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| Plan Name | SIERRA AUTOMOTIVE HOLDINGS, LLC |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | SIERRA AUTOMOTIVE HOLDINGS, LLC |
| Employer identification number (EIN): | 871703893 |
| NAIC Classification: | 441300 |
| NAIC Description: | Automotive Parts, Accessories, and Tire Stores |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2024-01-01 | ANGIE REYES | |||
| 502 | 2023-01-01 | ||||
| 502 | 2023-01-01 | ANGIE REYES | |||
| 502 | 2022-09-01 | RINALDI HALIM | 2023-05-26 | ||
| 502 | 2021-09-01 | RINALDI HALIM | 2023-03-24 | ||
| 502 | 2020-09-01 | RINALDI HALIM | 2021-11-22 |
| 2023: SIERRA AUTOMOTIVE HOLDINGS, LLC 2023 form 5500 responses | ||
|---|---|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Submission has been amended | No |
| 2023-01-01 | This submission is the final filing | No |
| 2023-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2023-01-01 | Plan is a collectively bargained plan | No |
| 2023-01-01 | Plan funding arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: SIERRA AUTOMOTIVE HOLDINGS, LLC 2022 form 5500 responses | ||
| 2022-09-01 | Type of plan entity | Single employer plan |
| 2022-09-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2022-09-01 | Plan funding arrangement – Insurance | Yes |
| 2022-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: SIERRA AUTOMOTIVE HOLDINGS, LLC 2021 form 5500 responses | ||
| 2021-09-01 | Type of plan entity | Single employer plan |
| 2021-09-01 | Plan funding arrangement – Insurance | Yes |
| 2021-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: SIERRA AUTOMOTIVE HOLDINGS, LLC 2020 form 5500 responses | ||
| 2020-09-01 | Type of plan entity | Single employer plan |
| 2020-09-01 | First time form 5500 has been submitted | Yes |
| 2020-09-01 | Plan funding arrangement – Insurance | Yes |
| 2020-09-01 | 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 | 00633365 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
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| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 00570575 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
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| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 633365 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
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| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 570575 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| |||||||||||||||||||||||||||||||||||||||||||||||||||||
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 633365 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 570575 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 234582 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 570575 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
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