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| Plan Name | PCC STRUCTURALS WAX CENTER, LLC DENTAL PLAN |
| Plan identification number | 503 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | PCC STRUCTURALS WAX CENTER, LLC |
| Employer identification number (EIN): | 931285854 |
| NAIC Classification: | 332900 |
Additional information about PCC STRUCTURALS WAX CENTER, LLC
| Jurisdiction of Incorporation: | Oregon Secretary of State Corporations Division |
| Incorporation Date: | 2018-04-06 |
| Company Identification Number: | 142726090 |
| Legal Registered Office Address: |
780 COMMERCIAL ST SE STE 100 SALEM United States of America (USA) 97301 |
More information about PCC STRUCTURALS WAX CENTER, LLC
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 503 | 2019-08-01 | RACHELLE BOX | 2020-07-29 |
| 2019: PCC STRUCTURALS WAX CENTER, LLC DENTAL PLAN 2019 form 5500 responses | ||
|---|---|---|
| 2019-08-01 | Type of plan entity | Single employer plan |
| 2019-08-01 | First time form 5500 has been submitted | Yes |
| 2019-08-01 | Submission has been amended | No |
| 2019-08-01 | This submission is the final filing | Yes |
| 2019-08-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2019-08-01 | Plan is a collectively bargained plan | No |
| 2019-08-01 | Plan funding arrangement – Insurance | Yes |
| 2019-08-01 | Plan benefit arrangement – Insurance | Yes |
| OREGON DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 54941 ) | |
| Policy contract number | 10016341 |
| Policy instance | 1 |
| OREGON DENTAL SERVICE (National Association of Insurance Commissioners NAIC id number: 54941 ) | |
| Policy contract number | 10016341 |
| Policy instance | 2 |
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