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| Plan Name | MIURA AMERICA CO., LTD. EMPLOYEE BENEFITS PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | MIURA AMERICA CO., LTD. |
| Employer identification number (EIN): | 680543295 |
| NAIC Classification: | 333410 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2023-04-01 | PAMELA BASKETTE | 2024-10-24 | ||
| 501 | 2022-04-01 | PAMELA BASKETTE | 2023-11-21 | ||
| 501 | 2021-04-01 | PAMELA BASKETTE | 2022-10-26 | ||
| 501 | 2020-04-01 | ||||
| 501 | 2019-04-01 | ||||
| 501 | 2018-04-01 | ||||
| 501 | 2017-04-01 | PAMELA BASKETTE |
| 2023: MIURA AMERICA CO., LTD. EMPLOYEE BENEFITS PLAN 2023 form 5500 responses | ||
|---|---|---|
| 2023-04-01 | Type of plan entity | Single employer plan |
| 2023-04-01 | Plan funding arrangement – Insurance | Yes |
| 2023-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2023-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2023-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2022: MIURA AMERICA CO., LTD. EMPLOYEE BENEFITS PLAN 2022 form 5500 responses | ||
| 2022-04-01 | Type of plan entity | Single employer plan |
| 2022-04-01 | Plan funding arrangement – Insurance | Yes |
| 2022-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: MIURA AMERICA CO., LTD. EMPLOYEE BENEFITS PLAN 2021 form 5500 responses | ||
| 2021-04-01 | Type of plan entity | Single employer plan |
| 2021-04-01 | Plan funding arrangement – Insurance | Yes |
| 2021-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: MIURA AMERICA CO., LTD. EMPLOYEE BENEFITS PLAN 2020 form 5500 responses | ||
| 2020-04-01 | Type of plan entity | Single employer plan |
| 2020-04-01 | Submission has been amended | No |
| 2020-04-01 | This submission is the final filing | No |
| 2020-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-04-01 | Plan is a collectively bargained plan | No |
| 2020-04-01 | Plan funding arrangement – Insurance | Yes |
| 2020-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: MIURA AMERICA CO., LTD. EMPLOYEE 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 | No |
| 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: MIURA AMERICA CO., LTD. EMPLOYEE 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: MIURA AMERICA CO., LTD. EMPLOYEE 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 – Insurance | Yes |
| 2017-04-01 | Plan benefit arrangement – Insurance | Yes |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | SGM0612236 | ||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||
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| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | 5599C | ||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||
| |||||||||||||||||||||||||||||||||
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | SGM0612236 | ||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | 5599C | ||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||
| GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | GB0713 | ||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||
| BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | GB0713 | ||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||
| BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | GB0713 | ||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | 10056 | ||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||
| GREATER GEORGIA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97217 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | GB0713 | ||||||||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||||||||
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | 05599A | ||||||||||||||||||||||||||||||||
| Policy instance | 8 | ||||||||||||||||||||||||||||||||
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | VDT601462 | ||||||||||||||||||||||||||||||||
| Policy instance | 7 | ||||||||||||||||||||||||||||||||
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | SGD606444 | ||||||||||||||||||||||||||||||||
| Policy instance | 6 | ||||||||||||||||||||||||||||||||
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | 9826264 | ||||||||||||||||||||||||||||||||
| Policy instance | 5 | ||||||||||||||||||||||||||||||||
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | 3334498 | ||||||||||||||||||||||||||||||||
| Policy instance | 4 | ||||||||||||||||||||||||||||||||
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | SOK604399 | ||||||||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||||||||
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | SGM606255 | ||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | 10056 | ||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | 05599A | ||||||||||||||||||||||||||||||||
| Policy instance | 8 | ||||||||||||||||||||||||||||||||
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | SGD606444 | ||||||||||||||||||||||||||||||||
| Policy instance | 7 | ||||||||||||||||||||||||||||||||
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | VDT601462 | ||||||||||||||||||||||||||||||||
| Policy instance | 6 | ||||||||||||||||||||||||||||||||
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | SOK604399 | ||||||||||||||||||||||||||||||||
| Policy instance | 5 | ||||||||||||||||||||||||||||||||
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | 10056 | ||||||||||||||||||||||||||||||||
| Policy instance | 4 | ||||||||||||||||||||||||||||||||
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | SGM606255 | ||||||||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||||||||
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | 3334498 | ||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | 9826264 | ||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | 3334498 | ||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | VDT601462 | ||||||||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||||||||
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | SOK604399 | ||||||||||||||||||||||||||||||||
| Policy instance | 4 | ||||||||||||||||||||||||||||||||
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | 9826264 | ||||||||||||||||||||||||||||||||
| Policy instance | 5 | ||||||||||||||||||||||||||||||||
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | SGM606255 | ||||||||||||||||||||||||||||||||
| Policy instance | 6 | ||||||||||||||||||||||||||||||||
| CONTINENTAL AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71730 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | 10056 | ||||||||||||||||||||||||||||||||
| Policy instance | 7 | ||||||||||||||||||||||||||||||||
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | SGD606444 | ||||||||||||||||||||||||||||||||
| Policy instance | 8 | ||||||||||||||||||||||||||||||||
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |||||||||||||||||||||||||||||||||
| Policy contract number | 05599A | ||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||
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