MN, 560111919
|
Plan sponsor’s
address |
337 S MERIDIAN ST, BELLE PLAINE, MN, 560111919
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-03-15 |
Name of individual signing |
BETH WADSLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-03-15 |
Name of individual signing |
BETH WADSLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE LUTHERAN HOME ASSOCIATION GROUP HEALTH PLAN
|
2015
|
410706147
|
2017-03-17
|
THE LUTHERAN HOME ASSOCIATION
|
125
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1996-09-01
|
Business code |
623000
|
Sponsor’s telephone number |
9528736000
|
Plan sponsor’s mailing address |
337 S MERIDIAN ST, BELLE PLAINE, MN, 560111919
|
Plan sponsor’s
address |
337 S MERIDIAN ST, BELLE PLAINE, MN, 560111919
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-03-15 |
Name of individual signing |
BETH WADSLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-03-15 |
Name of individual signing |
BETH WADSLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE LUTHERAN HOME ASSOCIATION LIFE AND DISABILITY PLAN
|
2015
|
410706147
|
2017-03-17
|
THE LUTHERAN HOME ASSOCIATION
|
245
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2014-09-01
|
Business code |
623000
|
Sponsor’s telephone number |
9528736000
|
Plan sponsor’s mailing address |
337 S MERIDIAN ST, BELLE PLAINE, MN, 560111919
|
Plan sponsor’s
address |
337 S MERIDIAN ST, BELLE PLAINE, MN, 560111919
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-03-17 |
Name of individual signing |
BETH WADSLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-03-17 |
Name of individual signing |
BETH WADSLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE LUTHERAN HOME GROUP HEALTH PLAN
|
2014
|
410706147
|
2016-03-04
|
THE LUTHERAN HOME ASSOCIATION
|
121
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1996-09-01
|
Business code |
623000
|
Sponsor’s telephone number |
9528736000
|
Plan sponsor’s mailing address |
337 S MERIDIAN ST, BELLE PLAINE, MN, 560111919
|
Plan sponsor’s
address |
337 S MERIDIAN ST, BELLE PLAINE, MN, 560111919
|
Number of participants as of the end of the plan year
Active participants |
125 |
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 that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2016-03-04 |
Name of individual signing |
BETH WADSLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-03-04 |
Name of individual signing |
BETH WADSLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE LUTHERAN HOME ASSOCIATION GROUP DENTAL PLAN
|
2014
|
410706147
|
2016-03-04
|
THE LUTHERAN HOME ASSOCIATION
|
143
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1996-11-01
|
Business code |
623000
|
Sponsor’s telephone number |
9528736000
|
Plan sponsor’s mailing address |
337 S MERIDIAN ST, BELLE PLAINE, MN, 560111919
|
Plan sponsor’s
address |
337 S MERIDIAN ST, BELLE PLAINE, MN, 560111919
|
Number of participants as of the end of the plan year
Active participants |
143 |
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 that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2016-03-04 |
Name of individual signing |
BETH WADSLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-03-04 |
Name of individual signing |
BETH WADSLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE LUTHERAN HOME ASSOCIATION LIFE AND DISABILITY PLAN
|
2014
|
410706147
|
2016-03-31
|
THE LUTHERAN HOME ASSOCIATION
|
245
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2014-09-01
|
Business code |
623000
|
Sponsor’s telephone number |
9528736000
|
Plan sponsor’s mailing address |
337 SOUTH MERIDIAN STREET, BELLE PLAINE, MN, 56011
|
Plan sponsor’s
address |
337 SOUTH MERIDIAN STREET, BELLE PLAINE, MN, 56011
|
Number of participants as of the end of the plan year
Active participants |
245 |
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 |
Signature of
Role |
Plan administrator |
Date |
2016-03-31 |
Name of individual signing |
BETH WADSLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-03-31 |
Name of individual signing |
BETH WADSLEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|