| Plan Name | MEDICAL, DENTAL, VISION HEALTH AND WELFARE BENEFIT PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | GRANITE PEAK DEVELOPMENT MANAGEMENT, INC. |
| Employer identification number (EIN): | 461558644 |
| NAIC Classification: | 541600 |
Additional information about GRANITE PEAK DEVELOPMENT MANAGEMENT, INC.
| Jurisdiction of Incorporation: | Wyoming Corporations Division |
| Incorporation Date: | 2012-07-24 |
| Company Identification Number: | 000626476 |
| Legal Registered Office Address: |
1300 Venture Way Ste 200 Casper United States of America (USA) 82609 |
More information about GRANITE PEAK DEVELOPMENT MANAGEMENT, INC.
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2021-01-01 | KRISTEEN JOHNSON | 2022-09-23 | ||
| 501 | 2020-01-01 | KRISTEEN JOHNSHON | 2021-07-23 | ||
| 501 | 2019-01-01 | HEATHER HUSMAN | 2020-08-13 | ||
| 501 | 2018-01-01 | HEATHER HUSMAN | 2019-08-01 |
| 2021: MEDICAL, DENTAL, VISION HEALTH AND WELFARE BENEFIT PLAN 2021 form 5500 responses | ||
|---|---|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: MEDICAL, DENTAL, VISION HEALTH AND WELFARE BENEFIT PLAN 2020 form 5500 responses | ||
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: MEDICAL, DENTAL, VISION HEALTH AND WELFARE BENEFIT PLAN 2019 form 5500 responses | ||
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: MEDICAL, DENTAL, VISION HEALTH AND WELFARE BENEFIT PLAN 2018 form 5500 responses | ||
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | First time form 5500 has been submitted | Yes |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 40000100023781 |
| Policy instance | 1 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 40000100023781 |
| Policy instance | 1 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 40000100023781 |
| Policy instance | 1 |
| DELTA DENTAL OF WYOMING (National Association of Insurance Commissioners NAIC id number: 15200 ) | |
| Policy contract number | 10339 |
| Policy instance | 1 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: N/A ) | |
| Policy contract number | 30046616 |
| Policy instance | 2 |