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| Plan Name | SUMMIT EMERGENCY PHYSICIANS HEALTH AND WELFARE PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | SUMMIT EMERGENCY PHYSICIANS |
| Employer identification number (EIN): | 710863828 |
| NAIC Classification: | 621111 |
| NAIC Description: | Offices of Physicians (except Mental Health Specialists) |
Additional information about SUMMIT EMERGENCY PHYSICIANS
| Jurisdiction of Incorporation: | Georgia Department of States Corporations Division |
| Incorporation Date: | |
| Company Identification Number: | 104056 |
More information about SUMMIT EMERGENCY PHYSICIANS
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2020-12-01 | JENNIFER HALL | 2021-09-08 | ||
| 501 | 2019-12-01 | JENNIFER HALL | 2021-09-08 |
| 2020: SUMMIT EMERGENCY PHYSICIANS HEALTH AND WELFARE PLAN 2020 form 5500 responses | ||
|---|---|---|
| 2020-12-01 | Type of plan entity | Single employer plan |
| 2020-12-01 | This submission is the final filing | Yes |
| 2020-12-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2020-12-01 | Plan funding arrangement – Insurance | Yes |
| 2020-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: SUMMIT EMERGENCY PHYSICIANS HEALTH AND WELFARE PLAN 2019 form 5500 responses | ||
| 2019-12-01 | Type of plan entity | Single employer plan |
| 2019-12-01 | First time form 5500 has been submitted | Yes |
| 2019-12-01 | Plan funding arrangement – Insurance | Yes |
| 2019-12-01 | Plan benefit arrangement – Insurance | Yes |
| BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) | |
| Policy contract number | GA9286 |
| Policy instance | 1 |
| BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 ) | |
| Policy contract number | GA9286 |
| Policy instance | 1 |
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