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| Plan Name | SECTION 125 PREMIUM PLAN ONLY FOR MOUNTAIN COMMUNITY ACTION PROGRAM, INC. |
| Plan identification number | 520 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | MOUNTAIN COMMUNITY ACTION PROGRAM, INC. |
| Employer identification number (EIN): | 540792030 |
| NAIC Classification: | 624200 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 520 | 2015-10-01 | REGINA WILLIAMS | 2017-02-01 | ||
| 520 | 2014-10-01 | DONNA HALL | 2016-01-19 | ||
| 520 | 2013-10-01 | DONNA HALL | 2015-04-29 |
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