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| Plan Name | SEAMON, WHITESIDE AND ASSOCIATES, INC. MEDICAL PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | SEAMON WHITESIDE & ASSOCIATES, INC. |
| Employer identification number (EIN): | 570807412 |
| NAIC Classification: | 541330 |
| NAIC Description: | Engineering Services |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2021-09-01 | ||||
| 501 | 2019-09-01 |
| Measure | Date | Value |
|---|---|---|
| 2021: SEAMON, WHITESIDE AND ASSOCIATES, INC. MEDICAL PLAN 2021 401k membership | ||
| Total participants, beginning-of-year | 2021-09-01 | 114 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-09-01 | 148 |
| Total of all active and inactive participants | 2021-09-01 | 148 |
| 2019: SEAMON, WHITESIDE AND ASSOCIATES, INC. MEDICAL PLAN 2019 401k membership | ||
| Total participants, beginning-of-year | 2019-09-01 | 98 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-09-01 | 98 |
| Total of all active and inactive participants | 2019-09-01 | 98 |
| 2021: SEAMON, WHITESIDE AND ASSOCIATES, INC. MEDICAL PLAN 2021 form 5500 responses | ||
|---|---|---|
| 2021-09-01 | Type of plan entity | Single employer plan |
| 2021-09-01 | Plan funding arrangement – Insurance | Yes |
| 2021-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: SEAMON, WHITESIDE AND ASSOCIATES, INC. MEDICAL PLAN 2019 form 5500 responses | ||
| 2019-09-01 | Type of plan entity | Single employer plan |
| 2019-09-01 | First time form 5500 has been submitted | Yes |
| 2019-09-01 | Plan funding arrangement – Insurance | Yes |
| 2019-09-01 | Plan benefit arrangement – Insurance | Yes |
| BLUECHOICE HEALTHPLAN (National Association of Insurance Commissioners NAIC id number: 95741 ) | |||||||||||||||||||||||||||
| Policy contract number | 05835 | ||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||
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| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |||||||||||||||||||||||||||
| Policy contract number | 00024973 | ||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||
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| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) | |||||||||||||||||||||||||||
| Policy contract number | 54942 | ||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||
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| BLUECHOICE HEALTHPLAN (National Association of Insurance Commissioners NAIC id number: 95741 ) | |||||||||||||||||||||||||||
| Policy contract number | 05835 | ||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||
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