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| Plan Name | REVENUE WELL SYSTEMS HEALTH AND WELFARE BENEFIT PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | REVENUE WELL SYSTEMS, LLC |
| Employer identification number (EIN): | 272103096 |
| NAIC Classification: | 541519 |
| NAIC Description: | Other Computer Related Services |
Additional information about REVENUE WELL SYSTEMS, LLC
| Jurisdiction of Incorporation: | Texas Secretary of State |
| Incorporation Date: | 2017-09-01 |
| Company Identification Number: | 0802806157 |
| Legal Registered Office Address: |
2275 HALF DAY RD STE 337 BANNOCKBURN United States of America (USA) 60015 |
More information about REVENUE WELL SYSTEMS, LLC
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2019-03-01 | SERGE LONGIN | 2020-10-06 |
| 2019: REVENUE WELL SYSTEMS HEALTH AND WELFARE BENEFIT PLAN 2019 form 5500 responses | ||
|---|---|---|
| 2019-03-01 | Type of plan entity | Single employer plan |
| 2019-03-01 | First time form 5500 has been submitted | Yes |
| 2019-03-01 | Submission has been amended | No |
| 2019-03-01 | This submission is the final filing | No |
| 2019-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-03-01 | Plan is a collectively bargained plan | No |
| 2019-03-01 | Plan funding arrangement – Insurance | Yes |
| 2019-03-01 | Plan benefit arrangement – Insurance | Yes |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) | |
| Policy contract number | OMB884 |
| Policy instance | 1 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | 5957853 |
| Policy instance | 2 |
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