| Plan Name | FORE AERO HOLDINGS LLC HEALTH AND WELFARE PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | FORE MACHINE, LLC |
| Employer identification number (EIN): | 815081850 |
| NAIC Classification: | 336410 |
Additional information about FORE MACHINE, LLC
| Jurisdiction of Incorporation: | Texas Secretary of State |
| Incorporation Date: | 2017-05-23 |
| Company Identification Number: | 0802729500 |
| Legal Registered Office Address: |
150 CALIFORNIA ST FL 21 SAN FRANCISCO United States of America (USA) 94111 |
More information about FORE MACHINE, LLC
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2017-07-01 |
| 2017: FORE AERO HOLDINGS LLC HEALTH AND WELFARE PLAN 2017 form 5500 responses | ||
|---|---|---|
| 2017-07-01 | Type of plan entity | Single employer plan |
| 2017-07-01 | First time form 5500 has been submitted | Yes |
| 2017-07-01 | Submission has been amended | No |
| 2017-07-01 | This submission is the final filing | No |
| 2017-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-07-01 | Plan is a collectively bargained plan | No |
| 2017-07-01 | Plan funding arrangement – Insurance | Yes |
| 2017-07-01 | Plan benefit arrangement – Insurance | Yes |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |
| Policy contract number | 00619307 |
| Policy instance | 1 |
| ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 ) | |
| Policy contract number | 12008369 |
| Policy instance | 2 |
| ACE AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 22667 ) | |
| Policy contract number | 12008369 |
| Policy instance | 3 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) | |
| Policy contract number | E4153243 |
| Policy instance | 4 |