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| Plan Name | BASIC LIFE/AD&D |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | SOUTHERN WAREHOUSING & DISTRIBUTION |
| Employer identification number (EIN): | 721539116 |
| NAIC Classification: | 484110 |
| NAIC Description: | General Freight Trucking, Local |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2022-12-01 | DAYTON SIMMS | 2024-06-28 |
| 2022: BASIC LIFE/AD&D 2022 form 5500 responses | ||
|---|---|---|
| 2022-12-01 | Type of plan entity | Single employer plan |
| 2022-12-01 | First time form 5500 has been submitted | Yes |
| 2022-12-01 | Plan funding arrangement – Insurance | Yes |
| 2022-12-01 | Plan benefit arrangement – Insurance | Yes |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |
| Policy contract number | GLUG0BG5V |
| Policy instance | 1 |
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