| Plan Name | FAMILY SERVICE LINCOLN MEDOVA LIFESTYLE HEALTH PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | FAMILY SERVICE ASSOCIATION OF LINCOLN |
| Employer identification number (EIN): | 470376584 |
| NAIC Classification: | 624100 |
| NAIC Description: | Individual and Family Services |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2022-01-01 | ROBERT MOORE | 2023-06-30 | ||
| 501 | 2021-01-01 | ROBERT MOORE | 2022-09-29 |