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Plan Name | KTNA HEALTH AND WELFARE PLAN |
Plan identification number | 501 |
401k Plan Type | Welfare Benefit |
Plan Features/Benefits |
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Company Name: | KOTOBUKIYA TREVES, NORTH AMERICA |
Employer identification number (EIN): | 680600082 |
NAIC Classification: | 339110 |
Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
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501 | 2022-01-01 | ANDREIA MARQUES | 2023-06-16 | ||
501 | 2021-12-01 | ANDREIA MARQUES | 2022-10-14 |
Measure | Date | Value |
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2022: KTNA HEALTH AND WELFARE PLAN 2022 401k membership | ||
Total participants, beginning-of-year | 2022-01-01 | 221 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 313 |
Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
Total of all active and inactive participants | 2022-01-01 | 313 |
Number of employers contributing to the scheme | 2022-01-01 | 0 |
2021: KTNA HEALTH AND WELFARE PLAN 2021 401k membership | ||
Total participants, beginning-of-year | 2021-12-01 | 100 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-12-01 | 221 |
Number of retired or separated participants receiving benefits | 2021-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2021-12-01 | 0 |
Total of all active and inactive participants | 2021-12-01 | 221 |
Number of employers contributing to the scheme | 2021-12-01 | 0 |
2022: KTNA HEALTH AND WELFARE PLAN 2022 form 5500 responses | ||
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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: KTNA HEALTH AND WELFARE PLAN 2021 form 5500 responses | ||
2021-12-01 | Type of plan entity | Single employer plan |
2021-12-01 | First time form 5500 has been submitted | Yes |
2021-12-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
2021-12-01 | Plan funding arrangement – Insurance | Yes |
2021-12-01 | Plan benefit arrangement – Insurance | Yes |
BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) | |||||||||||||||||||||||||||
Policy contract number | 419131 | ||||||||||||||||||||||||||
Policy instance | 1 | ||||||||||||||||||||||||||
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |||||||||||||||||||||||||||
Policy contract number | 922822 | ||||||||||||||||||||||||||
Policy instance | 1 | ||||||||||||||||||||||||||
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