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| Plan Name | MICHIGAN CARPET DELIVERY BENEFIT PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | SSBB INC |
| Employer identification number (EIN): | 270051057 |
| NAIC Classification: | 238300 |
Additional information about SSBB INC
| Jurisdiction of Incorporation: | Georgia Department of States Corporations Division |
| Incorporation Date: | |
| Company Identification Number: | 1559279 |
More information about SSBB INC
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2020-06-01 | RICHARD WALDNER | 2021-10-19 | ||
| 501 | 2019-06-01 | RICHARD WALDNER | 2020-12-15 |
| 2020: MICHIGAN CARPET DELIVERY BENEFIT PLAN 2020 form 5500 responses | ||
|---|---|---|
| 2020-06-01 | Type of plan entity | Single employer plan |
| 2020-06-01 | Plan funding arrangement – Insurance | Yes |
| 2020-06-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: MICHIGAN CARPET DELIVERY BENEFIT PLAN 2019 form 5500 responses | ||
| 2019-06-01 | Type of plan entity | Single employer plan |
| 2019-06-01 | First time form 5500 has been submitted | Yes |
| 2019-06-01 | Plan funding arrangement – Insurance | Yes |
| 2019-06-01 | Plan benefit arrangement – Insurance | Yes |
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) | |
| Policy contract number | 281129 |
| Policy instance | 1 |
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) | |
| Policy contract number | 281129 |
| Policy instance | 2 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) | |
| Policy contract number | 10173201001 |
| Policy instance | 3 |
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) | |
| Policy contract number | 7684 |
| Policy instance | 4 |
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) | |
| Policy contract number | 281129 |
| Policy instance | 1 |
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) | |
| Policy contract number | 281129 |
| Policy instance | 2 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) | |
| Policy contract number | 10173201001 |
| Policy instance | 3 |
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) | |
| Policy contract number | 7684 |
| Policy instance | 4 |
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