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| Plan Name | CERTIFIED TIRE SERVICE COMPANY WELFARE BENEFITS PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | CERTIFIED TIRE SERVICE COMPANY |
| Employer identification number (EIN): | 330774751 |
| NAIC Classification: | 441300 |
| NAIC Description: | Automotive Parts, Accessories, and Tire Stores |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2019-04-01 | ||||
| 501 | 2018-04-01 | ||||
| 501 | 2017-04-01 | MICHELE SCHOOF | |||
| 501 | 2016-04-01 | MICHELE SCHOOF | |||
| 501 | 2015-04-01 | MICHELE SCHOOF | |||
| 501 | 2014-04-01 | MICHELE SCHOOF | |||
| 501 | 2013-04-01 | MICHELE SCHOOF | |||
| 501 | 2012-04-01 | MICHELE SCHOOF | |||
| 501 | 2011-04-01 | MICHELE SCHOOF | |||
| 501 | 2010-04-01 | MICHELE SCHOOF |
| 2019: CERTIFIED TIRE SERVICE COMPANY WELFARE BENEFITS PLAN 2019 form 5500 responses | ||
|---|---|---|
| 2019-04-01 | Type of plan entity | Single employer plan |
| 2019-04-01 | Submission has been amended | No |
| 2019-04-01 | This submission is the final filing | Yes |
| 2019-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-04-01 | Plan is a collectively bargained plan | No |
| 2019-04-01 | Plan funding arrangement – Insurance | Yes |
| 2019-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: CERTIFIED TIRE SERVICE COMPANY WELFARE BENEFITS PLAN 2018 form 5500 responses | ||
| 2018-04-01 | Type of plan entity | Single employer plan |
| 2018-04-01 | Submission has been amended | No |
| 2018-04-01 | This submission is the final filing | No |
| 2018-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-04-01 | Plan is a collectively bargained plan | No |
| 2018-04-01 | Plan funding arrangement – Insurance | Yes |
| 2018-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: CERTIFIED TIRE SERVICE COMPANY WELFARE BENEFITS PLAN 2017 form 5500 responses | ||
| 2017-04-01 | Type of plan entity | Single employer plan |
| 2017-04-01 | Submission has been amended | No |
| 2017-04-01 | This submission is the final filing | No |
| 2017-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-04-01 | Plan is a collectively bargained plan | No |
| 2017-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: CERTIFIED TIRE SERVICE COMPANY WELFARE BENEFITS PLAN 2016 form 5500 responses | ||
| 2016-04-01 | Type of plan entity | Single employer plan |
| 2016-04-01 | Submission has been amended | No |
| 2016-04-01 | This submission is the final filing | No |
| 2016-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-04-01 | Plan is a collectively bargained plan | No |
| 2016-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: CERTIFIED TIRE SERVICE COMPANY WELFARE BENEFITS PLAN 2015 form 5500 responses | ||
| 2015-04-01 | Type of plan entity | Single employer plan |
| 2015-04-01 | Submission has been amended | No |
| 2015-04-01 | This submission is the final filing | No |
| 2015-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-04-01 | Plan is a collectively bargained plan | No |
| 2015-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: CERTIFIED TIRE SERVICE COMPANY WELFARE BENEFITS PLAN 2014 form 5500 responses | ||
| 2014-04-01 | Type of plan entity | Single employer plan |
| 2014-04-01 | Submission has been amended | No |
| 2014-04-01 | This submission is the final filing | No |
| 2014-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-04-01 | Plan is a collectively bargained plan | No |
| 2014-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: CERTIFIED TIRE SERVICE COMPANY WELFARE BENEFITS PLAN 2013 form 5500 responses | ||
| 2013-04-01 | Type of plan entity | Single employer plan |
| 2013-04-01 | Submission has been amended | No |
| 2013-04-01 | This submission is the final filing | No |
| 2013-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-04-01 | Plan is a collectively bargained plan | No |
| 2013-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: CERTIFIED TIRE SERVICE COMPANY WELFARE BENEFITS PLAN 2012 form 5500 responses | ||
| 2012-04-01 | Type of plan entity | Single employer plan |
| 2012-04-01 | Submission has been amended | No |
| 2012-04-01 | This submission is the final filing | No |
| 2012-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-04-01 | Plan is a collectively bargained plan | No |
| 2012-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: CERTIFIED TIRE SERVICE COMPANY WELFARE BENEFITS PLAN 2011 form 5500 responses | ||
| 2011-04-01 | Type of plan entity | Single employer plan |
| 2011-04-01 | Submission has been amended | No |
| 2011-04-01 | This submission is the final filing | No |
| 2011-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-04-01 | Plan is a collectively bargained plan | No |
| 2011-04-01 | Plan funding arrangement – Insurance | Yes |
| 2011-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: CERTIFIED TIRE SERVICE COMPANY WELFARE BENEFITS PLAN 2010 form 5500 responses | ||
| 2010-04-01 | Type of plan entity | Single employer plan |
| 2010-04-01 | First time form 5500 has been submitted | Yes |
| 2010-04-01 | Submission has been amended | No |
| 2010-04-01 | This submission is the final filing | No |
| 2010-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-04-01 | Plan is a collectively bargained plan | No |
| 2010-04-01 | Plan funding arrangement – Insurance | Yes |
| 2010-04-01 | Plan benefit arrangement – Insurance | Yes |
| DENTAL HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 41067 ) | |
| Policy contract number | 5088H/5088H-C |
| Policy instance | 3 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 22936 |
| Policy instance | 4 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 30025450 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 137882 |
| Policy instance | 2 |
| MONY (National Association of Insurance Commissioners NAIC id number: 78077 ) | |
| Policy contract number | 000641 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 22936 |
| Policy instance | 5 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 30025450 |
| Policy instance | 2 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 137882 |
| Policy instance | 3 |
| DENTAL HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 41067 ) | |
| Policy contract number | 5088H/5088H-C |
| Policy instance | 4 |
| AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) | |
| Policy contract number | N641H4 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 22936 |
| Policy instance | 5 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 137882 |
| Policy instance | 3 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 30025450 |
| Policy instance | 2 |
| DENTAL HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 41067 ) | |
| Policy contract number | 5088H/5088H-C |
| Policy instance | 4 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 137882 |
| Policy instance | 5 |
| AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60488 ) | |
| Policy contract number | W000000375 |
| Policy instance | 4 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 30025450 |
| Policy instance | 1 |
| DENTAL HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 41067 ) | |
| Policy contract number | 5088H/5088H-C |
| Policy instance | 2 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 22936 |
| Policy instance | 3 |
| DENTAL HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 41067 ) | |
| Policy contract number | 5088H/5088H-C |
| Policy instance | 5 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 10140952 |
| Policy instance | 4 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 30025450 |
| Policy instance | 3 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 137882 |
| Policy instance | 2 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 22936 |
| Policy instance | 1 |
| DENTAL HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 41067 ) | |
| Policy contract number | 5088H/5088H-C |
| Policy instance | 1 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 10140952 |
| Policy instance | 2 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 22936 |
| Policy instance | 3 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 137882 |
| Policy instance | 4 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 30025450 |
| Policy instance | 5 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 10140952 |
| Policy instance | 2 |
| DENTAL HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 41067 ) | |
| Policy contract number | 5088H/5088H-C |
| Policy instance | 3 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 137882 |
| Policy instance | 4 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 22936 |
| Policy instance | 6 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 30025450 |
| Policy instance | 1 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 10140952 |
| Policy instance | 5 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 30025450 |
| Policy instance | 4 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 22936 |
| Policy instance | 5 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 10140952 |
| Policy instance | 6 |
| DENTAL HEALTH SERVICES (National Association of Insurance Commissioners NAIC id number: 41067 ) | |
| Policy contract number | 5088H/5088H-C |
| Policy instance | 2 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 137882 |
| Policy instance | 3 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |
| Policy contract number | GVTL 04201 |
| Policy instance | 1 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |
| Policy contract number | GVTL 04201 |
| Policy instance | 1 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |
| Policy contract number | 518214 |
| Policy instance | 2 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 137882 |
| Policy instance | 3 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |
| Policy contract number | 704876G |
| Policy instance | 4 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 22936 |
| Policy instance | 5 |
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