| Plan Name | SURF OPCO LLC HEALTH AND WELFARE PLAN |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | SURF OPCO LLC |
| Employer identification number (EIN): | 861780704 |
| NAIC Classification: | 425110 |
| NAIC Description: | Business to Business Electronic Markets |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2020-06-01 | JASON GRAVES | 2022-09-08 |
| 2020: SURF OPCO LLC HEALTH AND WELFARE PLAN 2020 form 5500 responses | ||
|---|---|---|
| 2020-06-01 | Type of plan entity | Single employer plan |
| 2020-06-01 | This submission is the final filing | Yes |
| 2020-06-01 | Plan funding arrangement – Insurance | Yes |
| 2020-06-01 | 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 | 629848 |
| Policy instance | 1 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |
| Policy contract number | FLX968982 |
| Policy instance | 2 |