| Plan Name | MOOSE TOYS HEALTH AND WELFARE PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | MOOSE TOYS LLC |
| Employer identification number (EIN): | 824978423 |
| NAIC Classification: | 423920 |
| NAIC Description: | Toy and Hobby Goods and Supplies Merchant Wholesalers |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2023-02-01 | SHARON LOMAX | 2024-08-15 |
| 2023: MOOSE TOYS HEALTH AND WELFARE PLAN 2023 form 5500 responses | ||
|---|---|---|
| 2023-02-01 | Type of plan entity | Single employer plan |
| 2023-02-01 | First time form 5500 has been submitted | Yes |
| 2023-02-01 | Plan funding arrangement – Insurance | Yes |
| 2023-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2023-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2023-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||||||||||
| Policy contract number | L07716 | ||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||
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| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||||||||||
| Policy contract number | 344179 | ||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||
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| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |||||||||||||||||||||||||||
| Policy contract number | TS05380130 | ||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||
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