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| Plan Name | RED EARTH CASINO WELFARE BENEFITS PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | RED EARTH CASINO |
| Employer identification number (EIN): | 203162757 |
| NAIC Classification: | 713200 |
| NAIC Description: | Gambling Industries |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2020-03-01 |
| 2020: RED EARTH CASINO WELFARE BENEFITS PLAN 2020 form 5500 responses | ||
|---|---|---|
| 2020-03-01 | Type of plan entity | Single employer plan |
| 2020-03-01 | First time form 5500 has been submitted | Yes |
| 2020-03-01 | Submission has been amended | No |
| 2020-03-01 | This submission is the final filing | No |
| 2020-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-03-01 | Plan is a collectively bargained plan | No |
| 2020-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-03-01 | Plan benefit arrangement – Insurance | Yes |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 00559946 |
| Policy instance | 1 |
| CALIFORNIA PHYSICIANS SERVICE (National Association of Insurance Commissioners NAIC id number: 61557 ) | |
| Policy contract number | W0105026 |
| Policy instance | 2 |
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