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| Plan Name | LIGHTHOUSE BEHAVIORAL WELLNESS CENTERS, INC. LONG TERM DISABILITY PLAN |
| Plan identification number | 505 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | LIGHTHOUSE BEHAVIORAL WELLNESS CENTERS, INC. |
| Employer identification number (EIN): | 730618672 |
| NAIC Classification: | 621420 |
| NAIC Description: | Outpatient Mental Health and Substance Abuse Centers |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 505 | 2023-07-01 | ERIC HOWARD | 2025-01-21 | ||
| 505 | 2022-07-01 | ERIC HOWARD | 2024-11-01 | JESSICA PFAU | 2024-11-01 |
| 2023: LIGHTHOUSE BEHAVIORAL WELLNESS CENTERS, INC. LONG TERM DISABILITY PLAN 2023 form 5500 responses | ||
|---|---|---|
| 2023-07-01 | Type of plan entity | Single employer plan |
| 2023-07-01 | Plan funding arrangement – Insurance | Yes |
| 2023-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: LIGHTHOUSE BEHAVIORAL WELLNESS CENTERS, INC. LONG TERM DISABILITY PLAN 2022 form 5500 responses | ||
| 2022-07-01 | Type of plan entity | Single employer plan |
| 2022-07-01 | Plan funding arrangement – Insurance | Yes |
| 2022-07-01 | Plan benefit arrangement – Insurance | Yes |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |||||||||||||||||||
| Policy contract number | GLTD0C4Q8 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
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| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |||||||||||||||||||
| Policy contract number | GLTD0C4Q8 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
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