| Plan Name | MEDICAL PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | WHOLE FAMILY HEALTH CENTER |
| Employer identification number (EIN): | 650715258 |
| NAIC Classification: | 621498 |
| NAIC Description: | All Other Outpatient Care Centers |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2023-03-01 | THERESA MALONE | 2024-10-11 |
| 2023: MEDICAL PLAN 2023 form 5500 responses | ||
|---|---|---|
| 2023-03-01 | Type of plan entity | Single employer plan |
| 2023-03-01 | First time form 5500 has been submitted | Yes |
| 2023-03-01 | Plan funding arrangement – Insurance | Yes |
| 2023-03-01 | Plan benefit arrangement – Insurance | Yes |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |||||||||||||||||
| Policy contract number | 03805 | ||||||||||||||||
| Policy instance | 1 | ||||||||||||||||
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