Filing

Crown Linen Life Plan

Crown Linen Services Inc. • EIN 02-0272632 • Plan year 2004

Company Profile Source Archive

Filing Insights

Participants

Down

121 → 118

-3 • -2.48%

Assets

No comparison

- → -

No earlier value available.

Investment Management Fee

Admin expenses - • Total expenses -

Filing Details

Context

No event flags were generated for this filing.

Status Flags

Fidelity bond in place

Not reported

Limited-scope audit performed

Not reported

Contributions transmitted on time

Not reported

Participant loans in default

Not reported

Leases in default

Not reported

Reportable party-in-interest issues

Not reported

Loss discovered during year

Not reported

Assets with undetermined value

Not reported

Non-cash contributions

Not reported

Assets held for investment

Not reported

5% transactions reported

Not reported

All plan assets distributed

Not reported

Benefits paid when due

Not reported

Plan blackout period

Not reported

Plan termination resolution adopted

Not reported

Counterparties

Company Timeline

This filing is highlighted inside the broader sponsor history.

Year / Filing	Filings	Participants	Assets	Contributions	Contrib./Participant
2024	1	142	$0	$0	-
Crown Linen Life Plan	-	142	-	-	-
2023	1	144	$0	$0	-
Crown Linen Life Plan	-	144	-	-	-
2022	1	153	$0	$0	-
Crown Linen Life Plan	-	153	-	-	-
2021	1	131	$0	$0	-
Crown Linen Life Plan	-	131	-	-	-
2020	1	124	$0	$0	-
Crown Linen Life Plan	-	124	-	-	-
2019	1	115	$0	$0	-
Crown Linen Life Plan	-	115	-	-	-
2018	1	115	$0	$0	-
Crown Linen Life Plan	-	115	-	-	-
2017	1	114	$0	$0	-
Crown Linen Life Plan	-	114	-	-	-
2016	1	110	$0	$0	-
Crown Linen Life Plan	-	110	-	-	-
2015	1	136	$0	$0	-
Crown Linen Life Plan	-	136	-	-	-
2014	1	136	$0	$0	-
Crown Linen Life Plan	-	136	-	-	-
2013	1	136	$0	$0	-
Crown Linen Life Plan	-	136	-	-	-
2012	1	141	$0	$0	-
Crown Linen Life Plan	-	141	-	-	-
2011	1	132	$0	$0	-
Crown Linen Life Plan	-	132	-	-	-
2010	1	130	$0	$0	-
Crown Linen Life Plan	-	130	-	-	-
2009	1	104	$0	$0	-
Crown Linen Life Plan	-	104	-	-	-
2008	1	156	$0	$0	-
Crown Linen Life Plan	-	156	-	-	-
2007	1	131	$0	$0	-
Crown Linen Life Plan	-	131	-	-	-
2006	1	125	$0	$0	-
Crown Linen Life Plan	-	125	-	-	-
2005	1	122	$0	$0	-
Crown Linen Life Plan	-	122	-	-	-
2004	1	118	$0	$0	-
Crown Linen Life Plan	Current	118	-	-	-
2003	1	121	$0	$0	-
Crown Linen Life Plan	-	121	-	-	-
2002	1	123	$0	$0	-
Crown Linen Life Plan	-	123	-	-	-
2001	1	119	$0	$0	-
Crown Linen Life Plan	-	119	-	-	-
2000	1	124	$0	$0	-
Crown Linen Life Plan	-	124	-	-	-
1999	1	111	$0	$0	-
Crown Linen Life Plan	-	111	-	-	-

Schedule Details

Schedule A

Row 1
Filing Id: 84037265223065
Form Id: 61997695
Page Id: 2
Page Seq: 0
Page Row Num: 1
Row Num: 0
Image Form Id: 4010375265223060002
Ins Broker 01 Name: LEISMAN INSURANCE AGENCY
Ins Broker Comm Pd 01 Amount: $412
Ins Broker Fees Pd 01 Amount: $0
Ins Broker 01 Code: 3

Row 2
Filing Id: 84037265223065
Form Id: 61997696
Page Id: 2
Page Seq: 0
Page Row Num: 1
Row Num: 0
Image Form Id: 4010375265223060003
Ins Broker 01 Name: AON CONSULTING, INC OF MA
Ins Broker 01 Street Addr: 99 HIGH STREET, 14TH FLOOR
Ins Broker 01 City: BOSTON
Ins Broker 01 State: MA
Ins Broker 01 ZIP Code: 021100000
Ins Broker Comm Pd 01 Amount: $3,455
Ins Broker Fees Pd 01 Amount: $0
Ins Broker 01 Code: 3

Row 3
Filing Id: 84037265223065
Form Id: 61997697
Page Id: 1
Page Seq: 0
Page Row Num: 1
Row Num: 0
Image Form Id: 4010375265223060004
Ins Broker Comm Pd 01 Amount: $0
Ins Broker Fees Pd 01 Amount: $0

Row 4
Filing Id: 84037265223065
Form Id: 61997699
Page Id: 2
Page Seq: 0
Page Row Num: 1
Row Num: 0
Image Form Id: 4010375265223060006
Ins Broker 01 Name: AON CONSULTING, INC OF MA
Ins Broker 01 Street Addr: 99 HIGH STREET
Ins Broker 01 City: BOSTON
Ins Broker 01 State: MA
Ins Broker 01 ZIP Code: 021100000
Ins Broker Comm Pd 01 Amount: $11,000
Ins Broker Fees Pd 01 Amount: $0
Ins Broker 01 Code: 3

Row 5
Filing Id: 84037265223065
Form Id: 61997698
Page Id: 1
Page Seq: 0
Page Row Num: 1
Row Num: 0
Image Form Id: 4010375265223060005
Ins Broker Comm Pd 01 Amount: $0
Ins Broker Fees Pd 01 Amount: $0

Row 6
Filing Id: 84037265223065
Form Id: 61997699
Page Id: 2
Page Seq: 0
Page Row Num: 2
Row Num: 1
Image Form Id: 4010375265223060006
Ins Broker 01 Name: USI CONSULTING GROUP
Ins Broker 01 Street Addr: 95 GLASTONBURY BLVD
Ins Broker 01 City: GLASTONBURY
Ins Broker 01 State: CT
Ins Broker 01 ZIP Code: 060330000
Ins Broker Comm Pd 01 Amount: $4,628
Ins Broker Fees Pd 01 Amount: $0
Ins Broker 01 Code: 3

Row 7: Ins Carrier Name: BLUE CROSS & BLUE SHIELD OF MA, INC
Filing Id: 84037265223065
Form Id: 61997697
Schedule A EIN: 02-0272632
Schedule A Plan Num: 502
Schedule A Plan Year Begin Date: 2004-01-01
Schedule A Tax Period: 20041231
Ins Carrier Name: BLUE CROSS & BLUE SHIELD OF MA, INC
Ins Carrier EIN: 04-1045815
Ins Carrier Naic Code: 53228
Ins Contract Num: 4012977
Ins Prsn Covered End of year Count: 71
Ins Policy From Date: 2004-01-01
Ins Policy To Date: 2004-12-31
Ins Broker Comm Total Amount: $0
Ins Broker Fees Total Amount: $0
Pension End of year Gen Account Amount: $0
Pension End of year Sep Account Amount: $0
Pension Prem Paid Total Amount: $0
Pension Unpaid Premium Amount: $0
Pension Contract Cost Amount: $0
Pension End Prev Bal Amount: $0
Pension Contribution Dep Amount: $0
Pension Divnd Cr Dep Amount: $0
Pension Interest Cr Dur Yr Amount: $0
Pension Transfer From Amount: $0
Pension Other Amount: $0
Pension Total Additions Amount: $0
Pension Total Bal Addn Amount: $0
Pension Bnfts Dsbrsd Amount: $0
Pension Admin Chrg Amount: $0
Pension Transfer To Amount: $0
Pension Oth Ded Amount: $0
Pension Total Ded Amount: $0
Pension End of year Bal Amount: $0
Wlfr Type Bnft Indicator: B
Wlfr Premium Rcvd Amount: $0
Wlfr Unpaid Due Amount: $0
Wlfr Reserve Amount: $0
Wlfr Total Earned Prem Amount: $0
Wlfr Claims Paid Amount: $0
Wlfr Incr Reserve Amount: $0
Wlfr Incurred Claim Amount: $0
Wlfr Claims Chrgd Amount: $0
Wlfr Ret Commissions Amount: $0
Wlfr Ret Admin Amount: $0
Wlfr Ret Oth Cost Amount: $0
Wlfr Ret Oth Expense Amount: $0
Wlfr Ret Taxes Amount: $0
Wlfr Ret Charges Amount: $0
Wlfr Ret Oth Chrgs Amount: $0
Wlfr Ret Total Amount: $0
Wlfr Refund Amount: $0
Wlfr Held Bnfts Amount: $0
Wlfr Claims Reserve Amount: $0
Wlfr Oth Reserve Amount: $0
Wlfr Divnds Due Amount: $0
Wlfr Total Charges Paid Amount: $62,756
Wlfr Acquis Cost Amount: $0

Row 8: Ins Carrier Name: CARE FIRST BLUE CROSS BLUE SHIELD
Filing Id: 84037265223065
Form Id: 61997696
Schedule A EIN: 02-0272632
Schedule A Plan Num: 502
Schedule A Plan Year Begin Date: 2004-01-01
Schedule A Tax Period: 20041231
Ins Carrier Name: CARE FIRST BLUE CROSS BLUE SHIELD
Ins Carrier EIN: 53-0078070
Ins Carrier Naic Code: 53007
Ins Contract Num: UA19
Ins Prsn Covered End of year Count: 11
Ins Policy From Date: 2004-01-01
Ins Policy To Date: 2004-12-31
Ins Broker Comm Total Amount: $3,455
Ins Broker Fees Total Amount: $0
Pension End of year Gen Account Amount: $0
Pension End of year Sep Account Amount: $0
Pension Prem Paid Total Amount: $0
Pension Unpaid Premium Amount: $0
Pension Contract Cost Amount: $0
Pension End Prev Bal Amount: $0
Pension Contribution Dep Amount: $0
Pension Divnd Cr Dep Amount: $0
Pension Interest Cr Dur Yr Amount: $0
Pension Transfer From Amount: $0
Pension Other Amount: $0
Pension Total Additions Amount: $0
Pension Total Bal Addn Amount: $0
Pension Bnfts Dsbrsd Amount: $0
Pension Admin Chrg Amount: $0
Pension Transfer To Amount: $0
Pension Oth Ded Amount: $0
Pension Total Ded Amount: $0
Pension End of year Bal Amount: $0
Wlfr Type Bnft Indicator: AB
Wlfr Premium Rcvd Amount: $0
Wlfr Unpaid Due Amount: $0
Wlfr Reserve Amount: $0
Wlfr Total Earned Prem Amount: $0
Wlfr Claims Paid Amount: $0
Wlfr Incr Reserve Amount: $0
Wlfr Incurred Claim Amount: $0
Wlfr Claims Chrgd Amount: $0
Wlfr Ret Commissions Amount: $0
Wlfr Ret Admin Amount: $0
Wlfr Ret Oth Cost Amount: $0
Wlfr Ret Oth Expense Amount: $0
Wlfr Ret Taxes Amount: $0
Wlfr Ret Charges Amount: $0
Wlfr Ret Oth Chrgs Amount: $0
Wlfr Ret Total Amount: $0
Wlfr Refund Amount: $0
Wlfr Held Bnfts Amount: $0
Wlfr Claims Reserve Amount: $0
Wlfr Oth Reserve Amount: $0
Wlfr Divnds Due Amount: $0
Wlfr Total Charges Paid Amount: $116,909
Wlfr Acquis Cost Amount: $0

Row 9: Ins Carrier Name: ANTHEM HEALTH PLANS OF NH, INC DBA ANTHEM BCBS
Filing Id: 84037265223065
Form Id: 61997699
Schedule A EIN: 02-0272632
Schedule A Plan Num: 502
Schedule A Plan Year Begin Date: 2004-01-01
Schedule A Tax Period: 20041231
Ins Carrier Name: ANTHEM HEALTH PLANS OF NH, INC DBA ANTHEM BCBS
Ins Carrier EIN: 02-0510530
Ins Carrier Naic Code: 53759
Ins Contract Num: 343972
Ins Prsn Covered End of year Count: 40
Ins Policy From Date: 2004-01-01
Ins Policy To Date: 2004-12-31
Ins Broker Comm Total Amount: $15,628
Ins Broker Fees Total Amount: $0
Pension End of year Gen Account Amount: $0
Pension End of year Sep Account Amount: $0
Pension Prem Paid Total Amount: $0
Pension Unpaid Premium Amount: $0
Pension Contract Cost Amount: $0
Pension End Prev Bal Amount: $0
Pension Contribution Dep Amount: $0
Pension Divnd Cr Dep Amount: $0
Pension Interest Cr Dur Yr Amount: $0
Pension Transfer From Amount: $0
Pension Other Amount: $0
Pension Total Additions Amount: $0
Pension Total Bal Addn Amount: $0
Pension Bnfts Dsbrsd Amount: $0
Pension Admin Chrg Amount: $0
Pension Transfer To Amount: $0
Pension Oth Ded Amount: $0
Pension Total Ded Amount: $0
Pension End of year Bal Amount: $0
Wlfr Type Bnft Indicator: A
Wlfr Premium Rcvd Amount: $0
Wlfr Unpaid Due Amount: $0
Wlfr Reserve Amount: $0
Wlfr Total Earned Prem Amount: $0
Wlfr Claims Paid Amount: $0
Wlfr Incr Reserve Amount: $0
Wlfr Incurred Claim Amount: $0
Wlfr Claims Chrgd Amount: $0
Wlfr Ret Commissions Amount: $0
Wlfr Ret Admin Amount: $0
Wlfr Ret Oth Cost Amount: $0
Wlfr Ret Oth Expense Amount: $0
Wlfr Ret Taxes Amount: $0
Wlfr Ret Charges Amount: $0
Wlfr Ret Oth Chrgs Amount: $0
Wlfr Ret Total Amount: $0
Wlfr Refund Amount: $0
Wlfr Held Bnfts Amount: $0
Wlfr Claims Reserve Amount: $0
Wlfr Oth Reserve Amount: $0
Wlfr Divnds Due Amount: $0
Wlfr Total Charges Paid Amount: $391,596
Wlfr Acquis Cost Amount: $0

Row 10: Ins Carrier Name: TUFTS HEALTH PLAN
Filing Id: 84037265223065
Form Id: 61997698
Schedule A EIN: 02-0272632
Schedule A Plan Num: 502
Schedule A Plan Year Begin Date: 2004-01-01
Schedule A Tax Period: 20041231
Ins Carrier Name: TUFTS HEALTH PLAN
Ins Carrier EIN: 04-2674079
Ins Carrier Naic Code: 95688
Ins Contract Num: 81958000
Ins Prsn Covered End of year Count: 39
Ins Policy From Date: 2004-01-01
Ins Policy To Date: 2004-12-31
Ins Broker Comm Total Amount: $0
Ins Broker Fees Total Amount: $0
Pension End of year Gen Account Amount: $0
Pension End of year Sep Account Amount: $0
Pension Prem Paid Total Amount: $0
Pension Unpaid Premium Amount: $0
Pension Contract Cost Amount: $0
Pension End Prev Bal Amount: $0
Pension Contribution Dep Amount: $0
Pension Divnd Cr Dep Amount: $0
Pension Interest Cr Dur Yr Amount: $0
Pension Transfer From Amount: $0
Pension Other Amount: $0
Pension Total Additions Amount: $0
Pension Total Bal Addn Amount: $0
Pension Bnfts Dsbrsd Amount: $0
Pension Admin Chrg Amount: $0
Pension Transfer To Amount: $0
Pension Oth Ded Amount: $0
Pension Total Ded Amount: $0
Pension End of year Bal Amount: $0
Wlfr Type Bnft Indicator: A
Wlfr Premium Rcvd Amount: $0
Wlfr Unpaid Due Amount: $0
Wlfr Reserve Amount: $0
Wlfr Total Earned Prem Amount: $0
Wlfr Claims Paid Amount: $0
Wlfr Incr Reserve Amount: $0
Wlfr Incurred Claim Amount: $0
Wlfr Claims Chrgd Amount: $0
Wlfr Ret Commissions Amount: $0
Wlfr Ret Admin Amount: $0
Wlfr Ret Oth Cost Amount: $0
Wlfr Ret Oth Expense Amount: $0
Wlfr Ret Taxes Amount: $0
Wlfr Ret Charges Amount: $0
Wlfr Ret Oth Chrgs Amount: $0
Wlfr Ret Total Amount: $0
Wlfr Refund Amount: $0
Wlfr Held Bnfts Amount: $0
Wlfr Claims Reserve Amount: $0
Wlfr Oth Reserve Amount: $0
Wlfr Divnds Due Amount: $0
Wlfr Total Charges Paid Amount: $269,717
Wlfr Acquis Cost Amount: $0

Row 11: Ins Carrier Name: RELIANCE STANDARD
Filing Id: 84037265223065
Form Id: 61997695
Schedule A EIN: 02-0272632
Schedule A Plan Num: 502
Schedule A Plan Year Begin Date: 2004-01-01
Schedule A Tax Period: 20041231
Ins Carrier Name: RELIANCE STANDARD
Ins Carrier EIN: 36-0883760
Ins Carrier Naic Code: 68381
Ins Contract Num: GL 025001
Ins Prsn Covered End of year Count: 118
Ins Policy From Date: 2004-01-01
Ins Policy To Date: 2004-12-31
Ins Broker Comm Total Amount: $412
Ins Broker Fees Total Amount: $0
Pension End of year Gen Account Amount: $0
Pension End of year Sep Account Amount: $0
Pension Prem Paid Total Amount: $0
Pension Unpaid Premium Amount: $0
Pension Contract Cost Amount: $0
Pension End Prev Bal Amount: $0
Pension Contribution Dep Amount: $0
Pension Divnd Cr Dep Amount: $0
Pension Interest Cr Dur Yr Amount: $0
Pension Transfer From Amount: $0
Pension Other Amount: $0
Pension Total Additions Amount: $0
Pension Total Bal Addn Amount: $0
Pension Bnfts Dsbrsd Amount: $0
Pension Admin Chrg Amount: $0
Pension Transfer To Amount: $0
Pension Oth Ded Amount: $0
Pension Total Ded Amount: $0
Pension End of year Bal Amount: $0
Wlfr Type Bnft Indicator: DM
Wlfr Type Bnft Oth Text: AD&D
Wlfr Premium Rcvd Amount: $0
Wlfr Unpaid Due Amount: $0
Wlfr Reserve Amount: $0
Wlfr Total Earned Prem Amount: $0
Wlfr Claims Paid Amount: $0
Wlfr Incr Reserve Amount: $0
Wlfr Incurred Claim Amount: $0
Wlfr Claims Chrgd Amount: $0
Wlfr Ret Commissions Amount: $0
Wlfr Ret Admin Amount: $0
Wlfr Ret Oth Cost Amount: $0
Wlfr Ret Oth Expense Amount: $0
Wlfr Ret Taxes Amount: $0
Wlfr Ret Charges Amount: $0
Wlfr Ret Oth Chrgs Amount: $0
Wlfr Ret Total Amount: $0
Wlfr Refund Amount: $0
Wlfr Held Bnfts Amount: $0
Wlfr Claims Reserve Amount: $0
Wlfr Oth Reserve Amount: $0
Wlfr Divnds Due Amount: $0
Wlfr Total Charges Paid Amount: $7,452
Wlfr Acquis Cost Amount: $0