| Plan Name | GREAT LAKES MANUFACTURING HEALTH AND WELFARE PLAN |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | GREAT LAKES MANUFACTURING, INC. |
| Employer identification number (EIN): | 232922556 |
| NAIC Classification: | 332900 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2023-01-01 | TOM PAKULSKI | 2024-07-12 |
| 2023: GREAT LAKES MANUFACTURING HEALTH AND WELFARE PLAN 2023 form 5500 responses | ||
|---|---|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | First time form 5500 has been submitted | Yes |
| 2023-01-01 | Plan funding arrangement – Insurance | Yes |
| 2023-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) | |||||||||||||||||||||
| Policy contract number | E5846175 | ||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||
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| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) | |||||||||||||||||||||
| Policy contract number | 297893 | ||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||
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