Filing

Genesis Development Employee Medical Benefit Plan

Genesis Development • EIN 23-7363533 • Plan year 2000

Company Profile Source Archive

Filing Insights

Participants

55 → 81

26 • 47.27%

Assets

No comparison

- → -

No earlier value available.

Investment Management Fee

Admin expenses - • Total expenses -

Filing Details

Context

No event flags were generated for this filing.

Status Flags

Fidelity bond in place

Not reported

Limited-scope audit performed

Not reported

Contributions transmitted on time

Not reported

Participant loans in default

Not reported

Leases in default

Not reported

Reportable party-in-interest issues

Not reported

Loss discovered during year

Not reported

Assets with undetermined value

Not reported

Non-cash contributions

Not reported

Assets held for investment

Not reported

5% transactions reported

Not reported

All plan assets distributed

Not reported

Benefits paid when due

Not reported

Plan blackout period

Not reported

Plan termination resolution adopted

Not reported

Counterparties

Company Timeline

This filing is highlighted inside the broader sponsor history.

Year / Filing	Filings	Participants	Assets	Contributions	Contrib./Participant
2019	1	0	$0	$0	-
Genesis Development Employee Medical Benefit Plan	-	0	-	-	-
2018	1	226	$0	$0	-
Genesis Development Employee Medical Benefit Plan	-	226	-	-	-
2017	1	210	$0	$0	-
Genesis Development Employee Medical Benefit Plan	-	210	-	-	-
2016	1	193	$0	$0	-
Genesis Development Employee Medical Benefit Plan	-	193	-	-	-
2015	1	189	$0	$0	-
Genesis Development Employee Medical Benefit Plan	-	189	-	-	-
2014	1	160	$0	$0	-
Genesis Development Employee Medical Benefit Plan	-	160	-	-	-
2013	1	173	$0	$0	-
Genesis Development Employee Medical Benefit Plan	-	173	-	-	-
2012	1	144	$0	$0	-
Genesis Development Employee Medical Benefit Plan	-	144	-	-	-
2011	1	130	$0	$0	-
Genesis Development Employee Medical Benefit Plan	-	130	-	-	-
2010	1	141	$0	$0	-
Genesis Development Employee Medical Benefit Plan	-	141	-	-	-
2009	2	177	$0	$0	-
Genesis Development Employee Medical Benefit Plan	-	177	-	-	-
GENESIS DEVELOPMENT FLEXIBLE BENEFITS PLAN	-	-	-	-	-
2008	1	171	$0	$0	-
Genesis Development Employee Medical Benefit Plan	-	171	-	-	-
2007	1	180	$0	$0	-
Genesis Development Employee Medical Benefit Plan	-	180	-	-	-
2006	1	148	$0	$0	-
Genesis Development Employee Medical Benefit Plan	-	148	-	-	-
2005	1	147	$0	$0	-
Genesis Development Employee Medical Benefit Plan	-	147	-	-	-
2004	1	137	$0	$0	-
Genesis Development Employee Medical Benefit Plan	-	137	-	-	-
2001	1	78	$0	$0	-
Genesis Development Employee Medical Benefit Plan	-	78	-	-	-
2000	1	81	$0	$0	-
Genesis Development Employee Medical Benefit Plan	Current	81	-	-	-

Schedule Details

Schedule A

Row 1
Filing Id: 84037255047532
Form Id: 20349127
Page Id: 2
Page Seq: 0
Page Row Num: 1
Row Num: 0
Image Form Id: 30372255047030002
Ins Broker 01 Name: CBSA
Ins Broker 01 Street Addr: 10159 WAYZATA BLVD
Ins Broker 01 City: MINNETONKA
Ins Broker 01 State: MN
Ins Broker 01 ZIP Code: 553051503
Ins Broker Comm Pd 01 Amount: $0
Ins Broker Fees Pd 01 Amount: $11,159
Ins Broker Fees Pd 01 Text: ADMIN FEES
Ins Broker 01 Code: 5

Row 2
Filing Id: 84037255047532
Form Id: 20349128
Page Id: 2
Page Seq: 0
Page Row Num: 1
Row Num: 0
Image Form Id: 30372255047030003
Ins Broker 01 Name: CBSA
Ins Broker 01 Street Addr: 10159 WAYZATA BLVD
Ins Broker 01 City: MINNETONKA
Ins Broker 01 State: MN
Ins Broker 01 ZIP Code: 553051503
Ins Broker Comm Pd 01 Amount: $375
Ins Broker Fees Pd 01 Amount: $0
Ins Broker 01 Code: 5

Row 3
Filing Id: 84037255047532
Form Id: 20349127
Page Id: 2
Page Seq: 0
Page Row Num: 2
Row Num: 1
Image Form Id: 30372255047030002
Ins Broker 01 Name: TERRY LANG
Ins Broker 01 Street Addr: 1225 RUSHRIDGE ROAD
Ins Broker 01 City: JEFFERSON
Ins Broker 01 State: IA
Ins Broker 01 ZIP Code: 50129
Ins Broker Comm Pd 01 Amount: $4,438
Ins Broker Fees Pd 01 Amount: $0
Ins Broker 01 Code: 3

Row 4
Filing Id: 84037255047532
Form Id: 20349128
Page Id: 2
Page Seq: 0
Page Row Num: 2
Row Num: 1
Image Form Id: 30372255047030003
Ins Broker 01 Name: TERRY J LANG & ASSOC
Ins Broker 01 Street Addr: PO BOX 29/1225 RUSHRIDGE RD
Ins Broker 01 City: JEFFERSON
Ins Broker 01 State: IA
Ins Broker 01 ZIP Code: 50129
Ins Broker Comm Pd 01 Amount: $250
Ins Broker Fees Pd 01 Amount: $0
Ins Broker 01 Code: 3

Row 5: Ins Carrier Name: CONSECO LIFE
Filing Id: 84037255047532
Form Id: 20349127
Schedule A EIN: 23-7363533
Schedule A Plan Num: 501
Schedule A Plan Year Begin Date: 2000-05-01
Schedule A Tax Period: 20010430
Ins Carrier Name: CONSECO LIFE
Ins Carrier EIN: 04-2299444
Ins Carrier Naic Code: 65900
Ins Contract Num: PENDING
Ins Prsn Covered End of year Count: 81
Ins Policy From Date: 2000-05-01
Ins Policy To Date: 2001-04-30
Ins Broker Comm Total Amount: $4,438
Ins Broker Fees Total Amount: $11,159
Pension End of year Gen Account Amount: $0
Pension End of year Sep Account Amount: $0
Pension Prem Paid Total Amount: $0
Pension Unpaid Premium Amount: $0
Pension Contract Cost Amount: $0
Pension End Prev Bal Amount: $0
Pension Contribution Dep Amount: $0
Pension Divnd Cr Dep Amount: $0
Pension Interest Cr Dur Yr Amount: $0
Pension Transfer From Amount: $0
Pension Other Amount: $0
Pension Total Additions Amount: $0
Pension Total Bal Addn Amount: $0
Pension Bnfts Dsbrsd Amount: $0
Pension Admin Chrg Amount: $0
Pension Transfer To Amount: $0
Pension Oth Ded Amount: $0
Pension Total Ded Amount: $0
Pension End of year Bal Amount: $0
Wlfr Type Bnft Indicator: A
Wlfr Premium Rcvd Amount: $0
Wlfr Unpaid Due Amount: $0
Wlfr Reserve Amount: $0
Wlfr Total Earned Prem Amount: $0
Wlfr Claims Paid Amount: $0
Wlfr Incr Reserve Amount: $0
Wlfr Incurred Claim Amount: $0
Wlfr Claims Chrgd Amount: $0
Wlfr Ret Commissions Amount: $0
Wlfr Ret Admin Amount: $0
Wlfr Ret Oth Cost Amount: $0
Wlfr Ret Oth Expense Amount: $0
Wlfr Ret Taxes Amount: $0
Wlfr Ret Charges Amount: $0
Wlfr Ret Oth Chrgs Amount: $0
Wlfr Ret Total Amount: $0
Wlfr Refund Amount: $0
Wlfr Held Bnfts Amount: $0
Wlfr Claims Reserve Amount: $0
Wlfr Oth Reserve Amount: $0
Wlfr Divnds Due Amount: $0
Wlfr Total Charges Paid Amount: $55,998
Wlfr Acquis Cost Amount: $0

Row 6: Ins Carrier Name: JEFFERSON PILOT
Filing Id: 84037255047532
Form Id: 20349128
Schedule A EIN: 23-7363533
Schedule A Plan Num: 501
Schedule A Plan Year Begin Date: 2000-05-01
Schedule A Tax Period: 20010430
Ins Carrier Name: JEFFERSON PILOT
Ins Carrier EIN: 56-0359860
Ins Carrier Naic Code: 67865
Ins Contract Num: PENDING
Ins Prsn Covered End of year Count: 81
Ins Policy From Date: 2000-05-01
Ins Policy To Date: 2001-04-30
Ins Broker Comm Total Amount: $625
Ins Broker Fees Total Amount: $0
Pension End of year Gen Account Amount: $0
Pension End of year Sep Account Amount: $0
Pension Prem Paid Total Amount: $0
Pension Unpaid Premium Amount: $0
Pension Contract Cost Amount: $0
Pension End Prev Bal Amount: $0
Pension Contribution Dep Amount: $0
Pension Divnd Cr Dep Amount: $0
Pension Interest Cr Dur Yr Amount: $0
Pension Transfer From Amount: $0
Pension Other Amount: $0
Pension Total Additions Amount: $0
Pension Total Bal Addn Amount: $0
Pension Bnfts Dsbrsd Amount: $0
Pension Admin Chrg Amount: $0
Pension Transfer To Amount: $0
Pension Oth Ded Amount: $0
Pension Total Ded Amount: $0
Pension End of year Bal Amount: $0
Wlfr Type Bnft Indicator: D
Wlfr Premium Rcvd Amount: $0
Wlfr Unpaid Due Amount: $0
Wlfr Reserve Amount: $0
Wlfr Total Earned Prem Amount: $0
Wlfr Claims Paid Amount: $0
Wlfr Incr Reserve Amount: $0
Wlfr Incurred Claim Amount: $0
Wlfr Claims Chrgd Amount: $0
Wlfr Ret Commissions Amount: $0
Wlfr Ret Admin Amount: $0
Wlfr Ret Oth Cost Amount: $0
Wlfr Ret Oth Expense Amount: $0
Wlfr Ret Taxes Amount: $0
Wlfr Ret Charges Amount: $0
Wlfr Ret Oth Chrgs Amount: $0
Wlfr Ret Total Amount: $0
Wlfr Refund Amount: $0
Wlfr Held Bnfts Amount: $0
Wlfr Claims Reserve Amount: $0
Wlfr Oth Reserve Amount: $0
Wlfr Divnds Due Amount: $0
Wlfr Total Charges Paid Amount: $2,498
Wlfr Acquis Cost Amount: $0