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| Plan Name | MAYCOM, LLC HEALTH & WELFARE BENEFITS PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | MAYCOM, LLC |
| Employer identification number (EIN): | 061709969 |
| NAIC Classification: | 443142 |
| NAIC Description: | Electronics Stores |
Additional information about MAYCOM, LLC
| Jurisdiction of Incorporation: | Florida Department of State Division of Corporations |
| Incorporation Date: | 2003-04-10 |
| Company Identification Number: | L03000012886 |
| Legal Registered Office Address: |
523 N. HALIFAX AVE. DAYTONA BEACH 32118 |
More information about MAYCOM, LLC
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2020-02-01 | DAVE GINOCCHETTI | 2021-08-15 | ||
| 501 | 2019-02-01 | DAVE GINOCCHETTI | 2020-08-17 | ||
| 501 | 2018-02-01 | ||||
| 501 | 2017-02-01 | ||||
| 501 | 2016-02-01 |
| 2020: MAYCOM, LLC HEALTH & WELFARE BENEFITS PLAN 2020 form 5500 responses | ||
|---|---|---|
| 2020-02-01 | Type of plan entity | Single employer plan |
| 2020-02-01 | Submission has been amended | No |
| 2020-02-01 | This submission is the final filing | Yes |
| 2020-02-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2020-02-01 | Plan is a collectively bargained plan | No |
| 2020-02-01 | Plan funding arrangement – Insurance | Yes |
| 2020-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: MAYCOM, LLC HEALTH & WELFARE BENEFITS PLAN 2019 form 5500 responses | ||
| 2019-02-01 | Type of plan entity | Single employer plan |
| 2019-02-01 | Submission has been amended | No |
| 2019-02-01 | This submission is the final filing | No |
| 2019-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-02-01 | Plan is a collectively bargained plan | No |
| 2019-02-01 | Plan funding arrangement – Insurance | Yes |
| 2019-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: MAYCOM, LLC HEALTH & WELFARE BENEFITS PLAN 2018 form 5500 responses | ||
| 2018-02-01 | Type of plan entity | Single employer plan |
| 2018-02-01 | Submission has been amended | No |
| 2018-02-01 | This submission is the final filing | No |
| 2018-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-02-01 | Plan is a collectively bargained plan | No |
| 2018-02-01 | Plan funding arrangement – Insurance | Yes |
| 2018-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: MAYCOM, LLC HEALTH & WELFARE BENEFITS PLAN 2017 form 5500 responses | ||
| 2017-02-01 | Type of plan entity | Single employer plan |
| 2017-02-01 | Submission has been amended | No |
| 2017-02-01 | This submission is the final filing | No |
| 2017-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-02-01 | Plan is a collectively bargained plan | No |
| 2017-02-01 | Plan funding arrangement – Insurance | Yes |
| 2017-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: MAYCOM, LLC HEALTH & WELFARE BENEFITS PLAN 2016 form 5500 responses | ||
| 2016-02-01 | Type of plan entity | Single employer plan |
| 2016-02-01 | First time form 5500 has been submitted | Yes |
| 2016-02-01 | Submission has been amended | No |
| 2016-02-01 | This submission is the final filing | No |
| 2016-02-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-02-01 | Plan is a collectively bargained plan | No |
| 2016-02-01 | Plan funding arrangement – Insurance | Yes |
| 2016-02-01 | Plan benefit arrangement – Insurance | Yes |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |
| Policy contract number | TA0039 |
| Policy instance | 6 |
| TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 ) | |
| Policy contract number | 27134 |
| Policy instance | 5 |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95089 ) | |
| Policy contract number | 31850 |
| Policy instance | 4 |
| FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 ) | |
| Policy contract number | Y1029 - 63Y955 |
| Policy instance | 3 |
| FLORIDA HEALTH CARE PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 13567 ) | |
| Policy contract number | 822 |
| Policy instance | 2 |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |
| Policy contract number | 31850 |
| Policy instance | 1 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |
| Policy contract number | TA0039 |
| Policy instance | 6 |
| TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 ) | |
| Policy contract number | 27134 |
| Policy instance | 5 |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95089 ) | |
| Policy contract number | 31850 |
| Policy instance | 4 |
| FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 ) | |
| Policy contract number | Y1029 - 63Y955 |
| Policy instance | 3 |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |
| Policy contract number | 31850 |
| Policy instance | 1 |
| FLORIDA HEALTH CARE PLANS, INC. (National Association of Insurance Commissioners NAIC id number: 13567 ) | |
| Policy contract number | 822 |
| Policy instance | 2 |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |
| Policy contract number | 31850 |
| Policy instance | 1 |
| FLORIDA COMBINED LIFE (National Association of Insurance Commissioners NAIC id number: 20603 ) | |
| Policy contract number | Y1029-63Y955 |
| Policy instance | 2 |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |
| Policy contract number | 31850 |
| Policy instance | 4 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |
| Policy contract number | TA0039 |
| Policy instance | 3 |
| TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 ) | |
| Policy contract number | 00027134 |
| Policy instance | 5 |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |
| Policy contract number | 31850 |
| Policy instance | 4 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |
| Policy contract number | TA0039 |
| Policy instance | 3 |
| FLORIDA COMBINED LIFE (National Association of Insurance Commissioners NAIC id number: 20603 ) | |
| Policy contract number | Y1029-63Y955 |
| Policy instance | 2 |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: ) | |
| Policy contract number | 31850 |
| Policy instance | 1 |
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