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| Plan Name | CLEAN SCAPES MEDICAL AND WELFARE HEALTH PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | CLEAN SCAPES, LP |
| Employer identification number (EIN): | 371510151 |
| NAIC Classification: | 561730 |
| NAIC Description: | Landscaping Services |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2019-01-01 | DAVID WOLFE | 2020-05-28 | ||
| 501 | 2019-01-01 | DAVID WOLFE | 2021-08-30 | ||
| 501 | 2018-01-01 |
| Measure | Date | Value |
|---|---|---|
| 2019: CLEAN SCAPES MEDICAL AND WELFARE HEALTH PLAN 2019 401k membership | ||
| Total participants, beginning-of-year | 2019-01-01 | 110 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 182 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 182 |
| Number of employers contributing to the scheme | 2019-01-01 | 0 |
| 2018: CLEAN SCAPES MEDICAL AND WELFARE HEALTH PLAN 2018 401k membership | ||
| Total participants, beginning-of-year | 2018-01-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 110 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 110 |
| Number of employers contributing to the scheme | 2018-01-01 | 0 |
| 2019: CLEAN SCAPES MEDICAL AND WELFARE HEALTH PLAN 2019 form 5500 responses | ||
|---|---|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Submission has been amended | Yes |
| 2019-01-01 | This submission is the final filing | Yes |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: CLEAN SCAPES MEDICAL AND WELFARE HEALTH PLAN 2018 form 5500 responses | ||
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | First time form 5500 has been submitted | Yes |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |||||||||||||||||||||||||||||
| Policy contract number | 5954872 | ||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||
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| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |||||||||||||||||||||||||||||
| Policy contract number | 3339680 | ||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||
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