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| Plan Name | UTAH GASTROENTEROLOGY, PC WRAP PLAN |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | UTAH GASTROENTEROLOGY, P.C. |
| Employer identification number (EIN): | 870543318 |
| NAIC Classification: | 621111 |
| NAIC Description: | Offices of Physicians (except Mental Health Specialists) |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2020-08-01 | CHRISTINE MORRIS-GABRENAS | 2021-06-21 |
| 2020: UTAH GASTROENTEROLOGY, PC WRAP PLAN 2020 form 5500 responses | ||
|---|---|---|
| 2020-08-01 | Type of plan entity | Single employer plan |
| 2020-08-01 | First time form 5500 has been submitted | Yes |
| 2020-08-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2020-08-01 | Plan funding arrangement – Insurance | Yes |
| 2020-08-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-08-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) | |
| Policy contract number | 224190 |
| Policy instance | 1 |
| ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 ) | |
| Policy contract number | 14021814 |
| Policy instance | 2 |
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) | |
| Policy contract number | 22323 |
| Policy instance | 3 |
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