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| Plan Name | LAKESHORE COMMUNITY SERVICES, INC GROUP LIFE PLAN |
| Plan identification number | 506 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | LAKESHORE COMMUNITY SERVICES, INC. |
| Employer identification number (EIN): | 251577930 |
| NAIC Classification: | 624100 |
| NAIC Description: | Individual and Family Services |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 506 | 2015-03-01 | DONNA CARLINO | |||
| 506 | 2015-03-01 | DELIGHT STEVENS | 2021-11-23 | ||
| 506 | 2013-03-13 | RICHARD RUEDY | RICHARD RUEDY | 2014-07-25 |
| 2015: LAKESHORE COMMUNITY SERVICES, INC GROUP LIFE PLAN 2015 form 5500 responses | ||
|---|---|---|
| 2015-03-01 | Type of plan entity | Single employer plan |
| 2015-03-01 | Submission has been amended | No |
| 2015-03-01 | This submission is the final filing | No |
| 2015-03-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-03-01 | Plan is a collectively bargained plan | No |
| 2015-03-01 | Plan funding arrangement – Insurance | Yes |
| 2015-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: LAKESHORE COMMUNITY SERVICES, INC GROUP LIFE PLAN 2013 form 5500 responses | ||
| 2013-03-13 | Type of plan entity | Single employer plan |
| 2013-03-13 | Submission has been amended | No |
| 2013-03-13 | This submission is the final filing | No |
| 2013-03-13 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2013-03-13 | Plan is a collectively bargained plan | No |
| 2013-03-13 | Plan funding arrangement – Insurance | Yes |
| 2013-03-13 | Plan benefit arrangement – Insurance | Yes |
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) | |
| Policy contract number | P00686 |
| Policy instance | 1 |
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