COASTAL CLOUD EMPLOYEE HEALTH PLAN
|
2023
|
611706373
|
2024-06-12
|
COASTAL CLOUD
|
435
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2019-01-01
|
Business code |
541512
|
Sponsor’s telephone number |
8002379574
|
Plan sponsor’s mailing address |
1 HAMMOCK BEACH PKWY STE 200, PALM COAST, FL, 321370304
|
Plan sponsor’s
address |
1 HAMMOCK BEACH PKWY STE 200, PALM COAST, FL, 321370304
|
Number of participants as of the end of the plan year
Active participants |
450 |
Retired or separated participants receiving
benefits |
2 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2024-06-12 |
Name of individual signing |
MARCIA SMITH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
COASTAL CLOUD EMPLOYEE HEALTH PLAN
|
2022
|
611706373
|
2023-10-23
|
COASTAL CLOUD
|
365
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2019-01-01
|
Business code |
541512
|
Sponsor’s telephone number |
8002379574
|
Plan sponsor’s mailing address |
1 HAMMOCK BEACH PKWY STE 200, PALM COAST, FL, 321370304
|
Plan sponsor’s
address |
1 HAMMOCK BEACH PKWY STE 200, PALM COAST, FL, 321370304
|
Number of participants as of the end of the plan year
Active participants |
458 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2023-10-23 |
Name of individual signing |
MARCIA SMITH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
COASTAL CLOUD HEALTH & WELFARE BENEFITS PLAN
|
2022
|
611706373
|
2023-04-27
|
COASTAL CLOUD
|
365
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2019-01-01
|
Business code |
541512
|
Sponsor’s telephone number |
8002379574
|
Plan sponsor’s mailing address |
1 HAMMOCK BEACH PKWY STE 200, PALM COAST, FL, 321370304
|
Plan sponsor’s
address |
1 HAMMOCK BEACH PKWY STE 200, PALM COAST, FL, 321370304
|
Number of participants as of the end of the plan year
Active participants |
458 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2023-04-27 |
Name of individual signing |
MARCIA SMITH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
COASTAL CLOUD EMPLOYEE HEALTH PLAN
|
2021
|
611706373
|
2023-10-23
|
COASTAL CLOUD
|
207
|
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2019-01-01
|
Business code |
541512
|
Sponsor’s telephone number |
8002379574
|
Plan sponsor’s mailing address |
1 HAMMOCK BEACH PKWY STE 200, PALM COAST, FL, 321370304
|
Plan sponsor’s
address |
1 HAMMOCK BEACH PKWY STE 200, PALM COAST, FL, 321370304
|
Number of participants as of the end of the plan year
Active participants |
365 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2023-10-23 |
Name of individual signing |
MARCIA SMITH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
COASTAL CLOUD EMPLOYEE HEALTH PLAN
|
2021
|
611706373
|
2023-11-20
|
COASTAL CLOUD
|
207
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2019-01-01
|
Business code |
541512
|
Sponsor’s telephone number |
8002379574
|
Plan sponsor’s mailing address |
1 HAMMOCK BEACH PKWY STE 200, PALM COAST, FL, 321370304
|
Plan sponsor’s
address |
1 HAMMOCK BEACH PKWY STE 200, PALM COAST, FL, 321370304
|
Number of participants as of the end of the plan year
Active participants |
365 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2023-11-20 |
Name of individual signing |
MARCIA SMITH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
2021 COASTAL CLOUD HEALTH & WELFARE BENEFITS PLAN
|
2021
|
611706373
|
2022-07-28
|
COASTAL CLOUD
|
207
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2019-01-01
|
Business code |
541512
|
Sponsor’s telephone number |
8002379574
|
Plan sponsor’s mailing address |
1 HAMMOCK BEACH PKWY STE 200, PALM COAST, FL, 321370304
|
Plan sponsor’s
address |
1 HAMMOCK BEACH PKWY STE 200, PALM COAST, FL, 321370304
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2022-07-28 |
Name of individual signing |
MARCIA SMITH |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-07-28 |
Name of individual signing |
MARCIA SMITH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
COASTAL CLOUD EMPLOYEE HEALTH PLAN
|
2020
|
611706373
|
2021-07-26
|
COASTAL CLOUD
|
178
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2019-01-01
|
Business code |
541512
|
Sponsor’s telephone number |
8002379574
|
Plan sponsor’s mailing address |
1 HAMMOCK BEACH PKWY STE 200, PALM COAST, FL, 321370304
|
Plan sponsor’s
address |
1 HAMMOCK BEACH PKWY STE 200, PALM COAST, FL, 321370304
|
Plan administrator’s name and address
Administrator’s EIN |
611706373 |
Plan administrator’s name |
COASTAL CLOUD |
Plan administrator’s
address |
1 HAMMOCK BEACH PKWY STE 200, PALM COAST, FL, 321370304 |
Administrator’s telephone number |
8002379574 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-07-26 |
Name of individual signing |
MARCIA SMITH |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-07-26 |
Name of individual signing |
MARCIA SMITH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
COASTAL CLOUD EMPLOYEE HEALTH PLAN
|
2019
|
611706373
|
2020-05-13
|
COASTAL CLOUD
|
133
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2019-01-01
|
Business code |
541512
|
Sponsor’s telephone number |
8002379574
|
Plan sponsor’s mailing address |
1 HAMMOCK BEACH PKWY STE 200, PALM COAST, FL, 321370304
|
Plan sponsor’s
address |
1 HAMMOCK BEACH PKWY STE 200, PALM COAST, FL, 321370304
|
Plan administrator’s name and address
Administrator’s EIN |
611706373 |
Plan administrator’s name |
COASTAL CLOUD |
Plan administrator’s
address |
1 HAMMOCK BEACH PKWY STE 200, PALM COAST, FL, 321370304 |
Administrator’s telephone number |
8002379574 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2020-05-13 |
Name of individual signing |
MARCIA SMITH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
COASTAL CLOUD 401(K) PLAN
|
2018
|
611706373
|
2019-07-17
|
COASTAL CLOUD, LLC
|
114
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2016-05-01
|
Business code |
541600
|
Sponsor’s telephone number |
7036788577
|
Plan
sponsor’s DBA name |
COASTALCLOUD
|
Plan sponsor’s
address |
1 HAMMOCK BEACH PARKWAY, SUITE 200, PALM COAST, FL, 32137
|
Signature of
Role |
Plan administrator |
Date |
2019-07-17 |
Name of individual signing |
MARCIA SMITH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
COASTAL CLOUD 401(K) PLAN
|
2016
|
611706373
|
2017-05-24
|
COASTAL CLOUD, LLC
|
70
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2016-05-01
|
Business code |
541600
|
Sponsor’s telephone number |
7036788577
|
Plan
sponsor’s DBA name |
COASTALCLOUD
|
Plan sponsor’s
address |
1 HAMMOCK BEACH PARKWAY, SUITE 200, PALM COAST, FL, 32137
|
Signature of
Role |
Plan administrator |
Date |
2017-05-24 |
Name of individual signing |
MARCIA M. SMITH |
Valid signature |
Filed with authorized/valid electronic signature |
|
|