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| Plan Name | LINCOLN CREEK LUMBER CO., INC. MEDICAL PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | LINCOLN CREEK LUMBER CO., INC. |
| Employer identification number (EIN): | 910844224 |
| NAIC Classification: | 444190 |
| NAIC Description: | Other Building Material Dealers |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2023-04-01 | TIFFINY HURST | 2024-10-09 | ||
| 501 | 2022-04-01 | TIFFINY HURST | 2023-10-27 |
| 2023: LINCOLN CREEK LUMBER CO., INC. MEDICAL PLAN 2023 form 5500 responses | ||
|---|---|---|
| 2023-04-01 | Type of plan entity | Single employer plan |
| 2023-04-01 | Plan funding arrangement – Insurance | Yes |
| 2023-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: LINCOLN CREEK LUMBER CO., INC. MEDICAL PLAN 2022 form 5500 responses | ||
| 2022-04-01 | Type of plan entity | Single employer plan |
| 2022-04-01 | First time form 5500 has been submitted | Yes |
| 2022-04-01 | Plan funding arrangement – Insurance | Yes |
| 2022-04-01 | Plan benefit arrangement – Insurance | Yes |
| GROUP HEALTH OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 47055 ) | |||||||||||||||||||
| Policy contract number | 6307400 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
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| GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 ) | |||||||||||||||||||
| Policy contract number | 2388600 | ||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||
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| GROUP HEALTH OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 47055 ) | |||||||||||||||||||
| Policy contract number | 6307400 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| GROUP HEALTH COOPERATIVE (National Association of Insurance Commissioners NAIC id number: 95672 ) | |||||||||||||||||||
| Policy contract number | 2388600 | ||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||
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