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| Plan Name | THE CROM CORPORATION CANCER INSURANCE PLAN |
| Plan identification number | 505 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | CROM, LLC |
| Employer identification number (EIN): | 590702495 |
| NAIC Classification: | 237990 |
| NAIC Description: | Other Heavy and Civil Engineering Construction |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 505 | 2015-01-01 | JEFFREY POMEROY | JEFFREY POMEROY | 2017-01-24 |
| Measure | Date | Value |
|---|---|---|
| 2015: THE CROM CORPORATION CANCER INSURANCE PLAN 2015 401k membership | ||
| Total participants, beginning-of-year | 2015-01-01 | 134 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 0 |
| Total of all active and inactive participants | 2015-01-01 | 0 |
| Total participants | 2015-01-01 | 0 |
| 2015: THE CROM CORPORATION CANCER INSURANCE PLAN 2015 form 5500 responses | ||
|---|---|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Submission has been amended | Yes |
| 2015-01-01 | This submission is the final filing | Yes |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) | |
| Policy contract number | MCP46540 |
| Policy instance | 1 |
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