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| Plan Name | ACTIVE CONCEPTS, LLC MEDICAL PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | ACTIVE CONCEPTS, LLC |
| Employer identification number (EIN): | 223771082 |
| NAIC Classification: | 325100 |
Additional information about ACTIVE CONCEPTS, LLC
| Jurisdiction of Incorporation: | Texas Secretary of State |
| Incorporation Date: | 2013-04-20 |
| Company Identification Number: | 0801770604 |
| Legal Registered Office Address: |
1601 WELCH STE. B HOUSTON United States of America (USA) 77006 |
More information about ACTIVE CONCEPTS, LLC
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2023-12-01 | LUKE SHOOK | |||
| 501 | 2022-12-01 | ||||
| 501 | 2022-12-01 | LUKE SHOOK |
| 2022: ACTIVE CONCEPTS, LLC MEDICAL PLAN 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 | Submission has been amended | No |
| 2022-12-01 | This submission is the final filing | No |
| 2022-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-12-01 | Plan is a collectively bargained plan | No |
| 2022-12-01 | Plan funding arrangement – Insurance | Yes |
| 2022-12-01 | Plan benefit arrangement – Insurance | Yes |
| BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) | |
| Policy contract number | 14167273-1001 |
| Policy instance | 1 |
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