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| Plan Name | NONGSHIM AMERICA WELFARE BENEFIT PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | NONGSHIM AMERICA INC |
| Employer identification number (EIN): | 954502423 |
| NAIC Classification: | 311900 |
| NAIC Description: | Other Food Manufacturing |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2023-10-01 | ELEANOR MIN | |||
| 501 | 2022-10-01 | ||||
| 501 | 2022-10-01 | KRISTEN LEE | |||
| 501 | 2021-10-01 | ||||
| 501 | 2021-10-01 | HANA LEE | |||
| 501 | 2020-10-01 | ||||
| 501 | 2019-10-01 | ||||
| 501 | 2019-08-01 | JAE YOO | 2020-04-22 | JAE YOO | 2020-04-22 |
| 501 | 2018-08-01 | JAE YOO | 2020-02-27 | JAE YOO | 2020-02-27 |
| 501 | 2017-08-01 | JAE YOO | |||
| 501 | 2017-08-01 | ||||
| 501 | 2016-08-01 | JAE YOO | |||
| 501 | 2015-08-01 | JAE YOO |
| 2022: NONGSHIM AMERICA WELFARE BENEFIT PLAN 2022 form 5500 responses | ||
|---|---|---|
| 2022-10-01 | Type of plan entity | Single employer plan |
| 2022-10-01 | Submission has been amended | No |
| 2022-10-01 | This submission is the final filing | No |
| 2022-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-10-01 | Plan is a collectively bargained plan | No |
| 2022-10-01 | Plan funding arrangement – Insurance | Yes |
| 2022-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: NONGSHIM AMERICA WELFARE BENEFIT PLAN 2021 form 5500 responses | ||
| 2021-10-01 | Type of plan entity | Single employer plan |
| 2021-10-01 | Submission has been amended | No |
| 2021-10-01 | This submission is the final filing | No |
| 2021-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-10-01 | Plan is a collectively bargained plan | No |
| 2021-10-01 | Plan funding arrangement – Insurance | Yes |
| 2021-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: NONGSHIM AMERICA WELFARE BENEFIT PLAN 2020 form 5500 responses | ||
| 2020-10-01 | Type of plan entity | Single employer plan |
| 2020-10-01 | Submission has been amended | No |
| 2020-10-01 | This submission is the final filing | No |
| 2020-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-10-01 | Plan is a collectively bargained plan | No |
| 2020-10-01 | Plan funding arrangement – Insurance | Yes |
| 2020-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: NONGSHIM AMERICA WELFARE BENEFIT PLAN 2019 form 5500 responses | ||
| 2019-10-01 | Type of plan entity | Single employer plan |
| 2019-10-01 | Submission has been amended | No |
| 2019-10-01 | This submission is the final filing | No |
| 2019-10-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-10-01 | Plan is a collectively bargained plan | No |
| 2019-10-01 | Plan funding arrangement – Insurance | Yes |
| 2019-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-08-01 | Type of plan entity | Single employer plan |
| 2019-08-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2019-08-01 | Plan funding arrangement – Insurance | Yes |
| 2019-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: NONGSHIM AMERICA WELFARE BENEFIT PLAN 2018 form 5500 responses | ||
| 2018-08-01 | Type of plan entity | Single employer plan |
| 2018-08-01 | Plan funding arrangement – Insurance | Yes |
| 2018-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: NONGSHIM AMERICA WELFARE BENEFIT PLAN 2017 form 5500 responses | ||
| 2017-08-01 | Type of plan entity | Single employer plan |
| 2017-08-01 | Submission has been amended | Yes |
| 2017-08-01 | This submission is the final filing | No |
| 2017-08-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-08-01 | Plan is a collectively bargained plan | No |
| 2017-08-01 | Plan funding arrangement – Insurance | Yes |
| 2017-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: NONGSHIM AMERICA WELFARE BENEFIT PLAN 2016 form 5500 responses | ||
| 2016-08-01 | Type of plan entity | Single employer plan |
| 2016-08-01 | Submission has been amended | No |
| 2016-08-01 | This submission is the final filing | No |
| 2016-08-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-08-01 | Plan is a collectively bargained plan | No |
| 2016-08-01 | Plan funding arrangement – Insurance | Yes |
| 2016-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: NONGSHIM AMERICA WELFARE BENEFIT PLAN 2015 form 5500 responses | ||
| 2015-08-01 | Type of plan entity | Single employer plan |
| 2015-08-01 | Submission has been amended | No |
| 2015-08-01 | This submission is the final filing | No |
| 2015-08-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-08-01 | Plan is a collectively bargained plan | No |
| 2015-08-01 | Plan funding arrangement – Insurance | Yes |
| 2015-08-01 | Plan benefit arrangement – Insurance | Yes |
| STARMOUNT LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68985 ) | |
| Policy contract number | 918303 |
| Policy instance | 3 |
| STARMOUNT MANAGED DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 99999 ) | |
| Policy contract number | 918303 |
| Policy instance | 2 |
| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) | |
| Policy contract number | 278716 |
| Policy instance | 1 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |
| Policy contract number | 925472 |
| Policy instance | 2 |
| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) | |
| Policy contract number | 278716 |
| Policy instance | 1 |
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) | |
| Policy contract number | 864733 |
| Policy instance | 1 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |
| Policy contract number | 0627219 |
| Policy instance | 2 |
| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) | |
| Policy contract number | 278716 |
| Policy instance | 3 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |
| Policy contract number | 00627219 |
| Policy instance | 4 |
| CIGNA DENTAL HEALTH OF CALIFORNIA,INC (National Association of Insurance Commissioners NAIC id number: 0 ) | |
| Policy contract number | 0627219 |
| Policy instance | 5 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 ) | |
| Policy contract number | 00627219 |
| Policy instance | 4 |
| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) | |
| Policy contract number | 278716 |
| Policy instance | 3 |
| THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 ) | |
| Policy contract number | 1D039740 00000 |
| Policy instance | 2 |
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) | |
| Policy contract number | 864733 |
| Policy instance | 1 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |
| Policy contract number | 0918587 |
| Policy instance | 1 |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |
| Policy contract number | 0918585 |
| Policy instance | 2 |
| NIPPON LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 81264 ) | |
| Policy contract number | M640 |
| Policy instance | 1 |
| HUMANA (National Association of Insurance Commissioners NAIC id number: 70580 ) | |
| Policy contract number | 864733 |
| Policy instance | 2 |
| HUMANA INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 73288 ) | |
| Policy contract number | 864733 |
| Policy instance | 3 |
| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) | |
| Policy contract number | G0360 & G0200 |
| Policy instance | 4 |
| SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 ) | |
| Policy contract number | KM05946182 |
| Policy instance | 3 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | KM05946182 |
| Policy instance | 2 |
| ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 62825 ) | |
| Policy contract number | 278716 |
| Policy instance | 1 |
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