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| Plan Name | BCBS OF MONTANA GROUP LIFE INSURANCE PROGRAM |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | BMT EMPLOYEE BENEFITS TRUST, INC. |
| Employer identification number (EIN): | 261445922 |
| NAIC Classification: | 525920 |
| NAIC Description: | Trusts, Estates, and Agency Accounts |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2013-01-01 | ||||
| 502 | 2012-01-01 | CHRIS MANGER | |||
| 502 | 2011-01-01 | MARK A. BURZYNSKI | |||
| 502 | 2010-01-01 | MARK A BURZYNSKI | |||
| 502 | 2009-01-01 | MARK A. BURZYNSKI | MARK A. BURZYNSKI | 2010-10-13 |
| 2013: BCBS OF MONTANA GROUP LIFE INSURANCE PROGRAM 2013 form 5500 responses | ||
|---|---|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | This submission is the final filing | Yes |
| 2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: BCBS OF MONTANA GROUP LIFE INSURANCE PROGRAM 2012 form 5500 responses | ||
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: BCBS OF MONTANA GROUP LIFE INSURANCE PROGRAM 2011 form 5500 responses | ||
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: BCBS OF MONTANA GROUP LIFE INSURANCE PROGRAM 2010 form 5500 responses | ||
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: BCBS OF MONTANA GROUP LIFE INSURANCE PROGRAM 2009 form 5500 responses | ||
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
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