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| Plan Name | HUNTERS RUN P.O.A., INC. HEALTH & WELFARE PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC. |
| Employer identification number (EIN): | 592015694 |
| NAIC Classification: | 524140 |
Additional information about BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.
| Jurisdiction of Incorporation: | Florida Department of State Division of Corporations |
| Incorporation Date: | 1980-07-01 |
| Company Identification Number: | 753198 |
| Legal Registered Office Address: |
P O BOX 6200 (32314-6200) TALLAHASSEE 32399 |
More information about BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2021-01-01 | ||||
| 501 | 2018-01-01 |
| Measure | Date | Value |
|---|---|---|
| 2021: HUNTERS RUN P.O.A., INC. HEALTH & WELFARE PLAN 2021 401k membership | ||
| Total participants, beginning-of-year | 2021-01-01 | 220 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 190 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 1 |
| Total of all active and inactive participants | 2021-01-01 | 191 |
| Total participants | 2021-01-01 | 191 |
| 2018: HUNTERS RUN P.O.A., INC. HEALTH & WELFARE PLAN 2018 401k membership | ||
| Total participants, beginning-of-year | 2018-01-01 | 227 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 213 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 213 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2018-01-01 | 1 |
| Total participants | 2018-01-01 | 214 |
| Number of participants with account balances | 2018-01-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2018-01-01 | 0 |
| 2021: HUNTERS RUN P.O.A., INC. HEALTH & WELFARE PLAN 2021 form 5500 responses | ||
|---|---|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | First time form 5500 has been submitted | Yes |
| 2021-01-01 | Submission has been amended | No |
| 2021-01-01 | This submission is the final filing | No |
| 2021-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-01-01 | Plan is a collectively bargained plan | No |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: HUNTERS RUN P.O.A., INC. HEALTH & WELFARE 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 | Submission has been amended | No |
| 2018-01-01 | This submission is the final filing | No |
| 2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-01-01 | Plan is a collectively bargained plan | No |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 45111 | ||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||
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| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 45111 | ||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||
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