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| Plan Name | ORTHOFEET, INC. MEDICAL PLAN |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | ORTHOFEET INC |
| Employer identification number (EIN): | 222608205 |
| NAIC Classification: | 315990 |
| NAIC Description: | Apparel Accessories and Other Apparel Manufacturing |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2022-04-01 | MIKE SACCENTE | 2023-10-30 |
| 2022: ORTHOFEET, INC. MEDICAL PLAN 2022 form 5500 responses | ||
|---|---|---|
| 2022-04-01 | Type of plan entity | Single employer plan |
| 2022-04-01 | First time form 5500 has been submitted | Yes |
| 2022-04-01 | This submission is the final filing | Yes |
| 2022-04-01 | Plan funding arrangement – Insurance | Yes |
| 2022-04-01 | Plan benefit arrangement – Insurance | Yes |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |
| Policy contract number | 635979 |
| Policy instance | 1 |
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