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| Plan Name | ARCHRIVAL AGENTS MEDICAL PLAN |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | ARCHRIVAL AGENTS, INC. |
| Employer identification number (EIN): | 270602874 |
| NAIC Classification: | 541990 |
| NAIC Description: | All Other Professional, Scientific, and Technical Services |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2018-11-01 | ||||
| 502 | 2017-11-01 | ||||
| 502 | 2016-11-01 |
| BLUE CROSS BLUE SHIELD OF NEBRASKA (National Association of Insurance Commissioners NAIC id number: 77780 ) | |
| Policy contract number | 305463 |
| Policy instance | 1 |
| BLUE CROSS BLUE SHIELD OF NEBRASKA (National Association of Insurance Commissioners NAIC id number: 77780 ) | |
| Policy contract number | 305463 |
| Policy instance | 1 |
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