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| Plan Name | A.B. CLOSING CORPORATION - KAVALIRO MEDICAL PLAN |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | A.B. CLOSING CORPORATION, DBA KAVALIRO |
| Employer identification number (EIN): | 061681440 |
| NAIC Classification: | 561110 |
| NAIC Description: | Office Administrative Services |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2015-08-01 | STEPHANIE BRUHA | JENNIFER MILLER | 2017-02-21 | |
| 502 | 2015-08-01 | JENNIFER MILLER | 2019-02-22 |
| 2015: A.B. CLOSING CORPORATION - KAVALIRO MEDICAL PLAN 2015 form 5500 responses | ||
|---|---|---|
| 2015-08-01 | Type of plan entity | Single employer plan |
| 2015-08-01 | First time form 5500 has been submitted | Yes |
| 2015-08-01 | Submission has been amended | No |
| 2015-08-01 | This submission is the final filing | Yes |
| 2015-08-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-08-01 | Plan is a collectively bargained plan | No |
| 2015-08-01 | Plan funding arrangement – Insurance | Yes |
| 2015-08-01 | Plan benefit arrangement – Insurance | Yes |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |
| Policy contract number | 539293 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 711391 |
| Policy instance | 2 |
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