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Plan Name | 180 MEDICAL HEALTH PLAN |
Plan identification number | 502 |
401k Plan Type | Welfare Benefit |
Plan Features/Benefits |
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Company Name: | 180 MEDICAL, INC. |
Employer identification number (EIN): | 134211220 |
NAIC Classification: | 446190 |
Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
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502 | 2014-07-01 | SHARON HODNETT | |||
502 | 2013-07-01 | SHARON ZAJAC | SHARON ZAJAC | 2015-01-30 | |
502 | 2011-07-01 | SHARON HODNETT |
Measure | Date | Value |
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2014: 180 MEDICAL HEALTH PLAN 2014 401k membership | ||
Total participants, beginning-of-year | 2014-07-01 | 376 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-07-01 | 0 |
Number of retired or separated participants receiving benefits | 2014-07-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2014-07-01 | 0 |
Total of all active and inactive participants | 2014-07-01 | 0 |
2013: 180 MEDICAL HEALTH PLAN 2013 401k membership | ||
Total participants, beginning-of-year | 2013-07-01 | 137 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-07-01 | 376 |
Total of all active and inactive participants | 2013-07-01 | 376 |
Total participants | 2013-07-01 | 376 |
2011: 180 MEDICAL HEALTH PLAN 2011 401k membership | ||
Total participants, beginning-of-year | 2011-07-01 | 170 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-07-01 | 181 |
Number of retired or separated participants receiving benefits | 2011-07-01 | 0 |
Total of all active and inactive participants | 2011-07-01 | 181 |
Total participants | 2011-07-01 | 181 |
2014: 180 MEDICAL HEALTH PLAN 2014 form 5500 responses | ||
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2014-07-01 | Type of plan entity | Single employer plan |
2014-07-01 | Submission has been amended | No |
2014-07-01 | This submission is the final filing | Yes |
2014-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-07-01 | Plan is a collectively bargained plan | No |
2014-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
2014-07-01 | Plan benefit arrangement – Insurance | Yes |
2013: 180 MEDICAL HEALTH PLAN 2013 form 5500 responses | ||
2013-07-01 | Type of plan entity | Single employer plan |
2013-07-01 | First time form 5500 has been submitted | Yes |
2013-07-01 | Submission has been amended | No |
2013-07-01 | This submission is the final filing | No |
2013-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-07-01 | Plan is a collectively bargained plan | No |
2013-07-01 | Plan funding arrangement – Insurance | Yes |
2013-07-01 | Plan benefit arrangement – Insurance | Yes |
2011: 180 MEDICAL HEALTH PLAN 2011 form 5500 responses | ||
2011-07-01 | Type of plan entity | Single employer plan |
2011-07-01 | First time form 5500 has been submitted | Yes |
2011-07-01 | Submission has been amended | No |
2011-07-01 | This submission is the final filing | No |
2011-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2011-07-01 | Plan is a collectively bargained plan | No |
2011-07-01 | Plan funding arrangement – Insurance | Yes |
2011-07-01 | Plan benefit arrangement – Insurance | Yes |
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy contract number | 124635 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy contract number | 0847511 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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DELTA DENTAL (National Association of Insurance Commissioners NAIC id number: 53937 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy contract number | 9021 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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