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| Plan Name | WEST SIDE COMMUNITY HEALTH SERVICES EAP PLAN |
| Plan identification number | 508 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | WEST SIDE COMMUNITY HEALTH SERVICES |
| Employer identification number (EIN): | 237156236 |
| NAIC Classification: | 621498 |
| NAIC Description: | All Other Outpatient Care Centers |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 508 | 2021-01-01 | CHRISTIE JANSEN | 2022-07-19 |
| 2021: WEST SIDE COMMUNITY HEALTH SERVICES EAP PLAN 2021 form 5500 responses | ||
|---|---|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | First time form 5500 has been submitted | Yes |
| 2021-01-01 | This submission is the final filing | Yes |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| LIFEWORKS (National Association of Insurance Commissioners NAIC id number: 54121 ) | |
| Policy contract number | 400795 |
| Policy instance | 1 |
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