GROUP LIFE INSURANCE
|
2023
|
411758248
|
2024-07-30
|
ELIZABETH CHARLES CORPORATION
|
78
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
1998-02-01
|
Business code |
812112
|
Sponsor’s telephone number |
9529186607
|
Plan
sponsor’s DBA name |
ELIZABETH CHARLES CORPORATION
|
Plan sponsor’s mailing address |
6121 BAKER RD STE 108, MINNETONKA, MN, 553455961
|
Plan sponsor’s
address |
6121 BAKER RD STE 108, MINNETONKA, MN, 553455961
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2024-07-30 |
Name of individual signing |
JENNIFER GENTRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
AD&D INSURANCE
|
2023
|
411758248
|
2024-07-30
|
ELIZABETH CHARLES CORPORATION
|
41
|
|
File |
View Page
|
Three-digit plan number (PN) |
506
|
Effective date of plan |
1998-02-01
|
Business code |
812112
|
Sponsor’s telephone number |
9529186607
|
Plan
sponsor’s DBA name |
ELIZABETH CHARLES CORPORATION
|
Plan sponsor’s mailing address |
6121 BAKER RD STE 108, MINNETONKA, MN, 553455961
|
Plan sponsor’s
address |
6121 BAKER RD STE 108, MINNETONKA, MN, 553455961
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2024-07-30 |
Name of individual signing |
JENNIFER GENTRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL
|
2023
|
411758248
|
2024-07-30
|
ELIZABETH CHARLES CORPORATION
|
81
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2013-01-01
|
Business code |
812112
|
Sponsor’s telephone number |
9529186607
|
Plan
sponsor’s DBA name |
ELIZABETH CHARLES CORPORATION
|
Plan sponsor’s mailing address |
6121 BAKER RD STE 108, MINNETONKA, MN, 553455961
|
Plan sponsor’s
address |
6121 BAKER RD STE 108, MINNETONKA, MN, 553455961
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2024-07-30 |
Name of individual signing |
JENNIFER GENTRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HEALTH INSURANCE
|
2023
|
411758248
|
2024-07-30
|
ELIZABETH CHARLES CORPORATION
|
119
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2023-01-01
|
Business code |
812112
|
Sponsor’s telephone number |
9529186607
|
Plan
sponsor’s DBA name |
ELIZABETH CHARLES CORPORATION
|
Plan sponsor’s mailing address |
6121 BAKER RD STE 108, MINNETONKA, MN, 553455961
|
Plan sponsor’s
address |
6121 BAKER RD STE 108, MINNETONKA, MN, 553455961
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2024-07-30 |
Name of individual signing |
JENNIFER GENTRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHORT TERM DISABILITY INSURANCE PLAN
|
2023
|
411758248
|
2024-07-30
|
ELIZABETH CHARLES CORPORATION
|
75
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2013-01-01
|
Business code |
812112
|
Sponsor’s telephone number |
9529186607
|
Plan
sponsor’s DBA name |
ELIZABETH CHARLES CORPORATION
|
Plan sponsor’s mailing address |
6121 BAKER RD STE 108, MINNETONKA, MN, 553455961
|
Plan sponsor’s
address |
6121 BAKER RD STE 108, MINNETONKA, MN, 553455961
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2024-07-30 |
Name of individual signing |
JENNIFER GENTRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LONG TERM DISABILITY INSURANCE PLAN
|
2023
|
411758248
|
2024-07-30
|
ELIZABETH CHARLES CORPORATION
|
75
|
|
File |
View Page
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
2013-01-01
|
Business code |
812112
|
Sponsor’s telephone number |
9529186607
|
Plan
sponsor’s DBA name |
ELIZABETH CHARLES CORPORATION
|
Plan sponsor’s mailing address |
6121 BAKER RD STE 108, MINNETONKA, MN, 553455961
|
Plan sponsor’s
address |
6121 BAKER RD STE 108, MINNETONKA, MN, 553455961
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2024-07-30 |
Name of individual signing |
JENNIFER GENTRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LONG TERM DISABILITY INSURANCE PLAN
|
2022
|
411758248
|
2023-08-01
|
ELIZABETH CHARLES CORPORATION
|
74
|
|
File |
View Page
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
2013-01-01
|
Business code |
812112
|
Sponsor’s telephone number |
9529186607
|
Plan
sponsor’s DBA name |
ELIZABETH CHARLES CORPORATION
|
Plan sponsor’s mailing address |
6121 BAKER RD STE 108, MINNETONKA, MN, 553455961
|
Plan sponsor’s
address |
6121 BAKER RD STE 108, MINNETONKA, MN, 553455961
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-08-01 |
Name of individual signing |
JENNIFER GENTRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HEALTH INSURANCE PLAN
|
2022
|
411758248
|
2023-08-01
|
ELIZABETH CHARLES CORPORATION
|
72
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1998-02-01
|
Business code |
812112
|
Sponsor’s telephone number |
9529186607
|
Plan
sponsor’s DBA name |
ELIZABETH CHARLES CORPORATION
|
Plan sponsor’s mailing address |
6121 BAKER RD STE 108, MINNETONKA, MN, 553455961
|
Plan sponsor’s
address |
6121 BAKER RD STE 108, MINNETONKA, MN, 553455961
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-08-01 |
Name of individual signing |
JENNIFER GENTRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP LIFE INSURANCE
|
2022
|
411758248
|
2023-08-01
|
ELIZABETH CHARLES CORPORATION
|
79
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
1998-02-01
|
Business code |
812112
|
Sponsor’s telephone number |
9529186607
|
Plan
sponsor’s DBA name |
ELIZABETH CHARLES CORPORATION
|
Plan sponsor’s mailing address |
6121 BAKER RD STE 108, MINNETONKA, MN, 553455961
|
Plan sponsor’s
address |
6121 BAKER RD STE 108, MINNETONKA, MN, 553455961
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-08-01 |
Name of individual signing |
JENNIFER GENTRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SHORT TERM DISABILITY INSURANCE PLAN
|
2022
|
411758248
|
2023-08-01
|
ELIZABETH CHARLES CORPORATION
|
74
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2013-01-01
|
Business code |
812112
|
Sponsor’s telephone number |
9529186607
|
Plan
sponsor’s DBA name |
ELIZABETH CHARLES CORPORATION
|
Plan sponsor’s mailing address |
6121 BAKER RD STE 108, MINNETONKA, MN, 553455961
|
Plan sponsor’s
address |
6121 BAKER RD STE 108, MINNETONKA, MN, 55345
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-08-01 |
Name of individual signing |
JENNIFER GENTRY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|