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| Plan Name | VALLEY WIDE BEVERAGE COMPANY - HEALTH PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | FRESNO BEVERAGE COMPANY, INC. |
| Employer identification number (EIN): | 770057122 |
| NAIC Classification: | 424800 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2022-01-01 | ||||
| 501 | 2022-01-01 | KIMBERLY LESTER | |||
| 501 | 2021-01-01 | ||||
| 501 | 2021-01-01 | KIMBERLY LESTER | |||
| 501 | 2020-01-01 | ||||
| 501 | 2019-01-01 | ||||
| 501 | 2018-01-01 | KIMBERLY LESTER | |||
| 501 | 2017-01-01 | KIMBERLY LESTER | |||
| 501 | 2015-01-01 | TODD HOWERTON | |||
| 501 | 2013-01-01 | TODD HOWERTON | TODD HOWERTON | 2014-07-24 | |
| 501 | 2012-01-01 | TODD HOWERTON | TODD HOWERTON | 2013-07-23 | |
| 501 | 2011-01-01 | TODD HOWERTON | TODD HOWERTON | 2012-07-31 |
| 2022: VALLEY WIDE BEVERAGE COMPANY - HEALTH PLAN 2022 form 5500 responses | ||
|---|---|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: VALLEY WIDE BEVERAGE COMPANY - HEALTH PLAN 2021 form 5500 responses | ||
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: VALLEY WIDE BEVERAGE COMPANY - HEALTH PLAN 2020 form 5500 responses | ||
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: VALLEY WIDE BEVERAGE COMPANY - HEALTH PLAN 2019 form 5500 responses | ||
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: VALLEY WIDE BEVERAGE COMPANY - HEALTH PLAN 2018 form 5500 responses | ||
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: VALLEY WIDE BEVERAGE COMPANY - HEALTH PLAN 2017 form 5500 responses | ||
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: VALLEY WIDE BEVERAGE COMPANY - HEALTH PLAN 2015 form 5500 responses | ||
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: VALLEY WIDE BEVERAGE COMPANY - HEALTH PLAN 2013 form 5500 responses | ||
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: VALLEY WIDE BEVERAGE COMPANY - HEALTH PLAN 2012 form 5500 responses | ||
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: VALLEY WIDE BEVERAGE COMPANY - HEALTH PLAN 2011 form 5500 responses | ||
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | First time form 5500 has been submitted | Yes |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) | |||||||||||||||
| Policy contract number | 1150488 | ||||||||||||||
| Policy instance | 1 | ||||||||||||||
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| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||
| Policy contract number | 605840 | ||||||||||||||
| Policy instance | 3 | ||||||||||||||
| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) | |||||||||||||||
| Policy contract number | 279170 | ||||||||||||||
| Policy instance | 2 | ||||||||||||||
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||
| Policy contract number | 279170 | ||||||||||||||
| Policy instance | 1 | ||||||||||||||
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||
| Policy contract number | 605840 | ||||||||||||||
| Policy instance | 3 | ||||||||||||||
| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) | |||||||||||||||
| Policy contract number | 279170 | ||||||||||||||
| Policy instance | 2 | ||||||||||||||
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||
| Policy contract number | 279170 | ||||||||||||||
| Policy instance | 1 | ||||||||||||||
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||
| Policy contract number | 605840 | ||||||||||||||
| Policy instance | 3 | ||||||||||||||
| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) | |||||||||||||||
| Policy contract number | 279170 | ||||||||||||||
| Policy instance | 2 | ||||||||||||||
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||
| Policy contract number | 279170 | ||||||||||||||
| Policy instance | 1 | ||||||||||||||
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||
| Policy contract number | 279170 | ||||||||||||||
| Policy instance | 1 | ||||||||||||||
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||
| Policy contract number | 279170 | ||||||||||||||
| Policy instance | 1 | ||||||||||||||
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||
| Policy contract number | 279170 | ||||||||||||||
| Policy instance | 1 | ||||||||||||||
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |||||||||||||||
| Policy contract number | 605184 | ||||||||||||||
| Policy instance | 1 | ||||||||||||||
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |||||||||||||||
| Policy contract number | 605184 | ||||||||||||||
| Policy instance | 1 | ||||||||||||||
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |||||||||||||||
| Policy contract number | 605184 | ||||||||||||||
| Policy instance | 1 | ||||||||||||||
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