| Plan Name | COURTESY AUTOMOTIVE GROUP DENTAL AND VISION PLAN |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | COURTESY FORD, INC. |
| Employer identification number (EIN): | 580943526 |
| NAIC Classification: | 441110 |
| NAIC Description: | New Car Dealers |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2022-12-01 | ASHLEY KELLY | 2024-08-30 | ||
| 502 | 2021-12-01 | ASHLEY KELLY | 2024-08-30 | ||
| 502 | 2020-12-01 | ASHLEY KELLY | 2024-08-30 | ||
| 502 | 2019-12-01 | ASHLEY KELLY | 2024-08-30 |
| 2022: COURTESY AUTOMOTIVE GROUP DENTAL AND VISION PLAN 2022 form 5500 responses | ||
|---|---|---|
| 2022-12-01 | Type of plan entity | Single employer plan |
| 2022-12-01 | This submission is the final filing | Yes |
| 2022-12-01 | Plan funding arrangement – Insurance | Yes |
| 2022-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: COURTESY AUTOMOTIVE GROUP DENTAL AND VISION PLAN 2021 form 5500 responses | ||
| 2021-12-01 | Type of plan entity | Single employer plan |
| 2021-12-01 | Plan funding arrangement – Insurance | Yes |
| 2021-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: COURTESY AUTOMOTIVE GROUP DENTAL AND VISION PLAN 2020 form 5500 responses | ||
| 2020-12-01 | Type of plan entity | Single employer plan |
| 2020-12-01 | Plan funding arrangement – Insurance | Yes |
| 2020-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: COURTESY AUTOMOTIVE GROUP DENTAL AND VISION PLAN 2019 form 5500 responses | ||
| 2019-12-01 | Type of plan entity | Single employer plan |
| 2019-12-01 | First time form 5500 has been submitted | Yes |
| 2019-12-01 | Plan funding arrangement – Insurance | Yes |
| 2019-12-01 | Plan benefit arrangement – Insurance | Yes |
| BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) | |||||||||||||||||||||
| Policy contract number | GA9868 | ||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||
| BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) | |||||||||||||||||||||
| Policy contract number | GA9868 | ||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||
| BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) | |||||||||||||||||||||
| Policy contract number | GA9868 | ||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||
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| BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) | |||||||||||||||||||||
| Policy contract number | GA9868 | ||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||
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