| Plan Name | GREAT LAKES GASTROENTEROLOGY SOCA BENEFIT PLAN |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | GREAT LAKES GASTROENTEROLOGY LLC |
| Employer identification number (EIN): | 201466945 |
| NAIC Classification: | 621111 |
| NAIC Description: | Offices of Physicians (except Mental Health Specialists) |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2022-01-01 | MATT APPENZELLER | 2023-07-31 |