| Plan Name | BCBS OF FLORIDA BLUE OPTIONS |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | GULF COAST SUPPLY & MANUFACTURING, LLC |
| Employer identification number (EIN): | 900638028 |
| NAIC Classification: | 332300 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2018-07-01 | HARRY YEATMAN | 2019-12-23 |
| 2018: BCBS OF FLORIDA BLUE OPTIONS 2018 form 5500 responses | ||
|---|---|---|
| 2018-07-01 | Type of plan entity | Single employer plan |
| 2018-07-01 | First time form 5500 has been submitted | Yes |
| 2018-07-01 | Plan funding arrangement – Insurance | Yes |
| 2018-07-01 | Plan benefit arrangement – Insurance | Yes |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |
| Policy contract number | 81724 |
| Policy instance | 1 |