| Plan Name | CBC AMERICA CORP. HEALTH & WELFARE BENEFITS PLAN |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | CBC AMERICA CORP |
| Employer identification number (EIN): | 132978219 |
| NAIC Classification: | 423990 |
| NAIC Description: | Other Miscellaneous Durable Goods Merchant Wholesalers |
Additional information about CBC AMERICA CORP
| Jurisdiction of Incorporation: | North Carolina Secretary of State |
| Incorporation Date: | |
| Company Identification Number: | 1050116 |
More information about CBC AMERICA CORP
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2017-01-01 | ORSHI KOCSIS |
| 2017: CBC AMERICA CORP. HEALTH & WELFARE BENEFITS 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 | Submission has been amended | No |
| 2017-01-01 | This submission is the final filing | Yes |
| 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 benefit arrangement – Insurance | Yes |
| BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) | |
| Policy contract number | 0811967 |
| Policy instance | 1 |
| DELTA DENTAL OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54658 ) | |
| Policy contract number | 1122 |
| Policy instance | 2 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) | |
| Policy contract number | 1009746 |
| Policy instance | 3 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | TM05918762 |
| Policy instance | 4 |