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  5. INSURANCE CLAIM SERVICES, INC.

INSURANCE CLAIM SERVICES, INC.

Company Details

Entity Name: INSURANCE CLAIM SERVICES, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Domestic BCA
Status: Dissolved
Date Formed: 12 Nov 1996
Date of Dissolution: 08 Jan 2020
Company Number: CORP_59112376
File Number: 59112376
Type of Business: All Inclusive Purpose
Date Status Change: 08 Jan 2020
Place of Formation: ILLINOIS

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
INSURANCE CLAIM SERVICES, INC. 401(K) P/S PLAN 2019 371363701 2020-08-03 INSURANCE CLAIM SERVICES, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 524290
Sponsor’s telephone number 6183978800
Plan sponsor’s address PO BOX 23264, BELLEVILLE, IL, 62223

Signature of
Role Plan administrator
Date 2020-08-03
Name of individual signing CHARLES ALVES
Valid signature Filed with authorized/valid electronic signature
INSURANCE CLAIM SERVICES, INC. 401(K) P/S PLAN 2019 371363701 2020-07-30 INSURANCE CLAIM SERVICES, INC. 2
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 524290
Sponsor’s telephone number 6183978800
Plan sponsor’s address PO BOX 23264, BELLEVILLE, IL, 62223

Signature of
Role Employer/plan sponsor
Date 2020-07-30
Name of individual signing CHARLES ALVES
Valid signature Filed with authorized/valid electronic signature
INSURANCE CLAIM SERVICES, INC. 401(K) P/S PLAN 2019 371363701 2020-07-30 INSURANCE CLAIM SERVICES, INC. 2
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 524290
Sponsor’s telephone number 6183978800
Plan sponsor’s address PO BOX 23264, BELLEVILLE, IL, 62223

Signature of
Role Employer/plan sponsor
Date 2020-07-29
Name of individual signing CHARLES ALVES
Valid signature Filed with authorized/valid electronic signature
INSURANCE CLAIM SERVICES, INC. 401(K) P/S PLAN 2019 371363701 2020-06-08 INSURANCE CLAIM SERVICES, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 524290
Sponsor’s telephone number 6183978800
Plan sponsor’s address PO BOX 23264, SUITE 7, BELLEVILLE, IL, 62223

Plan administrator’s name and address
Administrator’s EIN 371363701
Plan administrator’s name INSURANCE CLAIM SERVICES, INC.
Plan administrator’s address PO BOX 23264, SUITE 7, BELLEVILLE, IL, 62223
Administrator’s telephone number 6183978800

Signature of
Role Plan administrator
Date 2020-06-08
Name of individual signing M. CHARLES ALVES
Valid signature Filed with authorized/valid electronic signature
INSURANCE CLAIM SERVICES, INC. 401(K) P/S PLAN 2018 371363701 2019-04-08 INSURANCE CLAIM SERVICES, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 524290
Sponsor’s telephone number 6183978800
Plan sponsor’s address PO BOX 23264, SUITE 7, BELLEVILLE, IL, 62223

Plan administrator’s name and address
Administrator’s EIN 371363701
Plan administrator’s name INSURANCE CLAIM SERVICES, INC.
Plan administrator’s address PO BOX 23264, SUITE 7, BELLEVILLE, IL, 62223
Administrator’s telephone number 6183978800

Signature of
Role Plan administrator
Date 2019-04-08
Name of individual signing M. CHARLES ALVES
Valid signature Filed with authorized/valid electronic signature
INSURANCE CLAIM SERVICES, INC. 401(K) P/S PLAN 2017 371363701 2018-04-05 INSURANCE CLAIM SERVICES, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 524290
Sponsor’s telephone number 6183978800
Plan sponsor’s address PO BOX 23264, SUITE 7, BELLEVILLE, IL, 62223

Plan administrator’s name and address
Administrator’s EIN 371363701
Plan administrator’s name INSURANCE CLAIM SERVICES, INC.
Plan administrator’s address PO BOX 23264, SUITE 7, BELLEVILLE, IL, 62223
Administrator’s telephone number 6183978800

Signature of
Role Plan administrator
Date 2018-04-05
Name of individual signing M. CHARLES ALVES
Valid signature Filed with authorized/valid electronic signature
INSURANCE CLAIM SERVICES, INC. 401(K) P/S PLAN 2016 371363701 2017-05-11 INSURANCE CLAIM SERVICES, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 524290
Sponsor’s telephone number 6183978800
Plan sponsor’s address 56 SOUTH 65TH STREET, SUITE 7, BELLEVILLE, IL, 62223

Plan administrator’s name and address
Administrator’s EIN 371363701
Plan administrator’s name INSURANCE CLAIM SERVICES, INC.
Plan administrator’s address 56 SOUTH 65TH STREET, SUITE 7, BELLEVILLE, IL, 62223
Administrator’s telephone number 6183978800

Signature of
Role Plan administrator
Date 2017-05-11
Name of individual signing CHARLES ALVES
Valid signature Filed with authorized/valid electronic signature
INSURANCE CLAIM SERVICES, INC. 401(K) P/S PLAN 2015 371363701 2016-06-08 INSURANCE CLAIM SERVICES, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 524290
Sponsor’s telephone number 6183978800
Plan sponsor’s address 56 SOUTH 65TH STREET, SUITE 7, BELLEVILLE, IL, 62223

Plan administrator’s name and address
Administrator’s EIN 371363701
Plan administrator’s name INSURANCE CLAIM SERVICES, INC.
Plan administrator’s address 56 SOUTH 65TH STREET, SUITE 7, BELLEVILLE, IL, 62223
Administrator’s telephone number 6183978800

Signature of
Role Plan administrator
Date 2016-06-08
Name of individual signing CHARLES ALVES
Valid signature Filed with authorized/valid electronic signature
INSURANCE CLAIM SERVICES, INC. 401(K) P/S PLAN 2014 371363701 2015-04-06 INSURANCE CLAIM SERVICES, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 524290
Sponsor’s telephone number 6183978800
Plan sponsor’s address 56 SOUTH 65TH STREET, SUITE 7, BELLEVILLE, IL, 62223

Plan administrator’s name and address
Administrator’s EIN 371363701
Plan administrator’s name INSURANCE CLAIM SERVICES, INC.
Plan administrator’s address 56 SOUTH 65TH STREET, SUITE 7, BELLEVILLE, IL, 62223
Administrator’s telephone number 6183978800

Signature of
Role Plan administrator
Date 2015-04-06
Name of individual signing JILL LAUER
Valid signature Filed with authorized/valid electronic signature
INSURANCE CLAIM SERVICES, INC. 401(K) P/S PLAN 2013 371363701 2014-04-25 INSURANCE CLAIM SERVICES, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 524290
Sponsor’s telephone number 6183978800
Plan sponsor’s address 56 SOUTH 65TH STREET, SUITE 7, BELLEVILLE, IL, 62223

Plan administrator’s name and address
Administrator’s EIN 371363701
Plan administrator’s name INSURANCE CLAIM SERVICES, INC.
Plan administrator’s address 56 SOUTH 65TH STREET, SUITE 7, BELLEVILLE, IL, 62223
Administrator’s telephone number 6183978800

Signature of
Role Plan administrator
Date 2014-04-25
Name of individual signing JILL LAUER
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
GEORGE E MARIFIAN, 23 PUBLIC SQ STE 300 POB 307, BELLEVILLE, 62222, ST. CLAIR Agent 2004-04-29

President

Name and Address Role
M CHARLES ALVES, 9905 HAYDITERD FAIRVIEW HGTS IL 62208 President

Historical Names

Name Change Date
INSURANCE CLAIMS SERVICES, INC. 2005-12-13

Shares

Class Series Voting Rights Authorized Shares Issued Shares Par Value
COMM No data Voting Rights 10000 100000 No data

Related by officers

GEORGE E MARIFIAN, 23 PUBLIC SQ STE 300 POB 307, BELLEVILLE, 62222, ST. CLAIR

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Related by address

No related companies by address

Date of last update: 13 Jan 2025

Sources: Illinois Office of the Secretary of State

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