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| Plan Name | ASSOCIATED ENERGY GROUP, LLC HEALTH PLAN |
| Plan identification number | 503 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | ASSOCIATED ENERGY GROUP, LLC |
| Employer identification number (EIN): | 760250408 |
| NAIC Classification: | 424700 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 503 | 2023-01-01 | RALPH ACEVEDO | 2024-04-30 | ||
| 503 | 2022-01-01 | ||||
| 503 | 2022-01-01 | JAY MOTSINGER | |||
| 503 | 2021-10-01 | ||||
| 503 | 2021-10-01 | JAY MOTSINGER |
| 2023: ASSOCIATED ENERGY GROUP, LLC HEALTH PLAN 2023 form 5500 responses | ||
|---|---|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Plan funding arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: ASSOCIATED ENERGY GROUP, LLC HEALTH PLAN 2022 form 5500 responses | ||
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Submission has been amended | No |
| 2022-01-01 | This submission is the final filing | No |
| 2022-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-01-01 | Plan is a collectively bargained plan | No |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: ASSOCIATED ENERGY GROUP, LLC HEALTH PLAN 2021 form 5500 responses | ||
| 2021-10-01 | Type of plan entity | Single employer plan |
| 2021-10-01 | First time form 5500 has been submitted | Yes |
| 2021-10-01 | Submission has been amended | No |
| 2021-10-01 | This submission is the final filing | No |
| 2021-10-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2021-10-01 | Plan is a collectively bargained plan | No |
| 2021-10-01 | Plan funding arrangement – Insurance | Yes |
| 2021-10-01 | Plan benefit arrangement – Insurance | Yes |
| ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. (National Association of Insurance Commissioners NAIC id number: 11011 ) | |||||||||||||||||||||||
| Policy contract number | L06923 | ||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||
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| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |||||||||||||||||||||||
| Policy contract number | 00635054 | ||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||
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| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |||||||||||||||||||||||
| Policy contract number | 0635054 | ||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||
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| ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. (National Association of Insurance Commissioners NAIC id number: 11011 ) | |||||||||||||||||||||||
| Policy contract number | 196127 | ||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||
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