| Plan Name | SOUTH JERSEY PAINT AND GLASS WELFARE BENEFIT PLAN |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | SOUTH JERSEY GLASS CO. INC. |
| Employer identification number (EIN): | 210699654 |
| NAIC Classification: | 442291 |
| NAIC Description: | Window Treatment Stores |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2023-06-15 | JODI TRIVELLINI | 2025-01-15 | ||
| 502 | 2022-06-15 | JODI TRIVELLINI | 2024-01-29 |
| 2023: SOUTH JERSEY PAINT AND GLASS WELFARE BENEFIT PLAN 2023 form 5500 responses | ||
|---|---|---|
| 2023-06-15 | Type of plan entity | Single employer plan |
| 2023-06-15 | Plan funding arrangement – Insurance | Yes |
| 2023-06-15 | Plan benefit arrangement – Insurance | Yes |
| 2022: SOUTH JERSEY PAINT AND GLASS WELFARE BENEFIT PLAN 2022 form 5500 responses | ||
| 2022-06-15 | Type of plan entity | Single employer plan |
| 2022-06-15 | First time form 5500 has been submitted | Yes |
| 2022-06-15 | Plan funding arrangement – Insurance | Yes |
| 2022-06-15 | Plan benefit arrangement – Insurance | Yes |
| HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) | |||||||||||||||||||||||
| Policy contract number | 8006O | ||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||
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| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) | |||||||||||||||||||||||
| Policy contract number | 50021928 | ||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||
| |||||||||||||||||||||||
| HORIZON HEALTHCARE SERVICES, INC. (National Association of Insurance Commissioners NAIC id number: 55069 ) | |||||||||||||||||||||||
| Policy contract number | 8006O | ||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||
| USABLE LIFE (National Association of Insurance Commissioners NAIC id number: 94358 ) | |||||||||||||||||||||||
| Policy contract number | 50021928 | ||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||