| Plan Name | TAHIRIH JUSTICE CENTER HEALTH AND WELFARE BENEFIT PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | TAHIRIH JUSTICE CENTER |
| Employer identification number (EIN): | 541858176 |
| NAIC Classification: | 541110 |
| NAIC Description: | Offices of Lawyers |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2020-08-01 |
| 2020: TAHIRIH JUSTICE CENTER HEALTH AND WELFARE BENEFIT PLAN 2020 form 5500 responses | ||
|---|---|---|
| 2020-08-01 | Type of plan entity | Single employer plan |
| 2020-08-01 | First time form 5500 has been submitted | Yes |
| 2020-08-01 | Submission has been amended | No |
| 2020-08-01 | This submission is the final filing | No |
| 2020-08-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-08-01 | Plan is a collectively bargained plan | No |
| 2020-08-01 | Plan funding arrangement – Insurance | Yes |
| 2020-08-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-08-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 ) | |
| Policy contract number | XT25 |
| Policy instance | 1 |
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) | |
| Policy contract number | 1114128 |
| Policy instance | 2 |