| Plan Name | COMMUNITY ACTION PROGRAM - BASIC LIFE/AD&D/STD PLAN |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | COMMUNITY ACTION PROGRAM - BELKNAP MERRIMACK COUNTIES INC. |
| Employer identification number (EIN): | 020270376 |
| NAIC Classification: | 624200 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2021-07-01 | JEANNE AGRI | 2022-12-22 | ||
| 502 | 2020-07-01 | JEANNE AGRI | 2022-10-14 |
| 2021: COMMUNITY ACTION PROGRAM - BASIC LIFE/AD&D/STD PLAN 2021 form 5500 responses | ||
|---|---|---|
| 2021-07-01 | Type of plan entity | Single employer plan |
| 2021-07-01 | This submission is the final filing | Yes |
| 2021-07-01 | Plan funding arrangement – Insurance | Yes |
| 2021-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: COMMUNITY ACTION PROGRAM - BASIC LIFE/AD&D/STD PLAN 2020 form 5500 responses | ||
| 2020-07-01 | Type of plan entity | Single employer plan |
| 2020-07-01 | Plan funding arrangement – Insurance | Yes |
| 2020-07-01 | Plan benefit arrangement – Insurance | Yes |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) | |
| Policy contract number | 169197 |
| Policy instance | 1 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | 910198 |
| Policy instance | 1 |