MEWA-ECE Form
This Form is Open to Public Inspection
OMB No. 1210-0116
Department of Labor
Employee Benefits Security Administration
Complete as applicable:
02/25/2021
Montana Contractors' Association
Health Care Trust
404 North 31st St, Ste 205
PO Box 30177
Billings, MT 59107
(406) 256-9910
81-0449239
501
Board of Trustees of the Montana Contractors' Association
Health Care Trust
404 North 31st St, Ste 205
PO Box 30177
Billings, MT 59107
(406) 256-9910
81-0449239
jfallon@mcatrusts.org
Board of Trustees of the Montana Contractors' Association
Health Care Trust
404 North 31st St, Ste 205
PO Box 30177
Billings, MT 59107
(406) 256-9910
81-0449239
Montana Contractors Association Trusts
404 North 31st St, Ste 205
PO Box 30177
Billings, MT 59107
(406) 256-9910
jfallon@mcatrusts.org
Lonnie Anderson
Trustee
PO Box 30177
Billings, MT 59107
(406) 256-9910
jfallon@mcatrusts.org
Ken Crouse
Ex-Officio Trustee
PO Box 30177
Billings, MT 59107
(406) 256-9910
jfallon@mcatrusts.org
Kerry Gray
Trustee
PO Box 30177
Billings, MT 59107
(406) 256-9910
jfallon@mcatrusts.org
Mary Jo Jackson
Trustee
PO Box 30177
Billings, MT 59107
(406) 256-9910
jfallon@mcatrusts.org
Hattie Redmon
Trustee
PO Box 30177
Billings, MT 59107
(406) 256-9910
jfallon@mcatrusts.org
Tim Robertson
Trustee
PO Box 30177
Billings, MT 59107
(406) 256-9910
jfallon@mcatrusts.org
Ken Stoeber
Trustee
PO Box 30177
Billings, MT 59107
(406) 256-9910
jfallon@mcatrusts.org
Vickie Tischendorf
Trustee
PO Box 30177
Billings, MT 59107
(406) 256-9910
jfallon@mcatrusts.org
Heidi Wadsworth
Trustee
PO Box 30177
Billings, MT 59107
(406) 256-9910
jfallon@mcatrusts.org
Dave Zinke
Trustee
PO Box 30177
Billings, MT 59107
(406) 256-9910
jfallon@mcatrusts.org
Wells Fargo Institutional Trust
PO Box 30058
Billings, MT 59107
(406) 657-3495
Segal Company
7951 E. Maplewood Ave., Suite 327
Greenwood Village, CO 80111
(303) 714-9900
94-1503999
Allegiance Benefit Plan Management
2806 S. Garfield St.
Missoula, MT 59806
(406) 721-2222
81-0400550
Navitus Health Solutions, LLC
2601 West Beltline Hwy, Suite 600
Madison, WI 53713
(866) 333-2757
04-3608530
Board of Trustees of the Montana Contractors' Association
Health Care Trust
404 North 31st St, Ste 205
PO Box 30177
Billings, MT 59107
(406) 256-9910
jfallon@mcatrusts.org
81-0449239
Yes
Yes
Travelers Casualty & Surety Company of America
Yes
Yes
If no, please explain.
No
If yes, please identify each litigation or enforcement proceeding to include (if applicable): (1) the case number, (2) the date, (3) the nature of the proceedings, (4) the court, (5) all parties (for example, plaintiffs and defendants or petitioners and respondents), and (6) the disposition.
No
If yes, please explain.
No
Entity | Year |
---|
17a | 17b | 17c | 17d | 17e | 17f | 17g | 17h | 17i | 17j |
---|---|---|---|---|---|---|---|---|---|
Enter all States where the MEWA or ECE is operating. | Is coverage provided? | State registration number. | Name of state agent or entity for service of process. | Is the entity a licensed health insurer in this State? | If yes to 17e, enter NAIC number. | If no to 17e, is the entity fully insured? | If yes to 17g, enter name and NAIC number of insurer. | Does the entity purchase stop loss coverage? | If yes to 17i, enter the name and NAIC number of insurer. |
MT
Is new? |
Yes | 3982 | Montana Contractors Association Trusts | No | No | Yes | HCC Life Insurance Company 92711 | ||
WY
Is new? |
Yes | Montana Contractors Association Trusts | No | No | Yes | HCC Life Insurance Company 92711 |
MT
2724
N/A
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Under penalty of perjury and other penalties set forth in the instructions, I declare that I have examined this report, including any accompanying attachments, and to the best of my knowledge and belief, it is true and correct. Under penalty of perjury and other penalties set forth in the instructions, I also declare that, unless this is an extension request, this report is complete.