| Plan Name | VIPER NORTHWEST, INC. |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | VIPER NORTHWEST, INC. |
| Employer identification number (EIN): | 931017559 |
| NAIC Classification: | 332110 |
Additional information about VIPER NORTHWEST, INC.
| Jurisdiction of Incorporation: | Oregon Secretary of State Corporations Division |
| Incorporation Date: | 1990-01-08 |
| Company Identification Number: | 18503680 |
| Legal Registered Office Address: |
1216 JACKSON ST SE ALBANY United States of America (USA) 97322 |
More information about VIPER NORTHWEST, INC.
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2021-01-01 | KIM PASCHKE | 2022-07-05 | ||
| 501 | 2020-01-01 | KRISTYNE SMITH | 2021-07-26 | ||
| 501 | 2019-01-01 | DENNIS SCOTT | 2020-04-02 | ||
| 501 | 2018-02-01 |
| 2021: VIPER NORTHWEST, INC. 2021 form 5500 responses | ||
|---|---|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | This submission is the final filing | Yes |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: VIPER NORTHWEST, INC. 2020 form 5500 responses | ||
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: VIPER NORTHWEST, INC. 2019 form 5500 responses | ||
| 2019-01-01 | Type of plan entity | Single employer plan |
| 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 |
| 2018: VIPER NORTHWEST, INC. 2018 form 5500 responses | ||
| 2018-02-01 | Type of plan entity | Single employer plan |
| 2018-02-01 | First time form 5500 has been submitted | Yes |
| 2018-02-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2018-02-01 | Plan funding arrangement – Insurance | Yes |
| 2018-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) | |
| Policy contract number | K5707 |
| Policy instance | 5 |
| LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 ) | |
| Policy contract number | OR076883 |
| Policy instance | 4 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) | |
| Policy contract number | 30081530 |
| Policy instance | 3 |
| OREGON DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 54941 ) | |
| Policy contract number | 10001227 |
| Policy instance | 2 |
| SAMARITAN HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 12257 ) | |
| Policy contract number | SAM0065 |
| Policy instance | 1 |
| OREGON DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 54941 ) | |
| Policy contract number | 10001227 |
| Policy instance | 2 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) | |
| Policy contract number | 30081530 |
| Policy instance | 3 |
| LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 ) | |
| Policy contract number | OR076883 |
| Policy instance | 4 |
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) | |
| Policy contract number | K5707 |
| Policy instance | 5 |
| SAMARITAN HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 12257 ) | |
| Policy contract number | SAM0065 |
| Policy instance | 1 |
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) | |
| Policy contract number | K5707 |
| Policy instance | 5 |
| LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 ) | |
| Policy contract number | OR076883 |
| Policy instance | 4 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) | |
| Policy contract number | 30081530 |
| Policy instance | 3 |
| OREGON DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 54941 ) | |
| Policy contract number | 10001227 |
| Policy instance | 2 |
| SAMARITAN HEALTH PLANS (National Association of Insurance Commissioners NAIC id number: 12257 ) | |
| Policy contract number | SAM0065 |
| Policy instance | 1 |
| OREGON DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 54941 ) | |
| Policy contract number | 10001227 |
| Policy instance | 2 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) | |
| Policy contract number | 30081530 |
| Policy instance | 3 |
| LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 ) | |
| Policy contract number | OR076883 |
| Policy instance | 4 |
| AFLAC (National Association of Insurance Commissioners NAIC id number: 60380 ) | |
| Policy contract number | K5707 |
| Policy instance | 5 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |
| Policy contract number | 2Y8366 |
| Policy instance | 1 |