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| Plan Name | K&M CASINOS, INC |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | K&M CASINOS INC |
| Employer identification number (EIN): | 822783063 |
| NAIC Classification: | 713100 |
| NAIC Description: | Amusement Parks and Arcades |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2019-03-01 | MANNY PEREZ | 2020-03-13 |
| 2019: K&M CASINOS, INC 2019 form 5500 responses | ||
|---|---|---|
| 2019-03-01 | Type of plan entity | Single employer plan |
| 2019-03-01 | First time form 5500 has been submitted | Yes |
| 2019-03-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2019-03-01 | Plan funding arrangement – Insurance | Yes |
| 2019-03-01 | Plan benefit arrangement – Insurance | Yes |
| PREMIER ACCESS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60237 ) | |
| Policy contract number | 14133 |
| Policy instance | 1 |
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) | |
| Policy contract number | 34372 |
| Policy instance | 2 |
| AMFIRST INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60250 ) | |
| Policy contract number | 17645 |
| Policy instance | 3 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |
| Policy contract number | 2X2269 |
| Policy instance | 4 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |
| Policy contract number | GLUG0AYYH |
| Policy instance | 5 |
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