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| Plan Name | THE SWAN CORPORATION HEALTH PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | SWAN SURFACES, LLC |
| Employer identification number (EIN): | 813016256 |
| NAIC Classification: | 339900 |
Additional information about SWAN SURFACES, LLC
| Jurisdiction of Incorporation: | Texas Secretary of State |
| Incorporation Date: | 2016-07-22 |
| Company Identification Number: | 0802505773 |
| Legal Registered Office Address: |
PO BOX 18010 EVANSVILLE United States of America (USA) 47719 |
More information about SWAN SURFACES, LLC
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2017-01-01 | ||||
| 501 | 2017-01-01 | ||||
| 501 | 2016-01-01 | STEVE COBB | |||
| 501 | 2016-01-01 | ||||
| 501 | 2016-01-01 | SANDY MOORE | 2018-04-02 |
| Measure | Date | Value |
|---|---|---|
| 2017: THE SWAN CORPORATION HEALTH PLAN 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-01-01 | 165 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 152 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
| Total of all active and inactive participants | 2017-01-01 | 152 |
| Number of employers contributing to the scheme | 2017-01-01 | 0 |
| 2016: THE SWAN CORPORATION HEALTH PLAN 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-01-01 | 153 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 157 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
| Total of all active and inactive participants | 2016-01-01 | 157 |
| 2017: THE SWAN CORPORATION HEALTH PLAN 2017 form 5500 responses | ||
|---|---|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Submission has been amended | Yes |
| 2017-01-01 | This submission is the final filing | Yes |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: THE SWAN CORPORATION HEALTH PLAN 2016 form 5500 responses | ||
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Submission has been amended | Yes |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |||||||||||||||||||||||||||||||||||||||
| Policy contract number | 508892 | ||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||
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| HEALTHY ALLIANCE LIFE INSURANCE COMPANY (G0262) (National Association of Insurance Commissioners NAIC id number: 78972 ) | |||||||||||||||||||||||||||||||||||||||
| Policy contract number | 247290 | ||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||
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