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| Plan Name | POWER MOBILE LIFE LLC |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | POWER MOBILE LIFE LLC |
| Employer identification number (EIN): | 475633348 |
| 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 |
|---|---|---|---|---|---|
| 501 | 2023-01-01 | OLGA ZENG | 2024-05-15 | ||
| 501 | 2022-01-01 | OLGA ZENG | 2023-05-31 | ||
| 501 | 2021-01-01 | OLGA ZENG | 2022-07-10 |
| 2023: POWER MOBILE LIFE LLC 2023 form 5500 responses | ||
|---|---|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Submission has been amended | Yes |
| 2023-01-01 | This submission is the final filing | Yes |
| 2023-01-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2023-01-01 | Plan funding arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: POWER MOBILE LIFE LLC 2022 form 5500 responses | ||
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: POWER MOBILE LIFE LLC 2021 form 5500 responses | ||
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | First time form 5500 has been submitted | Yes |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| ASURIS NORTHWEST HEALTH (National Association of Insurance Commissioners NAIC id number: 47350 ) | |||||||||||||||||||||
| Policy contract number | 10027533 | ||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||
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| REGENCE BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 53902 ) | |||||||||||||||||||||
| Policy contract number | 10027533 | ||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||
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| REGENCE BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 53902 ) | |||||||||||||||||||||
| Policy contract number | 10027533 | ||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||
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