| Plan Name | CHURCHILL ADMINISTRATIVE SERVICES, LLC DENTAL |
| Plan identification number | 504 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | CHURCHILL ADMINISTRATIVE SERVICES, LLC |
| Employer identification number (EIN): | 811093064 |
| NAIC Classification: | 531110 |
| NAIC Description: | Lessors of Residential Buildings and Dwellings |
Additional information about CHURCHILL ADMINISTRATIVE SERVICES, LLC
| Jurisdiction of Incorporation: | Texas Secretary of State |
| Incorporation Date: | 2016-01-08 |
| Company Identification Number: | 0802365326 |
| Legal Registered Office Address: |
1132 GLADE RD COLLEYVILLE United States of America (USA) 76034 |
More information about CHURCHILL ADMINISTRATIVE SERVICES, LLC
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 504 | 2019-10-01 | SANDY KLIDAS | 2021-07-13 | ||
| 504 | 2017-10-01 | SANDY KLIDAS | 2019-06-20 | ||
| 504 | 2016-10-01 | SANDY KLIDAS | |||
| 504 | 2016-05-01 | SANDY KLIDAS | SANDY KLIDAS | 2017-05-18 | |
| 504 | 2015-05-01 | 2016-10-26 | |||
| 504 | 2015-05-01 | BRADLEY E. FORSLUND |
| 2019: CHURCHILL ADMINISTRATIVE SERVICES, LLC DENTAL 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 |
| 2017: CHURCHILL ADMINISTRATIVE SERVICES, LLC DENTAL 2017 form 5500 responses | ||
| 2017-10-01 | Type of plan entity | Single employer plan |
| 2017-10-01 | Plan funding arrangement – Insurance | Yes |
| 2017-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: CHURCHILL ADMINISTRATIVE SERVICES, LLC DENTAL 2016 form 5500 responses | ||
| 2016-10-01 | Type of plan entity | Single employer plan |
| 2016-10-01 | Submission has been amended | No |
| 2016-10-01 | This submission is the final filing | No |
| 2016-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-10-01 | Plan is a collectively bargained plan | No |
| 2016-10-01 | Plan funding arrangement – Insurance | Yes |
| 2016-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-05-01 | Type of plan entity | Single employer plan |
| 2016-05-01 | Submission has been amended | No |
| 2016-05-01 | This submission is the final filing | No |
| 2016-05-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2016-05-01 | Plan is a collectively bargained plan | No |
| 2016-05-01 | Plan funding arrangement – Insurance | Yes |
| 2016-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: CHURCHILL ADMINISTRATIVE SERVICES, LLC DENTAL 2015 form 5500 responses | ||
| 2015-05-01 | Type of plan entity | Single employer plan |
| 2015-05-01 | First time form 5500 has been submitted | Yes |
| 2015-05-01 | Submission has been amended | No |
| 2015-05-01 | This submission is the final filing | No |
| 2015-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-05-01 | Plan is a collectively bargained plan | No |
| 2015-05-01 | Plan funding arrangement – Insurance | Yes |
| 2015-05-01 | Plan benefit arrangement – Insurance | Yes |
| BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 ) | |
| Policy contract number | 219572 |
| Policy instance | 1 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | KM05712605 |
| Policy instance | 1 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | KM05712605 |
| Policy instance | 1 |