401k Plan data: MEDICAL PLAN plan

MEDICAL PLAN 401k Plan overview

Plan Name	MEDICAL PLAN
Plan identification number	506

MEDICAL PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision)

401k Sponsoring company profile

ERVING INDUSTRIES, INC. has sponsored the creation of one or more 401k plans.

Company Name: ERVING INDUSTRIES, INC.

Employer identification number (EIN): 041291330

NAIC Classification: 322100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MEDICAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
506 2023-01-01 AUDRIE OSGOOD 2024-10-08
506 2022-01-01 AUDRIE OSGOOD 2023-08-30
506 2021-01-01 AUDRIE OSGOOD 2022-09-22
506 2020-01-01 AUDRIE OSGOOD 2021-09-13
506 2019-01-01 AUDRIE OSGOOD 2020-10-09
506 2018-01-01 WILLIAM WESCOTT WILLIAM WESCOTT 2019-07-17
506 2017-01-01 WILLIAM WESCOTT WILLIAM WESCOTT 2018-07-23
506 2016-01-01 VIVEK KULKARNI
506 2015-01-01 DENIS L EMMETT, TREASURER DENIS L. EMMETT, TREASURER 2016-09-29
506 2014-01-01 DENIS L EMMETT, TREASURER DENIS L. EMMETT, TREASURER 2015-10-13
506 2013-01-01 DENIS L EMMETT, TREASURER DENIS L EMMETT, TREASURER 2014-07-30
506 2012-01-01 DENIS L. EMMETT, TREASURER DENIS L. EMMETT, TREASURER 2013-10-11
506 2011-01-01 DENIS L. EMMETT, TREASURER
506 2010-01-01 DENIS L. EMMETT, TREASURER DENIS L. EMMETT, TREASURER 2011-10-11
506 2009-01-01 DENIS L. EMMETT, TREASURER DENIS L. EMMETT, TREASURER 2010-10-13

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
506	2023-01-01	AUDRIE OSGOOD	2024-10-08
506	2022-01-01	AUDRIE OSGOOD	2023-08-30
506	2021-01-01	AUDRIE OSGOOD	2022-09-22
506	2020-01-01	AUDRIE OSGOOD	2021-09-13
506	2019-01-01	AUDRIE OSGOOD	2020-10-09
506	2018-01-01	WILLIAM WESCOTT		WILLIAM WESCOTT	2019-07-17
506	2017-01-01	WILLIAM WESCOTT		WILLIAM WESCOTT	2018-07-23
506	2016-01-01	VIVEK KULKARNI
506	2015-01-01	DENIS L EMMETT, TREASURER		DENIS L. EMMETT, TREASURER	2016-09-29
506	2014-01-01	DENIS L EMMETT, TREASURER		DENIS L. EMMETT, TREASURER	2015-10-13
506	2013-01-01	DENIS L EMMETT, TREASURER		DENIS L EMMETT, TREASURER	2014-07-30
506	2012-01-01	DENIS L. EMMETT, TREASURER		DENIS L. EMMETT, TREASURER	2013-10-11
506	2011-01-01	DENIS L. EMMETT, TREASURER
506	2010-01-01	DENIS L. EMMETT, TREASURER		DENIS L. EMMETT, TREASURER	2011-10-11
506	2009-01-01	DENIS L. EMMETT, TREASURER		DENIS L. EMMETT, TREASURER	2010-10-13

Plan Statistics for MEDICAL PLAN

401k plan membership statisitcs for MEDICAL PLAN

Measure Date Value
2023: MEDICAL PLAN 2023 401k membership
Total participants, beginning-of-year 2023-01-01 118
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 118
Number of retired or separated participants receiving benefits 2023-01-01 0
Number of other retired or separated participants entitled to future benefits 2023-01-01 0
Total of all active and inactive participants 2023-01-01 118
Number of employers contributing to the scheme 2023-01-01 0
2022: MEDICAL PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 118
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 118
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 118
Number of employers contributing to the scheme 2022-01-01 0
2021: MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 125
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 118
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 0
Total of all active and inactive participants 2021-01-01 118
Number of employers contributing to the scheme 2021-01-01 0
2020: MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 130
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 125
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 125
Number of employers contributing to the scheme 2020-01-01 0
2019: MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 124
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 130
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 130
Number of employers contributing to the scheme 2019-01-01 0
2018: MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 169
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 124
Total of all active and inactive participants 2018-01-01 124
Total participants 2018-01-01 124
2017: MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 197
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 116
Number of retired or separated participants receiving benefits 2017-01-01 53
Total of all active and inactive participants 2017-01-01 169
Total participants 2017-01-01 169
2016: MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 120
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 136
Number of retired or separated participants receiving benefits 2016-01-01 61
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 197
2015: MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 179
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 105
Number of retired or separated participants receiving benefits 2015-01-01 66
Total of all active and inactive participants 2015-01-01 171
2014: MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 177
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 117
Number of retired or separated participants receiving benefits 2014-01-01 62
Total of all active and inactive participants 2014-01-01 179
2013: MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 120
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 111
Number of retired or separated participants receiving benefits 2013-01-01 66
Number of other retired or separated participants entitled to future benefits 2013-01-01 2
Total of all active and inactive participants 2013-01-01 179
2012: MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 189
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 120
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 120
2011: MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 205
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 117
Number of retired or separated participants receiving benefits 2011-01-01 72
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 189
2010: MEDICAL PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 211
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 123
Number of retired or separated participants receiving benefits 2010-01-01 82
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 205
2009: MEDICAL PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 230
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 128
Number of retired or separated participants receiving benefits 2009-01-01 83
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 211

Measure	Date	Value
2023: MEDICAL PLAN 2023 401k membership
Total participants, beginning-of-year	2023-01-01	118
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	118
Number of retired or separated participants receiving benefits	2023-01-01	0
Number of other retired or separated participants entitled to future benefits	2023-01-01	0
Total of all active and inactive participants	2023-01-01	118
Number of employers contributing to the scheme	2023-01-01	0
2022: MEDICAL PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	118
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	118
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	118
Number of employers contributing to the scheme	2022-01-01	0
2021: MEDICAL PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	125
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	118
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	118
Number of employers contributing to the scheme	2021-01-01	0
2020: MEDICAL PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	130
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	125
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	125
Number of employers contributing to the scheme	2020-01-01	0
2019: MEDICAL PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	124
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	130
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	130
Number of employers contributing to the scheme	2019-01-01	0
2018: MEDICAL PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	169
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	124
Total of all active and inactive participants	2018-01-01	124
Total participants	2018-01-01	124
2017: MEDICAL PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	197
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	116
Number of retired or separated participants receiving benefits	2017-01-01	53
Total of all active and inactive participants	2017-01-01	169
Total participants	2017-01-01	169
2016: MEDICAL PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	120
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	136
Number of retired or separated participants receiving benefits	2016-01-01	61
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	197
2015: MEDICAL PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	179
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	105
Number of retired or separated participants receiving benefits	2015-01-01	66
Total of all active and inactive participants	2015-01-01	171
2014: MEDICAL PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	177
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	117
Number of retired or separated participants receiving benefits	2014-01-01	62
Total of all active and inactive participants	2014-01-01	179
2013: MEDICAL PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	120
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	111
Number of retired or separated participants receiving benefits	2013-01-01	66
Number of other retired or separated participants entitled to future benefits	2013-01-01	2
Total of all active and inactive participants	2013-01-01	179
2012: MEDICAL PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	189
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	120
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	120
2011: MEDICAL PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	205
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	117
Number of retired or separated participants receiving benefits	2011-01-01	72
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	189
2010: MEDICAL PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	211
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	123
Number of retired or separated participants receiving benefits	2010-01-01	82
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	205
2009: MEDICAL PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	230
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	128
Number of retired or separated participants receiving benefits	2009-01-01	83
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	211

Form 5500 Responses for MEDICAL PLAN

2023: MEDICAL PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2023-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2022: MEDICAL PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: MEDICAL PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: MEDICAL PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: MEDICAL PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: MEDICAL PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: MEDICAL PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: MEDICAL PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: MEDICAL PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: MEDICAL PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2013: MEDICAL PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: MEDICAL PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: MEDICAL PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: MEDICAL PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: MEDICAL PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

FALLON HEALTH AND LIFE INSURANCE COMPANY - FHLAC (National Association of Insurance Commissioners NAIC id number: 66828 )
Policy contract number	C004491532C01
Policy instance	2
FALLON COMMUNITY HEALTH PLAN -MEDICARE (National Association of Insurance Commissioners NAIC id number: 95541 )
Policy contract number	C004491532C01
Policy instance	1
FALLON HEALTH AND LIFE INSURANCE COMPANY - FHLAC (National Association of Insurance Commissioners NAIC id number: 66828 )
Policy contract number	C004491532C01
Policy instance	2
FALLON COMMUNITY HEALTH PLAN -MEDICARE (National Association of Insurance Commissioners NAIC id number: 95541 )
Policy contract number	C004491532C01
Policy instance	1
FALLON HEALTH AND LIFE INSURANCE COMPANY - FHLAC (National Association of Insurance Commissioners NAIC id number: 66828 )
Policy contract number	C004491532C01
Policy instance	2
FALLON COMMUNITY HEALTH PLAN -MEDICARE (National Association of Insurance Commissioners NAIC id number: 95541 )
Policy contract number	C004491532C01
Policy instance	1
FALLON COMMUNITY HEALTH PLAN -MEDICARE (National Association of Insurance Commissioners NAIC id number: 95541 )
Policy contract number	C004491532C01
Policy instance	2
FALLON HEALTH AND LIFE INSURANCE COMPANY - FHLAC (National Association of Insurance Commissioners NAIC id number: 66828 )
Policy contract number	C004491532C01
Policy instance	1
FALLON HEALTH AND LIFE INSURANCE COMPANY - FHLAC (National Association of Insurance Commissioners NAIC id number: 66828 )
Policy contract number	C004491532C01
Policy instance	4
FALLON HEALTH AND LIFE INSURANCE COMPANY - FHLAC (National Association of Insurance Commissioners NAIC id number: 66828 )
Policy contract number	C004491532C01
Policy instance	3
FALLON COMMUNITY HEALTH PLAN -MEDICARE (National Association of Insurance Commissioners NAIC id number: 95541 )
Policy contract number	C004491532C01
Policy instance	2
FALLON COMMUNITY HEALTH PLAN -MEDICARE (National Association of Insurance Commissioners NAIC id number: 95541 )
Policy contract number	C00449153C01
Policy instance	1

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Company Name:	ERVING INDUSTRIES, INC.
Employer identification number (EIN):	041291330
NAIC Classification:	322100