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| Plan Name | KANIKSU MEDICAL PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | BOUNDARY REGIONAL COMMUNITY HEALTH CENTER, INC. |
| Employer identification number (EIN): | 043634356 |
| NAIC Classification: | 621399 |
| NAIC Description: | Offices of All Other Miscellaneous Health Practitioners |
Additional information about BOUNDARY REGIONAL COMMUNITY HEALTH CENTER, INC.
| Jurisdiction of Incorporation: | Idaho Secretary Of State |
| Incorporation Date: | |
| Company Identification Number: | C143212 |
More information about BOUNDARY REGIONAL COMMUNITY HEALTH CENTER, INC.
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2023-01-01 | MEAGAN FORGE SNYDER | 2024-09-26 | ||
| 501 | 2022-01-01 | MEAGAN SNYDER | 2023-07-24 | ||
| 501 | 2021-01-01 | MEAGAN FORGE | 2022-07-25 | ||
| 501 | 2020-01-01 | MEAGAN E. FORGE | 2021-09-23 | ||
| 501 | 2019-01-01 | MEAGAN FORGE | 2020-08-05 | ||
| 501 | 2018-01-01 | MEAGAN FORGE | 2019-08-05 | ||
| 501 | 2017-01-01 |
| 2023: KANIKSU MEDICAL PLAN 2023 form 5500 responses | ||
|---|---|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Plan funding arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: KANIKSU MEDICAL PLAN 2022 form 5500 responses | ||
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: KANIKSU 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 benefit arrangement – Insurance | Yes |
| 2020: KANIKSU 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 benefit arrangement – Insurance | Yes |
| 2019: KANIKSU 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 benefit arrangement – Insurance | Yes |
| 2018: KANIKSU MEDICAL PLAN 2018 form 5500 responses | ||
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: KANIKSU MEDICAL PLAN 2017 form 5500 responses | ||
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | First time form 5500 has been submitted | Yes |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| REGENCE BLUESHIELD OF IDAHO (National Association of Insurance Commissioners NAIC id number: 60131 ) | |||||||||||||||||||
| Policy contract number | 10009072 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
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| REGENCE BLUESHIELD OF IDAHO (National Association of Insurance Commissioners NAIC id number: 60131 ) | |||||||||||||||||||
| Policy contract number | 10009072 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| |||||||||||||||||||
| REGENCE BLUESHIELD OF IDAHO (National Association of Insurance Commissioners NAIC id number: 60131 ) | |||||||||||||||||||
| Policy contract number | 10009072 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| REGENCE BLUESHIELD OF IDAHO (National Association of Insurance Commissioners NAIC id number: 60131 ) | |||||||||||||||||||
| Policy contract number | 10009072 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| REGENCE BLUESHIELD OF IDAHO (National Association of Insurance Commissioners NAIC id number: 60131 ) | |||||||||||||||||||
| Policy contract number | 10009072 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| REGENCE BLUESHIELD OF IDAHO (National Association of Insurance Commissioners NAIC id number: 60131 ) | |||||||||||||||||||
| Policy contract number | 10009072 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| REGENCE BLUESHIELD OF IDAHO (National Association of Insurance Commissioners NAIC id number: 60131 ) | |||||||||||||||||||
| Policy contract number | 10009072 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
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