GARDEN VALLEY DENTAL INSURANCE PLAN
|
2017
|
410271520
|
2018-07-12
|
GARDEN VALLEY TELEPHONE COMPANY
|
105
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1993-01-01
|
Business code |
517000
|
Sponsor’s telephone number |
2186872400
|
Plan
sponsor’s DBA name |
GARDEN VALLEY
|
Plan sponsor’s mailing address |
PO BOX 259, ERSKINE, MN, 565350259
|
Plan sponsor’s
address |
201 ROSS AVENUE, ERSKINE, MN, 56535
|
Number of participants as of the end of the plan year
Active participants |
0 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2018-07-12 |
Name of individual signing |
MARK KLINKHAMMER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-07-12 |
Name of individual signing |
MARK KLINKHAMMER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GARDEN VALLEY HEALTH INSURANCE PLAN
|
2016
|
410271520
|
2018-07-11
|
GARDEN VALLEY TELEPHONE COMPANY
|
102
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1986-01-01
|
Business code |
517000
|
Sponsor’s telephone number |
2186872400
|
Plan
sponsor’s DBA name |
GARDEN VALLEY
|
Plan sponsor’s mailing address |
PO BOX 259, ERSKINE, MN, 565350259
|
Plan sponsor’s
address |
201 ROSS AVENUE, ERSKING, MN, 56535
|
Number of participants as of the end of the plan year
Active participants |
0 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2018-07-11 |
Name of individual signing |
MARK KLINKHAMMER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-07-11 |
Name of individual signing |
MARK KLINKHAMMER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GARDEN VALLEY DENTAL INSURANCE PLAN
|
2016
|
410271520
|
2017-03-09
|
GARDEN VALLEY TELEPHONE COMPANY
|
107
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1993-01-01
|
Business code |
517000
|
Sponsor’s telephone number |
2186872400
|
Plan
sponsor’s DBA name |
GARDEN VALLEY
|
Plan sponsor’s mailing address |
PO BOX 259, ERSKINE, MN, 565350259
|
Plan sponsor’s
address |
201 ROSS AVENUE, ERSKINE, MN, 56535
|
Number of participants as of the end of the plan year
Active participants |
82 |
Retired or separated participants receiving
benefits |
23 |
Signature of
Role |
Plan administrator |
Date |
2017-03-09 |
Name of individual signing |
MARK KLINKHAMMER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-03-09 |
Name of individual signing |
MARK KLINKHAMMER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GARDEN VALLEY HEALTH INSURANCE PLAN
|
2016
|
410271520
|
2017-05-16
|
GARDEN VALLEY TELEPHONE COMPANY
|
102
|
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1986-01-01
|
Business code |
517000
|
Sponsor’s telephone number |
2186872400
|
Plan
sponsor’s DBA name |
GARDEN VALLEY
|
Plan sponsor’s mailing address |
PO BOX 259, ERSKINE, MN, 565350259
|
Plan sponsor’s
address |
201 ROSS AVENUE, ERSKINE, MN, 56535
|
Number of participants as of the end of the plan year
Active participants |
82 |
Retired or separated participants receiving
benefits |
20 |
Signature of
Role |
Plan administrator |
Date |
2017-05-16 |
Name of individual signing |
MARK KLINKHAMMER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-05-16 |
Name of individual signing |
MARK KLINKHAMMER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GARDEN VALLEY DENTAL INSURANCE PLAN
|
2015
|
410271520
|
2016-06-20
|
GARDEN VALLEY TELEPHONE COMPANY
|
105
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1993-01-01
|
Business code |
517000
|
Sponsor’s telephone number |
2186872400
|
Plan sponsor’s mailing address |
201 ROSS AVENUE, PO BOX 259, ERSKINE, MN, 56535
|
Plan sponsor’s
address |
201 ROSS AVENUE, PO BOX 259, ERSKINE, MN, 56535
|
Number of participants as of the end of the plan year
Active participants |
84 |
Retired or separated participants receiving
benefits |
23 |
Signature of
Role |
Plan administrator |
Date |
2016-06-20 |
Name of individual signing |
MARK KLINKHAMMER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-06-20 |
Name of individual signing |
MARK KLINKHAMMER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GARDEN VALLEY HEALTH INSURANCE PLAN
|
2015
|
410271520
|
2016-06-20
|
GARDEN VALLEY TELEPHONE COMPANY
|
101
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1986-01-01
|
Business code |
517000
|
Sponsor’s telephone number |
2186872400
|
Plan
sponsor’s DBA name |
GARDEN VALLEY
|
Plan sponsor’s mailing address |
201 ROSS AVENUE, PO BOX 259, ERSKINE, MN, 56535
|
Plan sponsor’s
address |
201 ROSS AVENUE, PO BOX 259, ERSKINE, MN, 56535
|
Number of participants as of the end of the plan year
Active participants |
82 |
Retired or separated participants receiving
benefits |
20 |
Signature of
Role |
Plan administrator |
Date |
2016-06-20 |
Name of individual signing |
MARK KLINKHAMMER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-06-20 |
Name of individual signing |
MARK KLINKHAMMER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GARDEN VALLEY DENTAL INSURANCE PLAN
|
2014
|
410271520
|
2015-07-28
|
GARDEN VALLEY TELEPHONE COMPANY
|
109
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1993-01-01
|
Business code |
517000
|
Sponsor’s telephone number |
2186872400
|
Plan sponsor’s mailing address |
201 ROSS AVENUE, PO BOX 259, ERSKINE, MN, 56535
|
Plan sponsor’s
address |
201 ROSS AVENUE, PO BOX 259, ERSKINE, MN, 56535
|
Number of participants as of the end of the plan year
Active participants |
81 |
Retired or separated participants receiving
benefits |
24 |
Signature of
Role |
Plan administrator |
Date |
2015-07-28 |
Name of individual signing |
MARK KLINKHAMMER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-07-28 |
Name of individual signing |
MARK KLINKHAMMER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GARDEN VALLEY HEALTH INSURANCE PLAN
|
2014
|
410271520
|
2015-05-07
|
GARDEN VALLEY TELEPHONE COMPANY
|
105
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1986-01-01
|
Business code |
517000
|
Sponsor’s telephone number |
2186872400
|
Plan
sponsor’s DBA name |
GARDEN VALLEY
|
Plan sponsor’s mailing address |
201 ROSS AVENUE, PO BOX 259, ERSKINE, MN, 56535
|
Plan sponsor’s
address |
201 ROSS AVENUE, PO BOX 259, ERSKINE, MN, 56535
|
Number of participants as of the end of the plan year
Active participants |
81 |
Retired or separated participants receiving
benefits |
20 |
Signature of
Role |
Plan administrator |
Date |
2015-05-07 |
Name of individual signing |
MARK KLINKHAMMER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-05-07 |
Name of individual signing |
MARK KLINKHAMMER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GARDEN VALLEY DENTAL INSURANCE PLAN
|
2013
|
410271520
|
2014-05-13
|
GARDEN VALLEY TELEPHONE COMPANY
|
108
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1993-01-01
|
Business code |
517000
|
Sponsor’s telephone number |
2186872400
|
Plan sponsor’s mailing address |
PO BOX 259, ERSKINE, MN, 56535
|
Plan sponsor’s
address |
201 ROSS AVENUE, ERSKINE, MN, 56535
|
Number of participants as of the end of the plan year
Active participants |
85 |
Retired or separated participants receiving
benefits |
24 |
Signature of
Role |
Plan administrator |
Date |
2014-05-13 |
Name of individual signing |
MARK KLINKHAMMER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-05-13 |
Name of individual signing |
MARK KLINKHAMMER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GARDEN VALLEY HEALTH INSURANCE PLAN
|
2013
|
410271520
|
2014-05-13
|
GARDEN VALLEY TELEPHONE COMPANY
|
110
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1986-01-01
|
Business code |
517000
|
Sponsor’s telephone number |
2186872400
|
Plan sponsor’s mailing address |
PO BOX 259, ERSKINE, MN, 56535
|
Plan sponsor’s
address |
201 ROSS AVENUE, ERSKINE, MN, 56535
|
Number of participants as of the end of the plan year
Active participants |
85 |
Retired or separated participants receiving
benefits |
20 |
Signature of
Role |
Plan administrator |
Date |
2014-05-13 |
Name of individual signing |
MARK KLINKHAMMER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-05-13 |
Name of individual signing |
MARK KLINKHAMMER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|