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| Plan Name | OLYMPIC SPORT AND SPINE LIFE |
| Plan identification number | 503 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | OLYMPIC SPORTS & SPINE PLLC |
| Employer identification number (EIN): | 822950138 |
| NAIC Classification: | 621340 |
| NAIC Description: | Offices of Physical, Occupational and Speech Therapists, and Audiologists |
Additional information about OLYMPIC SPORTS & SPINE PLLC
| Jurisdiction of Incorporation: | Washington Secretary of State Corporations Division |
| Incorporation Date: | 2017-09-22 |
| Company Identification Number: | 604171643 |
| Legal Registered Office Address: |
6625 WAGNER WAY STE 203 GIG HARBOR United States of America (USA) 983358392 |
More information about OLYMPIC SPORTS & SPINE PLLC
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 503 | 2023-01-01 | BRIAN THACKER | 2024-04-16 | ||
| 503 | 2022-01-01 | TIFFANY GUTIERREZ | 2023-04-26 | ||
| 503 | 2021-01-01 | BRIAN THACKER | 2022-07-12 | ||
| 503 | 2020-01-01 | BEVERLY BALTAZAR | 2022-03-30 | ||
| 503 | 2019-01-01 | BEVERLY BALTAZAR | 2022-03-30 | ||
| 503 | 2018-04-01 | BEVERLY BALTAZAR | 2022-03-30 |
| 2023: OLYMPIC SPORT AND SPINE LIFE 2023 form 5500 responses | ||
|---|---|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Plan funding arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: OLYMPIC SPORT AND SPINE LIFE 2022 form 5500 responses | ||
| 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: OLYMPIC SPORT AND SPINE LIFE 2021 form 5500 responses | ||
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: OLYMPIC SPORT AND SPINE LIFE 2020 form 5500 responses | ||
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: OLYMPIC SPORT AND SPINE LIFE 2019 form 5500 responses | ||
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: OLYMPIC SPORT AND SPINE LIFE 2018 form 5500 responses | ||
| 2018-04-01 | Type of plan entity | Single employer plan |
| 2018-04-01 | First time form 5500 has been submitted | Yes |
| 2018-04-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2018-04-01 | Plan funding arrangement – Insurance | Yes |
| 2018-04-01 | Plan benefit arrangement – Insurance | Yes |
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) | |||||||||||||||||||||||
| Policy contract number | 01-017883-00 | ||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||
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| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) | |||||||||||||||||||||||
| Policy contract number | 01-017883-00 | ||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||
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| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) | |||||||||||||||||||||||
| Policy contract number | 01-017883-00 | ||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) | |||||||||||||||||||||||
| Policy contract number | 01-017883-00 | ||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||
| UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||||||
| Policy contract number | 54433243 | ||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||
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