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| Plan Name | TRIVIUM MANAGEMENT GROUP, LLC HEALTH & WELFARE PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | TRIVIUM MANAGEMENT GROUP, LLC |
| Employer identification number (EIN): | 464468842 |
| NAIC Classification: | 621610 |
| NAIC Description: | Home Health Care Services |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2021-04-01 | LISA SCOTT | 2022-10-25 |
| 2021: TRIVIUM MANAGEMENT GROUP, LLC HEALTH & WELFARE PLAN 2021 form 5500 responses | ||
|---|---|---|
| 2021-04-01 | Type of plan entity | Single employer plan |
| 2021-04-01 | First time form 5500 has been submitted | Yes |
| 2021-04-01 | Plan funding arrangement – Insurance | Yes |
| 2021-04-01 | Plan benefit arrangement – Insurance | Yes |
| BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 ) | |
| Policy contract number | 129058 |
| Policy instance | 1 |
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