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| Plan Name | COLUMBUS FOUNDATION, INC WELFARE BENEFIT PLAN |
| Plan identification number | 505 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | COLUMBUS FOUNDATION, INC |
| Employer identification number (EIN): | 876130042 |
| NAIC Classification: | 624100 |
| NAIC Description: | Individual and Family Services |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 505 | 2019-01-01 | PATTI TIMM | 2020-07-31 |
| 2019: COLUMBUS FOUNDATION, INC WELFARE BENEFIT PLAN 2019 form 5500 responses | ||
|---|---|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | First time form 5500 has been submitted | Yes |
| 2019-01-01 | Submission has been amended | No |
| 2019-01-01 | This submission is the final filing | No |
| 2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-01-01 | Plan is a collectively bargained plan | No |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) | |
| Policy contract number | E4687372 |
| Policy instance | 1 |
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |
| Policy contract number | 879269G |
| Policy instance | 2 |
| HEALTHIEST YOU (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | HY2841 |
| Policy instance | 3 |
| INTERMOUNTAIN EAP (National Association of Insurance Commissioners NAIC id number: 0000 ) | |
| Policy contract number | NA |
| Policy instance | 4 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | 5939676 |
| Policy instance | 5 |
| DENTIST DIRECT, LLC (National Association of Insurance Commissioners NAIC id number: 52429 ) | |
| Policy contract number | ACL2K |
| Policy instance | 6 |
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