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| Plan Name | EMERALD FOREST PRODUCTS HEALTH AND WELFARE BENEFITS PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | EMERALD FOREST PRODUCTS |
| Employer identification number (EIN): | 931763216 |
| NAIC Classification: | 321210 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2015-06-01 | LISA BAER | LISA BAER | 2016-02-15 | |
| 501 | 2014-06-01 | LISA BAER | LISA BAER | 2016-02-15 | |
| 501 | 2013-06-01 | SUE VICKERS | SUE VICKERS | 2015-03-12 |
| 2015: EMERALD FOREST PRODUCTS HEALTH AND WELFARE BENEFITS PLAN 2015 form 5500 responses | ||
|---|---|---|
| 2015-06-01 | Type of plan entity | Single employer plan |
| 2015-06-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2015-06-01 | Plan funding arrangement – Insurance | Yes |
| 2015-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: EMERALD FOREST PRODUCTS HEALTH AND WELFARE BENEFITS PLAN 2014 form 5500 responses | ||
| 2014-06-01 | Type of plan entity | Single employer plan |
| 2014-06-01 | Plan funding arrangement – Insurance | Yes |
| 2014-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: EMERALD FOREST PRODUCTS HEALTH AND WELFARE BENEFITS PLAN 2013 form 5500 responses | ||
| 2013-06-01 | Type of plan entity | Single employer plan |
| 2013-06-01 | Plan funding arrangement – Insurance | Yes |
| 2013-06-01 | Plan benefit arrangement – Insurance | Yes |
| LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 ) | |
| Policy contract number | OR000090 |
| Policy instance | 1 |
| LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 ) | |
| Policy contract number | OR000090 |
| Policy instance | 1 |
| LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 ) | |
| Policy contract number | OR000090 |
| Policy instance | 1 |
| PACIFICSOURCE HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 54976 ) | |
| Policy contract number | G0021669 |
| Policy instance | 2 |
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