Original filing (PDF)20230507221956NAL0036351104001

CCC PAYROLL COMPANY LLC

Name: CCC PAYROLL COMPANY LLC — CCC PAYROLL COMPANY LLC MEDOVA LIFESTYLE HEALTH PLAN, Form 5500 (2022)
Creator: CCC PAYROLL COMPANY LLC

Form 5500-SF

FILING_RECEIVED

CCC PAYROLL COMPANY LLC MEDOVA LIFESTYLE HEALTH PLAN

Health & welfare plan

Active participants

Accounts w/ balance

—

Plan assets (EOY)

Net assets (EOY)

-$3K

Plan health score (directional)

/ 100

Grade A

Top-tier plan health

Directional indicator computed from public Form 5500 data — compliance, concentration, cost, vendor stack and participation. Not a fiduciary tool.

Compliance & disclosures

100

Concentration risk

Total plan cost

Vendor stack

100

Participation health

Decision-maker contacts

CFO / Head of HR / Benefits Manager — verified email + LinkedIn for CCC PAYROLL COMPANY LLC.

Plan sponsor

Name

CCC PAYROLL COMPANY LLC

EIN

26-3788244

Address

406 W VOTAW ST · PORTLAND, IN · 473711344

Phone

(260) 726-3404

Industry

Professional & Technical Servicessee all

Plan administrator

Name

RECEIVERSHIP MANAGEMENT INC

EIN

20-0200514

City

MADISON, TN

Phone

(615) 370-0051

Plan characteristics

Plan number

501

Plan year

2022

Plan year begin

2022-01-01

Tax period

2022-12-31

Filed

2023-05-07

Welfare benefit codes

4A · Health (other than dental or vision)

Audit & trust (Schedule H)

Auditor

—

Trustee / custodian

—

Trustee phone

—

Small plan (5500-SF) — Schedule H data not available.

Service providers (Schedule C)

Small plans don't disclose service providers

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