| Plan Name | WESTERN STATE DESIGN HEALTH AND WELFARE BENEFIT PLANS |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | WESTERN STATE DESIGN, INC. |
| Employer identification number (EIN): | 813796471 |
| NAIC Classification: | 812310 |
| NAIC Description: | Coin-Operated Laundries and Drycleaners |
Additional information about WESTERN STATE DESIGN, INC.
| Jurisdiction of Incorporation: | Alaska Department Commerce, Community & Economic Development |
| Incorporation Date: | 2008-03-25 |
| Company Identification Number: | 114938 |
| Legal Registered Office Address: |
14241 NE WOODINVILLE DUVALL RD. WOODINVILLE United States of America (USA) 98072 |
More information about WESTERN STATE DESIGN, INC.
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2022-12-01 | MARIANNE LENCI | 2024-04-18 |
| 2022: WESTERN STATE DESIGN HEALTH AND WELFARE BENEFIT PLANS 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 funding arrangement – General assets of the sponsor | Yes |
| 2022-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-12-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 ) | |
| Policy contract number | 1352400 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST (National Association of Insurance Commissioners NAIC id number: 95540 ) | |
| Policy contract number | 662 |
| Policy instance | 2 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 30018170 |
| Policy instance | 3 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | TS05997716 |
| Policy instance | 4 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 12089 |
| Policy instance | 5 |