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| Plan Name | LUV CAR WASH GROUP LLC HEALTH AND WELFARE BENEFIT PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | LUV CAR WASH GROUP, LLC |
| Employer identification number (EIN): | 872449305 |
| NAIC Classification: | 812990 |
| NAIC Description: | All Other Personal Services |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2022-11-01 | DIANE RICHARDSON | 2024-08-02 |
| 2022: LUV CAR WASH GROUP LLC HEALTH AND WELFARE BENEFIT PLAN 2022 form 5500 responses | ||
|---|---|---|
| 2022-11-01 | Type of plan entity | Single employer plan |
| 2022-11-01 | First time form 5500 has been submitted | Yes |
| 2022-11-01 | Plan funding arrangement – Insurance | Yes |
| 2022-11-01 | 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 | 637414 |
| Policy instance | 1 |
| PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 ) | |
| Policy contract number | 1148638 |
| Policy instance | 2 |
| MEDIEXCEL HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 15347 ) | |
| Policy contract number | E130 |
| Policy instance | 3 |
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