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| Plan Name | ALTERNATIVE STAFFING EMPLOYEE MEDICAL PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | ALTERNATIVE STAFFING, INC. |
| Employer identification number (EIN): | 364139251 |
| NAIC Classification: | 561300 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2020-01-01 | ||||
| 501 | 2020-01-01 | ||||
| 501 | 2019-01-01 | ||||
| 501 | 2018-01-01 | ||||
| 501 | 2017-01-01 | KYLE CARSTENSEN | |||
| 501 | 2016-01-01 | KYLE CARSTENSEN | |||
| 501 | 2015-01-01 | KYLE CARSTENSEN |
| QBE A&H (National Association of Insurance Commissioners NAIC id number: 10219 ) | |
| Policy contract number | LGS01982-20 |
| Policy instance | 1 |
| QBE A&H (National Association of Insurance Commissioners NAIC id number: 10219 ) | |
| Policy contract number | LGS01982-19 |
| Policy instance | 1 |
| QBE A&H (National Association of Insurance Commissioners NAIC id number: 10219 ) | |
| Policy contract number | LGS01982-18 |
| Policy instance | 1 |
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