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| Plan Name | NATURAL CHOICE FOODS HEALTH AND WELFARE PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | NATURAL CHOICE FOODS, INC. |
| Employer identification number (EIN): | 383355157 |
| NAIC Classification: | 424400 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2022-09-01 | DEBORAH PHILLIPS | 2024-02-02 | ||
| 501 | 2021-09-01 | DEBORAH PHILLIPS | 2023-02-22 | ||
| 501 | 2020-09-01 | BRIAN JONES | 2022-03-31 |
| 2022: NATURAL CHOICE FOODS HEALTH AND WELFARE PLAN 2022 form 5500 responses | ||
|---|---|---|
| 2022-09-01 | Type of plan entity | Single employer plan |
| 2022-09-01 | Plan funding arrangement – Insurance | Yes |
| 2022-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: NATURAL CHOICE FOODS HEALTH AND WELFARE PLAN 2021 form 5500 responses | ||
| 2021-09-01 | Type of plan entity | Single employer plan |
| 2021-09-01 | Plan funding arrangement – Insurance | Yes |
| 2021-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: NATURAL CHOICE FOODS HEALTH AND WELFARE PLAN 2020 form 5500 responses | ||
| 2020-09-01 | Type of plan entity | Single employer plan |
| 2020-09-01 | First time form 5500 has been submitted | Yes |
| 2020-09-01 | Plan funding arrangement – Insurance | Yes |
| 2020-09-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-09-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |
| Policy contract number | GLLP0B3BL |
| Policy instance | 5 |
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) | |
| Policy contract number | 280474 |
| Policy instance | 4 |
| BLUE CARE NETWORK OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 95610 ) | |
| Policy contract number | 280474 |
| Policy instance | 3 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) | |
| Policy contract number | 30060182 |
| Policy instance | 2 |
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) | |
| Policy contract number | 5162 |
| Policy instance | 1 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |
| Policy contract number | GLLP0B3BL |
| Policy instance | 5 |
| PRIORITY HEALTH (National Association of Insurance Commissioners NAIC id number: 12208 ) | |
| Policy contract number | 791350 S001 |
| Policy instance | 4 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) | |
| Policy contract number | 30060182 |
| Policy instance | 3 |
| PRIORITY HEALTH (National Association of Insurance Commissioners NAIC id number: 95561 ) | |
| Policy contract number | 791350 |
| Policy instance | 2 |
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) | |
| Policy contract number | 5162 |
| Policy instance | 1 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |
| Policy contract number | GLLP0B3BL |
| Policy instance | 5 |
| PRIORITY HEALTH (National Association of Insurance Commissioners NAIC id number: 12208 ) | |
| Policy contract number | 791350 S001 |
| Policy instance | 4 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) | |
| Policy contract number | 30060182 |
| Policy instance | 3 |
| PRIORITY HEALTH (National Association of Insurance Commissioners NAIC id number: 95561 ) | |
| Policy contract number | 791350 |
| Policy instance | 2 |
| DELTA DENTAL OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54305 ) | |
| Policy contract number | 5162 |
| Policy instance | 1 |
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