401k Plan data: CHROME HEARTS LLC WELFARE BENEFITS PLAN plan

CHROME HEARTS LLC WELFARE BENEFITS PLAN 401k Plan overview

Plan Name	CHROME HEARTS LLC WELFARE BENEFITS PLAN
Plan identification number	501

CHROME HEARTS LLC WELFARE BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

CHROME HEARTS LLC has sponsored the creation of one or more 401k plans.

Company Name: CHROME HEARTS LLC

Employer identification number (EIN): 562501506

NAIC Classification: 315210
NAIC Description: Cut and Sew Apparel Contractors

Additional information about CHROME HEARTS LLC

Jurisdiction of Incorporation: Florida Department of State Division of Corporations

Incorporation Date: 2016-03-03

Company Identification Number: L16000044395

Legal Registered Office Address: 4025 NE 2ND AVE

MIAMI

33137

More information about CHROME HEARTS LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CHROME HEARTS LLC WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-10-01 DEVON DICIAULA 2024-07-15
501 2021-10-01 ELIZABETH DE LEON 2023-07-12
501 2020-10-01 DALIBOR SNYDER 2022-05-04
501 2019-10-01 DALIBOR SNYDER 2021-05-11
501 2018-10-01
501 2017-10-01
501 2017-04-01 GINA LUNA
501 2016-04-01 GINA LUNA
501 2015-04-01 GINA LUNA
501 2014-04-01 ROSE-MARIE RICHMOND
501 2013-04-01 ROSE-MARIE RICHMOND
501 2012-04-01 ROSE-MARIE RICHMOND
501 2011-04-01 ROSE-MARIE RICHMOND
501 2010-04-01 ROSE-MARIE RICHMOND
501 2009-04-01 ROSE-MARIE RICHMOND

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2022-10-01	DEVON DICIAULA	2024-07-15
501	2021-10-01	ELIZABETH DE LEON	2023-07-12
501	2020-10-01	DALIBOR SNYDER	2022-05-04
501	2019-10-01	DALIBOR SNYDER	2021-05-11
501	2018-10-01
501	2017-10-01
501	2017-04-01	GINA LUNA
501	2016-04-01	GINA LUNA
501	2015-04-01	GINA LUNA
501	2014-04-01	ROSE-MARIE RICHMOND
501	2013-04-01	ROSE-MARIE RICHMOND
501	2012-04-01	ROSE-MARIE RICHMOND
501	2011-04-01	ROSE-MARIE RICHMOND
501	2010-04-01	ROSE-MARIE RICHMOND
501	2009-04-01	ROSE-MARIE RICHMOND

Plan Statistics for CHROME HEARTS LLC WELFARE BENEFITS PLAN

401k plan membership statisitcs for CHROME HEARTS LLC WELFARE BENEFITS PLAN

Measure Date Value
2022: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year 2022-10-01 585
Total number of active participants reported on line 7a of the Form 5500 2022-10-01 354
Number of retired or separated participants receiving benefits 2022-10-01 0
Number of other retired or separated participants entitled to future benefits 2022-10-01 0
Total of all active and inactive participants 2022-10-01 354
Number of employers contributing to the scheme 2022-10-01 0
2021: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year 2021-10-01 590
Total number of active participants reported on line 7a of the Form 5500 2021-10-01 585
Number of retired or separated participants receiving benefits 2021-10-01 5
Number of other retired or separated participants entitled to future benefits 2021-10-01 0
Total of all active and inactive participants 2021-10-01 590
Number of employers contributing to the scheme 2021-10-01 0
2020: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-10-01 558
Total number of active participants reported on line 7a of the Form 5500 2020-10-01 594
Number of retired or separated participants receiving benefits 2020-10-01 0
Number of other retired or separated participants entitled to future benefits 2020-10-01 0
Total of all active and inactive participants 2020-10-01 594
Number of employers contributing to the scheme 2020-10-01 0
2019: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-10-01 600
Total number of active participants reported on line 7a of the Form 5500 2019-10-01 558
Number of retired or separated participants receiving benefits 2019-10-01 0
Number of other retired or separated participants entitled to future benefits 2019-10-01 0
Total of all active and inactive participants 2019-10-01 558
Number of employers contributing to the scheme 2019-10-01 0
2018: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year 2018-10-01 415
Total number of active participants reported on line 7a of the Form 5500 2018-10-01 599
Number of retired or separated participants receiving benefits 2018-10-01 1
Number of other retired or separated participants entitled to future benefits 2018-10-01 0
Total of all active and inactive participants 2018-10-01 600
2017: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-10-01 396
Total number of active participants reported on line 7a of the Form 5500 2017-10-01 414
Number of retired or separated participants receiving benefits 2017-10-01 1
Number of other retired or separated participants entitled to future benefits 2017-10-01 0
Total of all active and inactive participants 2017-10-01 415
Total participants, beginning-of-year 2017-04-01 555
Total number of active participants reported on line 7a of the Form 5500 2017-04-01 393
Number of retired or separated participants receiving benefits 2017-04-01 3
Number of other retired or separated participants entitled to future benefits 2017-04-01 0
Total of all active and inactive participants 2017-04-01 396
2016: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-04-01 541
Total number of active participants reported on line 7a of the Form 5500 2016-04-01 553
Number of retired or separated participants receiving benefits 2016-04-01 2
Number of other retired or separated participants entitled to future benefits 2016-04-01 0
Total of all active and inactive participants 2016-04-01 555
2015: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-04-01 534
Total number of active participants reported on line 7a of the Form 5500 2015-04-01 539
Number of retired or separated participants receiving benefits 2015-04-01 2
Number of other retired or separated participants entitled to future benefits 2015-04-01 0
Total of all active and inactive participants 2015-04-01 541
2014: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-04-01 303
Total number of active participants reported on line 7a of the Form 5500 2014-04-01 534
Number of retired or separated participants receiving benefits 2014-04-01 0
Number of other retired or separated participants entitled to future benefits 2014-04-01 0
Total of all active and inactive participants 2014-04-01 534
2013: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-04-01 318
Total number of active participants reported on line 7a of the Form 5500 2013-04-01 303
Number of retired or separated participants receiving benefits 2013-04-01 0
Number of other retired or separated participants entitled to future benefits 2013-04-01 0
Total of all active and inactive participants 2013-04-01 303
2012: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-04-01 254
Total number of active participants reported on line 7a of the Form 5500 2012-04-01 318
Number of retired or separated participants receiving benefits 2012-04-01 0
Number of other retired or separated participants entitled to future benefits 2012-04-01 0
Total of all active and inactive participants 2012-04-01 318
2011: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-04-01 239
Total number of active participants reported on line 7a of the Form 5500 2011-04-01 252
Number of retired or separated participants receiving benefits 2011-04-01 2
Number of other retired or separated participants entitled to future benefits 2011-04-01 0
Total of all active and inactive participants 2011-04-01 254
2010: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year 2010-04-01 230
Total number of active participants reported on line 7a of the Form 5500 2010-04-01 238
Number of retired or separated participants receiving benefits 2010-04-01 1
Number of other retired or separated participants entitled to future benefits 2010-04-01 0
Total of all active and inactive participants 2010-04-01 239
2009: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-04-01 245
Total number of active participants reported on line 7a of the Form 5500 2009-04-01 229
Number of retired or separated participants receiving benefits 2009-04-01 1
Number of other retired or separated participants entitled to future benefits 2009-04-01 0
Total of all active and inactive participants 2009-04-01 230

Measure	Date	Value
2022: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2022 401k membership
Total participants, beginning-of-year	2022-10-01	585
Total number of active participants reported on line 7a of the Form 5500	2022-10-01	354
Number of retired or separated participants receiving benefits	2022-10-01	0
Number of other retired or separated participants entitled to future benefits	2022-10-01	0
Total of all active and inactive participants	2022-10-01	354
Number of employers contributing to the scheme	2022-10-01	0
2021: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2021 401k membership
Total participants, beginning-of-year	2021-10-01	590
Total number of active participants reported on line 7a of the Form 5500	2021-10-01	585
Number of retired or separated participants receiving benefits	2021-10-01	5
Number of other retired or separated participants entitled to future benefits	2021-10-01	0
Total of all active and inactive participants	2021-10-01	590
Number of employers contributing to the scheme	2021-10-01	0
2020: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-10-01	558
Total number of active participants reported on line 7a of the Form 5500	2020-10-01	594
Number of retired or separated participants receiving benefits	2020-10-01	0
Number of other retired or separated participants entitled to future benefits	2020-10-01	0
Total of all active and inactive participants	2020-10-01	594
Number of employers contributing to the scheme	2020-10-01	0
2019: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-10-01	600
Total number of active participants reported on line 7a of the Form 5500	2019-10-01	558
Number of retired or separated participants receiving benefits	2019-10-01	0
Number of other retired or separated participants entitled to future benefits	2019-10-01	0
Total of all active and inactive participants	2019-10-01	558
Number of employers contributing to the scheme	2019-10-01	0
2018: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year	2018-10-01	415
Total number of active participants reported on line 7a of the Form 5500	2018-10-01	599
Number of retired or separated participants receiving benefits	2018-10-01	1
Number of other retired or separated participants entitled to future benefits	2018-10-01	0
Total of all active and inactive participants	2018-10-01	600
2017: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-10-01	396
Total number of active participants reported on line 7a of the Form 5500	2017-10-01	414
Number of retired or separated participants receiving benefits	2017-10-01	1
Number of other retired or separated participants entitled to future benefits	2017-10-01	0
Total of all active and inactive participants	2017-10-01	415
Total participants, beginning-of-year	2017-04-01	555
Total number of active participants reported on line 7a of the Form 5500	2017-04-01	393
Number of retired or separated participants receiving benefits	2017-04-01	3
Number of other retired or separated participants entitled to future benefits	2017-04-01	0
Total of all active and inactive participants	2017-04-01	396
2016: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-04-01	541
Total number of active participants reported on line 7a of the Form 5500	2016-04-01	553
Number of retired or separated participants receiving benefits	2016-04-01	2
Number of other retired or separated participants entitled to future benefits	2016-04-01	0
Total of all active and inactive participants	2016-04-01	555
2015: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-04-01	534
Total number of active participants reported on line 7a of the Form 5500	2015-04-01	539
Number of retired or separated participants receiving benefits	2015-04-01	2
Number of other retired or separated participants entitled to future benefits	2015-04-01	0
Total of all active and inactive participants	2015-04-01	541
2014: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-04-01	303
Total number of active participants reported on line 7a of the Form 5500	2014-04-01	534
Number of retired or separated participants receiving benefits	2014-04-01	0
Number of other retired or separated participants entitled to future benefits	2014-04-01	0
Total of all active and inactive participants	2014-04-01	534
2013: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-04-01	318
Total number of active participants reported on line 7a of the Form 5500	2013-04-01	303
Number of retired or separated participants receiving benefits	2013-04-01	0
Number of other retired or separated participants entitled to future benefits	2013-04-01	0
Total of all active and inactive participants	2013-04-01	303
2012: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-04-01	254
Total number of active participants reported on line 7a of the Form 5500	2012-04-01	318
Number of retired or separated participants receiving benefits	2012-04-01	0
Number of other retired or separated participants entitled to future benefits	2012-04-01	0
Total of all active and inactive participants	2012-04-01	318
2011: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-04-01	239
Total number of active participants reported on line 7a of the Form 5500	2011-04-01	252
Number of retired or separated participants receiving benefits	2011-04-01	2
Number of other retired or separated participants entitled to future benefits	2011-04-01	0
Total of all active and inactive participants	2011-04-01	254
2010: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2010 401k membership
Total participants, beginning-of-year	2010-04-01	230
Total number of active participants reported on line 7a of the Form 5500	2010-04-01	238
Number of retired or separated participants receiving benefits	2010-04-01	1
Number of other retired or separated participants entitled to future benefits	2010-04-01	0
Total of all active and inactive participants	2010-04-01	239
2009: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-04-01	245
Total number of active participants reported on line 7a of the Form 5500	2009-04-01	229
Number of retired or separated participants receiving benefits	2009-04-01	1
Number of other retired or separated participants entitled to future benefits	2009-04-01	0
Total of all active and inactive participants	2009-04-01	230

Form 5500 Responses for CHROME HEARTS LLC WELFARE BENEFITS PLAN

2022: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2022 form 5500 responses
2022-10-01	Type of plan entity	Single employer plan
2022-10-01	Plan funding arrangement – Insurance	Yes
2022-10-01	Plan benefit arrangement – Insurance	Yes
2021: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2021 form 5500 responses
2021-10-01	Type of plan entity	Single employer plan
2021-10-01	Plan funding arrangement – Insurance	Yes
2021-10-01	Plan benefit arrangement – Insurance	Yes
2020: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2020 form 5500 responses
2020-10-01	Type of plan entity	Single employer plan
2020-10-01	Plan funding arrangement – Insurance	Yes
2020-10-01	Plan benefit arrangement – Insurance	Yes
2019: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2019 form 5500 responses
2019-10-01	Type of plan entity	Single employer plan
2019-10-01	Plan funding arrangement – Insurance	Yes
2019-10-01	Plan benefit arrangement – Insurance	Yes
2018: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2018 form 5500 responses
2018-10-01	Type of plan entity	Single employer plan
2018-10-01	Submission has been amended	No
2018-10-01	This submission is the final filing	No
2018-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-10-01	Plan is a collectively bargained plan	No
2018-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-10-01	Plan benefit arrangement – Insurance	Yes
2017: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2017 form 5500 responses
2017-10-01	Type of plan entity	Single employer plan
2017-10-01	Submission has been amended	No
2017-10-01	This submission is the final filing	No
2017-10-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-10-01	Plan is a collectively bargained plan	No
2017-10-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-10-01	Plan benefit arrangement – Insurance	Yes
2017-04-01	Type of plan entity	Single employer plan
2017-04-01	Submission has been amended	No
2017-04-01	This submission is the final filing	No
2017-04-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2017-04-01	Plan is a collectively bargained plan	No
2017-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-04-01	Plan benefit arrangement – Insurance	Yes
2016: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2016 form 5500 responses
2016-04-01	Type of plan entity	Single employer plan
2016-04-01	Submission has been amended	No
2016-04-01	This submission is the final filing	No
2016-04-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-04-01	Plan is a collectively bargained plan	No
2016-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-04-01	Plan benefit arrangement – Insurance	Yes
2015: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2015 form 5500 responses
2015-04-01	Type of plan entity	Single employer plan
2015-04-01	Submission has been amended	No
2015-04-01	This submission is the final filing	No
2015-04-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-04-01	Plan is a collectively bargained plan	No
2015-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-04-01	Plan benefit arrangement – Insurance	Yes
2014: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2014 form 5500 responses
2014-04-01	Type of plan entity	Single employer plan
2014-04-01	Submission has been amended	No
2014-04-01	This submission is the final filing	No
2014-04-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-04-01	Plan is a collectively bargained plan	No
2014-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-04-01	Plan benefit arrangement – Insurance	Yes
2013: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2013 form 5500 responses
2013-04-01	Type of plan entity	Single employer plan
2013-04-01	Submission has been amended	No
2013-04-01	This submission is the final filing	No
2013-04-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-04-01	Plan is a collectively bargained plan	No
2013-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-04-01	Plan benefit arrangement – Insurance	Yes
2012: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2012 form 5500 responses
2012-04-01	Type of plan entity	Single employer plan
2012-04-01	Submission has been amended	Yes
2012-04-01	This submission is the final filing	No
2012-04-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-04-01	Plan is a collectively bargained plan	No
2012-04-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-04-01	Plan benefit arrangement – Insurance	Yes
2011: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2011 form 5500 responses
2011-04-01	Type of plan entity	Single employer plan
2011-04-01	Submission has been amended	No
2011-04-01	This submission is the final filing	No
2011-04-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-04-01	Plan is a collectively bargained plan	No
2011-04-01	Plan funding arrangement – Insurance	Yes
2011-04-01	Plan benefit arrangement – Insurance	Yes
2010: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2010 form 5500 responses
2010-04-01	Type of plan entity	Single employer plan
2010-04-01	Submission has been amended	No
2010-04-01	This submission is the final filing	No
2010-04-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-04-01	Plan is a collectively bargained plan	No
2010-04-01	Plan funding arrangement – Insurance	Yes
2010-04-01	Plan benefit arrangement – Insurance	Yes
2009: CHROME HEARTS LLC WELFARE BENEFITS PLAN 2009 form 5500 responses
2009-04-01	Type of plan entity	Single employer plan
2009-04-01	Submission has been amended	No
2009-04-01	This submission is the final filing	No
2009-04-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-04-01	Plan is a collectively bargained plan	No
2009-04-01	Plan funding arrangement – Insurance	Yes
2009-04-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	230698
Policy instance	2
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	5965968
Policy instance	6
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	175510HNO
Policy instance	5
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number	175510
Policy instance	4
SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 )
Policy contract number	5965968
Policy instance	3
HAWAII MEDICAL SERVICE ASSOCIATION (National Association of Insurance Commissioners NAIC id number: 95804 )
Policy contract number	10350
Policy instance	1
HAWAII MEDICAL SERVICE ASSOCIATION (National Association of Insurance Commissioners NAIC id number: 95804 )
Policy contract number	10350
Policy instance	1
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	230698
Policy instance	2
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	5965968
Policy instance	6
SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 )
Policy contract number	5965968
Policy instance	3
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number	175510
Policy instance	4
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	175510HNO
Policy instance	5
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	230698
Policy instance	2
SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 )
Policy contract number	5965968
Policy instance	3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	5965968
Policy instance	5
ARMADACARE (National Association of Insurance Commissioners NAIC id number: 66281 )
Policy contract number	MZ0936302H
Policy instance	4
HAWAII MEDICAL SERVICE ASSOCIATION (National Association of Insurance Commissioners NAIC id number: 95804 )
Policy contract number	10350
Policy instance	1
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	5965968
Policy instance	4
HAWAII MEDICAL SERVICE ASSOCIATION (National Association of Insurance Commissioners NAIC id number: 95804 )
Policy contract number	10350
Policy instance	1
SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 )
Policy contract number	5965968
Policy instance	3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	230698
Policy instance	2
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number	C21163
Policy instance	8
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	230698
Policy instance	3
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract number	HDD10
Policy instance	4
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	C21163
Policy instance	6
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract number	C21163
Policy instance	5
CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 )
Policy contract number	24736
Policy instance	1
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number	10350
Policy instance	7
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract number	199904
Policy instance	2
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number	C21163
Policy instance	4
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract number	199904
Policy instance	3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	230698
Policy instance	2
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number	10350
Policy instance	7
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract number	HDD10
Policy instance	5
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract number	C21163
Policy instance	6
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	C21163
Policy instance	1
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract number	C21163
Policy instance	1
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract number	199904
Policy instance	2
AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 )
Policy contract number	HDD10
Policy instance	3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number	C21163
Policy instance	4
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number	10350
Policy instance	5
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	C21163
Policy instance	6
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	230698
Policy instance	7
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number	10350
Policy instance	3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number	C21163
Policy instance	5
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract number	C21163
Policy instance	4
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	230698
Policy instance	2
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	C21163
Policy instance	1
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number	10350
Policy instance	5
ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 )
Policy contract number	C21163
Policy instance	1
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	C21163
Policy instance	2
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract number	C21163
Policy instance	3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	230698
Policy instance	4
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number	10350
Policy instance	2
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	230698
Policy instance	4
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00398709
Policy instance	1
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	C21163
Policy instance	3
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number	09945
Policy instance	2
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	70272
Policy instance	7
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number	GTP9113322
Policy instance	8
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	C21163
Policy instance	9
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00398709
Policy instance	2
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	230698
Policy instance	1
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 48321 )
Policy contract number	12246532
Policy instance	8
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	C21163
Policy instance	7
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number	GTP9113322
Policy instance	6
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number	10350
Policy instance	5
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	70272
Policy instance	4
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00398709
Policy instance	6
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	TS05613918
Policy instance	5
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 48321 )
Policy contract number	12246532
Policy instance	4
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	230698
Policy instance	3
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number	09945
Policy instance	1
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number	10350
Policy instance	3
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	230698
Policy instance	9
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	TS05613918
Policy instance	7
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00398709
Policy instance	8
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	C21163
Policy instance	2
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	00272-0001
Policy instance	6
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number	GTP9113322
Policy instance	1
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number	10350
Policy instance	4
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number	09945
Policy instance	3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 48321 )
Policy contract number	12246532
Policy instance	5
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number	00398709
Policy instance	1
DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 52566 )
Policy contract number	00272-0001
Policy instance	2
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	C21163
Policy instance	3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number	H46810
Policy instance	4
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number	TS05613918
Policy instance	6
KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number	230698
Policy instance	7
NATIONAL UNION (National Association of Insurance Commissioners NAIC id number: 19445 )
Policy contract number	GTP9113322
Policy instance	8
HAWAII MEDICAL SERVICE ASSOC. (National Association of Insurance Commissioners NAIC id number: 49948 )
Policy contract number	10350
Policy instance	9
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 48321 )
Policy contract number	12246532
Policy instance	5

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Company Name:	CHROME HEARTS LLC
Employer identification number (EIN):	562501506
NAIC Classification:	315210
NAIC Description:	Cut and Sew Apparel Contractors

Jurisdiction of Incorporation:	Florida Department of State Division of Corporations
Incorporation Date:	2016-03-03
Company Identification Number:	L16000044395
Legal Registered Office Address:	4025 NE 2ND AVE MIAMI 33137