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| Plan Name | CLEARCOVER BASIC LIFE PLAN |
| Plan identification number | 506 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | CLEARCOVER, INC. |
| Employer identification number (EIN): | 813825981 |
| NAIC Classification: | 524150 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 506 | 2023-01-01 | HALEE ISKALIS | 2024-08-21 | ||
| 506 | 2022-01-01 | HALEE ISKALIS | 2023-10-05 |
| 2023: CLEARCOVER BASIC LIFE 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: CLEARCOVER BASIC LIFE PLAN 2022 form 5500 responses | ||
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | First time form 5500 has been submitted | Yes |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |||||||||||||||||||||
| Policy contract number | GLUG0BTXW | ||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||
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| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |||||||||||||||||||||
| Policy contract number | GLUG0BTXW | ||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||
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