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| Plan Name | KAKTOVIK HOLDINGS, LLC HEALTH & WELFARE BENEFIT PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | KAKTOVIK HOLDINGS, LLC |
| Employer identification number (EIN): | 824950495 |
| NAIC Classification: | 551112 |
| NAIC Description: | Offices of Other Holding Companies |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2018-02-01 | TAMMIE RITNER | 2019-09-19 | ||
| 501 | 2018-02-01 | TAMMIE RITNER | 2019-10-24 |
| Measure | Date | Value |
|---|---|---|
| 2018: KAKTOVIK HOLDINGS, LLC HEALTH & WELFARE BENEFIT PLAN 2018 401k membership | ||
| Total participants, beginning-of-year | 2018-02-01 | 104 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-02-01 | 0 |
| Number of retired or separated participants receiving benefits | 2018-02-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-02-01 | 0 |
| Total of all active and inactive participants | 2018-02-01 | 0 |
| Number of employers contributing to the scheme | 2018-02-01 | 0 |
| 2018: KAKTOVIK HOLDINGS, LLC HEALTH & WELFARE BENEFIT PLAN 2018 form 5500 responses | ||
|---|---|---|
| 2018-02-01 | Type of plan entity | Single employer plan |
| 2018-02-01 | First time form 5500 has been submitted | Yes |
| 2018-02-01 | Submission has been amended | Yes |
| 2018-02-01 | This submission is the final filing | Yes |
| 2018-02-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2018-02-01 | Plan funding arrangement – Insurance | Yes |
| 2018-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |||||||||||||||||||||||||||||||
| Policy contract number | 883181G | ||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||
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| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62049 ) | |||||||||||||||||||||||||||||||
| Policy contract number | E5027370 | ||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||
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| MAGELLAN HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||||||||||||||
| Policy contract number | KAKTO-001 | ||||||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||||||
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