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| Plan Name | DIV HOLDINGS, LLC WELFARE BENEFIT PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | DIV HOLDINGS, LLC DBA JARDIN PREMIUM CANNABIS AUTHORITY |
| Employer identification number (EIN): | 811522174 |
| NAIC Classification: | 111900 |
| NAIC Description: | Other Crop Farming |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2023-04-01 | BRANDON WIEGAND | 2024-10-21 | ||
| 501 | 2022-04-01 | ||||
| 501 | 2022-04-01 | JESSE HARRINGTON |
| Measure | Date | Value |
|---|---|---|
| 2023: DIV HOLDINGS, LLC WELFARE BENEFIT PLAN 2023 401k membership | ||
| Total participants, beginning-of-year | 2023-04-01 | 114 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-04-01 | 120 |
| Number of retired or separated participants receiving benefits | 2023-04-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2023-04-01 | 0 |
| Total of all active and inactive participants | 2023-04-01 | 120 |
| Number of employers contributing to the scheme | 2023-04-01 | 0 |
| 2022: DIV HOLDINGS, LLC WELFARE BENEFIT PLAN 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-04-01 | 136 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-04-01 | 114 |
| Number of retired or separated participants receiving benefits | 2022-04-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2022-04-01 | 0 |
| Total of all active and inactive participants | 2022-04-01 | 115 |
| 2023: DIV HOLDINGS, LLC WELFARE BENEFIT 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: DIV HOLDINGS, LLC WELFARE BENEFIT PLAN 2022 form 5500 responses | ||
| 2022-04-01 | Type of plan entity | Single employer plan |
| 2022-04-01 | First time form 5500 has been submitted | Yes |
| 2022-04-01 | Submission has been amended | No |
| 2022-04-01 | This submission is the final filing | No |
| 2022-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-04-01 | Plan is a collectively bargained plan | No |
| 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 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |||||||||||||||||||||||||
| Policy contract number | 1470078 | ||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||
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| KANSAS CITY LIFE (National Association of Insurance Commissioners NAIC id number: 65129 ) | |||||||||||||||||||||||||
| Policy contract number | 65129 | ||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||
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| RENAISSANCE LIFE & HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61700 ) | |||||||||||||||||||||||||
| Policy contract number | 106715 | ||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||
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| RENAISSANCE LIFE & HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61700 ) | |||||||||||||||||||||||||
| Policy contract number | 106715 | ||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||
| KANSAS CITY LIFE (National Association of Insurance Commissioners NAIC id number: 65129 ) | |||||||||||||||||||||||||
| Policy contract number | 65129 | ||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |||||||||||||||||||||||||
| Policy contract number | 03L7279 | ||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||
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