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| Plan Name | PREMIER HOME CARE LLC MEDOVA LIFESTYLE HEALTH PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | PREMIER HOME CARE LLC |
| Employer identification number (EIN): | 203014168 |
| NAIC Classification: | 621210 |
| NAIC Description: | Offices of Dentists |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2021-11-01 | ROBERT MOORE | 2023-06-30 | ||
| 501 | 2020-11-01 | ROBERT MOORE | 2022-07-28 |