401k Plan data: LINCOLN CREEK LUMBER CO., INC. MEDICAL PLAN plan

LINCOLN CREEK LUMBER CO., INC. MEDICAL PLAN 401k Plan overview

Plan Name	LINCOLN CREEK LUMBER CO., INC. MEDICAL PLAN
Plan identification number	501

LINCOLN CREEK LUMBER CO., INC. MEDICAL PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	SELECT distinct(Description) AS Description FROM 401k_benefit_codes LEFT JOIN 401k_benefit_code_description ON BenefitCode=Code COLLATE utf8_unicode_ci WHERE EIN='910844224' AND PlanID='501'

401k Sponsoring company profile

LINCOLN CREEK LUMBER CO., INC. has sponsored the creation of one or more 401k plans.

Company Name: LINCOLN CREEK LUMBER CO., INC.

Employer identification number (EIN): 910844224

NAIC Classification: 444190
NAIC Description: Other Building Material Dealers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LINCOLN CREEK LUMBER CO., INC. MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-04-01 TIFFINY HURST 2024-10-09
501 2022-04-01 TIFFINY HURST 2023-10-27

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2023-04-01	TIFFINY HURST	2024-10-09
501	2022-04-01	TIFFINY HURST	2023-10-27

Insurance Providers Used on plan

GROUP HEALTH OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 47055 )

Policy contract number

6307400

Policy instance

Insurance contract or identification number	6307400
Number of Individuals Covered	52
Insurance policy start date	2023-04-01
Insurance policy end date	2024-03-31
Total amount of commissions paid to insurance broker	USD $27,839
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $560,049
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 )

Policy contract number

2388600

Policy instance

Insurance contract or identification number	2388600
Number of Individuals Covered	9
Insurance policy start date	2023-04-01
Insurance policy end date	2024-03-31
Total amount of commissions paid to insurance broker	USD $4,524
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $90,484
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

GROUP HEALTH OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 47055 )

Policy contract number

6307400

Policy instance

GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 )

Policy contract number

2388600

Policy instance

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Company Name:	LINCOLN CREEK LUMBER CO., INC.
Employer identification number (EIN):	910844224
NAIC Classification:	444190
NAIC Description:	Other Building Material Dealers