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| Plan Name | OXYGEN SERVICE COMPANY MEDICAL PLAN |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | OXYGEN SERVICE COMPANY |
| Employer identification number (EIN): | 410887242 |
| NAIC Classification: | 423990 |
| NAIC Description: | Other Miscellaneous Durable Goods Merchant Wholesalers |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2020-08-01 | RYAN MIELKE | 2021-11-11 |
| HEALTHPARTNERS (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 15475 |
| Policy instance | 1 |
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