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  5. PRACTICEPROTECTION INSURANCE SERVICES, LLC

PRACTICEPROTECTION INSURANCE SERVICES, LLC

Company Details

Entity Name: PRACTICEPROTECTION INSURANCE SERVICES, LLC
Jurisdiction: FLORIDA
Filing Type: Foreign Limited Liability Company
Status: Active
Date Filed: 15 Nov 2017 (7 years ago)
Document Number: M17000009742
FEI/EIN Number 35-2598742
Address: 13241 Bartram Park Blvd, Ste 113, Jacksonville, FL 32258
Mail Address: 13241 Bartram Park Blvd, Ste 113, Jacksonville, FL 32258
ZIP code: 32258
County: Duval
Place of Formation: VERMONT

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PRACTICEPROTECTION INSURANCE SERVICES 401(K) PLAN 2023 352598742 2024-05-13 PRACTICEPROTECTION INSURANCE SERVICES, LLC 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-02-11
Business code 524210
Sponsor’s telephone number 8882172779
Plan sponsor’s address 13241 BARTRAM PARK BLVD, STE 113, JACKSONVILLE, FL, 32258

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2024-05-13
Name of individual signing QIAN LIU
Valid signature Filed with authorized/valid electronic signature
PRACTICEPROTECTION INSURANCE SERVICES 401(K) PLAN 2022 352598742 2023-06-09 PRACTICEPROTECTION INSURANCE SERVICES, LLC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-02-11
Business code 524210
Sponsor’s telephone number 8882172779
Plan sponsor’s address 13241 BARTRAM PARK BLVD, STE 113, JACKSONVILLE, FL, 32258

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2023-06-09
Name of individual signing CHRISTINE RIMER
Valid signature Filed with authorized/valid electronic signature
PRACTICEPROTECTION INSURANCE SERVICES 401(K) PLAN 2021 352598742 2022-09-09 PRACTICEPROTECTION INSURANCE SERVICES, LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-02-11
Business code 524210
Sponsor’s telephone number 8882172779
Plan sponsor’s address 13241 BARTRAM PARK BLVD, STE 113, JACKSONVILLE, FL, 32258

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1645 E 6TH STREET, SUITE 200, AUSTIN, TX, 78702
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2022-09-09
Name of individual signing CHRISTINE RIMER
Valid signature Filed with authorized/valid electronic signature
PRACTICEPROTECTION INSURANCE SERVICES 401(K) PLAN 2020 352598742 2021-04-27 PRACTICEPROTECTION INSURANCE SERVICES, LLC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-02-11
Business code 524210
Sponsor’s telephone number 9042548390
Plan sponsor’s address 106 JULINGTON PLAZA DR, STE 5, SAINT JOHNS, FL, 32259

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2021-04-27
Name of individual signing CAROL HO
Valid signature Filed with authorized/valid electronic signature
PRACTICEPROTECTION INSURANCE SERVICES 401(K) PLAN 2019 352598742 2020-06-16 PRACTICEPROTECTION INSURANCE SERVICES, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-02-11
Business code 524210
Sponsor’s telephone number 9042548390
Plan sponsor’s address 106 JULINGTON PLAZA DR, STE 5, SAINT JOHNS, FL, 32259

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2020-06-16
Name of individual signing CAROL HO
Valid signature Filed with authorized/valid electronic signature
PRACTICEPROTECTION INSURANCE SERVICES 401(K) PLAN 2018 352598742 2020-05-18 PRACTICEPROTECTION INSURANCE SERVICES, LLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-02-11
Business code 524210
Sponsor’s telephone number 9042548390
Plan sponsor’s address 106 JULINGTON PLAZA DR, STE 5, SAINT JOHNS, FL, 32259

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2020-05-18
Name of individual signing CAROL HO
Valid signature Filed with authorized/valid electronic signature
PRACTICEPROTECTION INSURANCE SERVICES 401(K) PLAN 2018 352598742 2020-05-06 PRACTICEPROTECTION INSURANCE SERVICES, LLC 2
Three-digit plan number (PN) 001
Effective date of plan 2018-02-11
Business code 524210
Sponsor’s telephone number 9042548390
Plan sponsor’s address 106 JULINGTON PLAZA DR, STE 5, SAINT JOHNS, FL, 32259

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2020-05-06
Name of individual signing CAROL HO
Valid signature Filed with authorized/valid electronic signature
PRACTICEPROTECTION INSURANCE SERVICES 401(K) PLAN 2018 352598742 2019-07-17 PRACTICEPROTECTION INSURANCE SERVICES, LLC 2
Three-digit plan number (PN) 001
Effective date of plan 2018-02-11
Business code 524210
Sponsor’s telephone number 9042548390
Plan sponsor’s address 106 JULINGTON PLAZA DR, STE 5, SAINT JOHNS, FL, 32259

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2019-07-17
Name of individual signing CAROL HO
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
WALLACE, MICHAEL J Agent 13241 Bartram Park Blvd, Ste 113, Jacksonville, FL 32258

Manager

Name Role Address
STETZEL, ERIC J Manager 3202 STERLING RIDGE COVE, FORT WAYNE, IN 46825
WALLACE, MICHAEL J Manager 780 E DORCHESTER DR., SAINT JOHNS, FL 32259
SMITH, MICHAEL T Manager 965 FAWN VIEW DR., CARMEL, IN 46032
BROWN, CORY E Manager 4892 Broadleaf Drive, Pace, FL 32571
STETZEL, MARK Manager 4321 WOODBRIAR PASS, FORT WAYNE, IN 46835

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2022-01-26 13241 Bartram Park Blvd, Ste 113, Jacksonville, FL 32258 No data
CHANGE OF MAILING ADDRESS 2022-01-26 13241 Bartram Park Blvd, Ste 113, Jacksonville, FL 32258 No data
REGISTERED AGENT ADDRESS CHANGED 2022-01-26 13241 Bartram Park Blvd, Ste 113, Jacksonville, FL 32258 No data

Documents

Name Date
ANNUAL REPORT 2024-04-01
ANNUAL REPORT 2023-03-10
ANNUAL REPORT 2022-01-26
ANNUAL REPORT 2021-02-03
ANNUAL REPORT 2020-03-16
ANNUAL REPORT 2019-04-30
ANNUAL REPORT 2018-03-08
Foreign Limited 2017-11-15

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WALLACE, MICHAEL J

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SMITH, MICHAEL T

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BROWN, CORY E

GREENBRIER REGULATORY CONSULTING, LLC

Related by address

No related companies by address

Date of last update: 18 Jan 2025

Sources: Florida Department of State

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