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| Plan Name | JACK LAURIE GROUP ANCILLARY PLAN |
| Plan identification number | 504 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | JACK LAURIE FLOORS, LLC |
| Employer identification number (EIN): | 271567831 |
| NAIC Classification: | 238300 |
Additional information about JACK LAURIE FLOORS, LLC
| Jurisdiction of Incorporation: | Indiana Secretary of State |
| Incorporation Date: | |
| Company Identification Number: | 009123100480 |
More information about JACK LAURIE FLOORS, LLC
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 504 | 2024-01-01 | R. SCOTT LIUBERT | |||
| 504 | 2023-01-01 | CINDY MELTON | 2024-10-02 |
| 2023: JACK LAURIE GROUP ANCILLARY PLAN 2023 form 5500 responses | ||
|---|---|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | First time form 5500 has been submitted | Yes |
| 2023-01-01 | Plan funding arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) | |||||||||||||||||||||||||||||
| Policy contract number | 944283 | ||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||
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