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| Plan Name | MONGIOVI & SON EMPLOYEE BENEFITS PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | MONGIOVI & SON PLUMBING CONTRACTOR, LP |
| Employer identification number (EIN): | 251824555 |
| NAIC Classification: | 238220 |
| NAIC Description: | Plumbing, Heating, and Air-Conditioning Contractors |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2021-01-01 | ||||
| 501 | 2021-01-01 | ||||
| 501 | 2021-01-01 | RACHELE MONGIOVI | |||
| 501 | 2020-01-01 |
| 2021: MONGIOVI & SON EMPLOYEE BENEFITS PLAN 2021 form 5500 responses | ||
|---|---|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Submission has been amended | No |
| 2021-01-01 | This submission is the final filing | No |
| 2021-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-01-01 | Plan is a collectively bargained plan | No |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: MONGIOVI & SON EMPLOYEE BENEFITS PLAN 2020 form 5500 responses | ||
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | First time form 5500 has been submitted | Yes |
| 2020-01-01 | Submission has been amended | No |
| 2020-01-01 | This submission is the final filing | No |
| 2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-01-01 | Plan is a collectively bargained plan | No |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) | |
| Policy contract number | LFG85 |
| Policy instance | 7 |
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) | |
| Policy contract number | YV123 |
| Policy instance | 6 |
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) | |
| Policy contract number | YV156 |
| Policy instance | 5 |
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) | |
| Policy contract number | YV134 |
| Policy instance | 4 |
| LIBERTY NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | N/A |
| Policy instance | 3 |
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) | |
| Policy contract number | 920619 |
| Policy instance | 2 |
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) | |
| Policy contract number | 199109 |
| Policy instance | 1 |
| UNITED CONCORDIA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 85766 ) | |
| Policy contract number | 920619 |
| Policy instance | 7 |
| HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 ) | |
| Policy contract number | 199109 |
| Policy instance | 6 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 00456536 |
| Policy instance | 5 |
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) | |
| Policy contract number | YV156 |
| Policy instance | 4 |
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) | |
| Policy contract number | YV134 |
| Policy instance | 3 |
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) | |
| Policy contract number | YV123 |
| Policy instance | 2 |
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) | |
| Policy contract number | LFG85 |
| Policy instance | 1 |
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