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| Plan Name | VANN BROTHERS HEALTH AND WELFARE PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | VANN BROTHERS |
| Employer identification number (EIN): | 942228979 |
| NAIC Classification: | 111300 |
| NAIC Description: | Fruit and Tree Nut Farming |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2023-06-01 | NIKKI AZEVEDO | 2024-10-24 |
| 2023: VANN BROTHERS HEALTH AND WELFARE PLAN 2023 form 5500 responses | ||
|---|---|---|
| 2023-06-01 | Type of plan entity | Single employer plan |
| 2023-06-01 | First time form 5500 has been submitted | Yes |
| 2023-06-01 | Plan funding arrangement – Insurance | Yes |
| 2023-06-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2023-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2023-06-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) | |||||||||||||||||||||
| Policy contract number | 284938 | ||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||
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| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |||||||||||||||||||||
| Policy contract number | KM05969866 | ||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||
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| ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 ) | |||||||||||||||||||||
| Policy contract number | 284938 | ||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||
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