HEAD INJURY ASSOCIATION, INC. EMPLOYEE HEALTH PLAN
|
2021
|
112946185
|
2022-12-27
|
HEAD INJURY ASSOCIATION, INC.
|
281
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2015-06-01
|
Business code |
621498
|
Sponsor’s telephone number |
6315432245
|
Plan sponsor’s mailing address |
300 KENNEDY DR, HAUPPAUGE, NY, 117884013
|
Plan sponsor’s
address |
300 KENNEDY DR, HAUPPAUGE, NY, 117884013
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2022-12-20 |
Name of individual signing |
BARBARA SENZEL |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-12-20 |
Name of individual signing |
BARBARA SENZEL |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HEAD INJURY ASSOCIATION, INC. EMPLOYEE HEALTH PLAN
|
2020
|
112946185
|
2022-01-11
|
HEAD INJURY ASSOCIATION, INC.
|
193
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2015-06-01
|
Business code |
621498
|
Sponsor’s telephone number |
6315432245
|
Plan sponsor’s mailing address |
300 KENNEDY DR, HAUPPAUGE, NY, 117884013
|
Plan sponsor’s
address |
300 KENNEDY DR, HAUPPAUGE, NY, 117884013
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2022-01-11 |
Name of individual signing |
DANUTA PONIATOWSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-01-11 |
Name of individual signing |
DANUTA PONIATOWSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HEAD INJURY ASSOCIATION, INC. EMPLOYEE VISION PLAN
|
2020
|
112946185
|
2022-01-11
|
HEAD INJURY ASSOCIATION, INC.
|
189
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2015-06-01
|
Business code |
621498
|
Sponsor’s telephone number |
6315432245
|
Plan sponsor’s mailing address |
300 KENNEDY DR, HAUPPAUGE, NY, 117884013
|
Plan sponsor’s
address |
300 KENNEDY DR, HAUPPAUGE, NY, 117884013
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2022-01-11 |
Name of individual signing |
DANUTA PONIATOWSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-01-11 |
Name of individual signing |
DANUTA PONIATOWSKI |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HEAD INJURY ASSOCIATION, INC. EMPLOYEE VISION PLAN
|
2019
|
112946185
|
2021-01-22
|
HEAD INJURY ASSOCIATION, INC.
|
190
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2015-06-01
|
Business code |
621498
|
Sponsor’s telephone number |
6315432245
|
Plan sponsor’s mailing address |
300 KENNEDY DR, HAUPPAUGE, NY, 117884013
|
Plan sponsor’s
address |
300 KENNEDY DR, HAUPPAUGE, NY, 117884013
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-01-22 |
Name of individual signing |
LIZ GIORDANO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-01-22 |
Name of individual signing |
LIZ GIORDANO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HEAD INJURY ASSOCIATION, INC. EMPLOYEE HEALTH PLAN
|
2019
|
112946185
|
2021-01-22
|
HEAD INJURY ASSOCIATION, INC.
|
194
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2015-06-01
|
Business code |
621498
|
Sponsor’s telephone number |
6315432245
|
Plan sponsor’s mailing address |
300 KENNEDY DR, HAUPPAUGE, NY, 117884013
|
Plan sponsor’s
address |
300 KENNEDY DR, HAUPPAUGE, NY, 117884013
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-01-22 |
Name of individual signing |
LIZ GIORDANO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-01-22 |
Name of individual signing |
LIZ GIORDANO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HEAD INJURY ASSOCIATION, INC. EMPLOYEE VISION PLAN
|
2019
|
112946185
|
2020-12-03
|
HEAD INJURY ASSOCIATION, INC.
|
190
|
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2015-06-01
|
Business code |
621498
|
Sponsor’s telephone number |
6315432245
|
Plan sponsor’s mailing address |
300 KENNEDY DR, HAUPPAUGE, NY, 117884013
|
Plan sponsor’s
address |
300 KENNEDY DR, HAUPPAUGE, NY, 117884013
|
Number of participants as of the end of the plan year
Signature of
Role |
Employer/plan sponsor |
Date |
2020-12-03 |
Name of individual signing |
LIZ GIORDANO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HEAD INJURY ASSOCIATION, INC. EMPLOYEE HEALTH PLAN
|
2019
|
112946185
|
2020-12-03
|
HEAD INJURY ASSOCIATION, INC.
|
194
|
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2015-06-01
|
Business code |
621498
|
Sponsor’s telephone number |
6315432245
|
Plan sponsor’s mailing address |
300 KENNEDY DR, HAUPPAUGE, NY, 117884013
|
Plan sponsor’s
address |
300 KENNEDY DR, HAUPPAUGE, NY, 117884013
|
Number of participants as of the end of the plan year
Signature of
Role |
Employer/plan sponsor |
Date |
2020-12-03 |
Name of individual signing |
LIZ GIORDANO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HEAD INJURY ASSOCIATION, INC. EMPLOYEE HEALTH PLAN
|
2018
|
112946185
|
2020-03-14
|
HEAD INJURY ASSOCIATION, INC.
|
162
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2015-06-01
|
Business code |
621498
|
Sponsor’s telephone number |
6315432245
|
Plan sponsor’s mailing address |
300 KENNEDY DR, HAUPPAUGE, NY, 117884013
|
Plan sponsor’s
address |
300 KENNEDY DR, HAUPPAUGE, NY, 117884013
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2020-03-13 |
Name of individual signing |
LIZ GIORDANO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL AND VISION INSURANCE PLAN OF THE HEAD INJURY ASSOCIATION
|
2013
|
112946185
|
2014-09-02
|
HEAD INJURY ASSOCIATION, INC
|
94
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
1996-01-01
|
Business code |
813000
|
Sponsor’s telephone number |
6315432245
|
Plan sponsor’s mailing address |
300 KENNEDY DRIVE, HAUPPAUGE, NY, 11788
|
Plan sponsor’s
address |
300 KENNEDY DRIVE, HAUPPAUGE, NY, 11788
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-09-02 |
Name of individual signing |
ALAN SEILER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-09-02 |
Name of individual signing |
ALAN SEILER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LIFE INSURANCE AND LTD PLANS OF THE HEAD INJURY ASSOCIATION
|
2013
|
112946185
|
2014-09-02
|
HEAD INJURY ASSOCIATION
|
105
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1991-01-01
|
Business code |
813000
|
Sponsor’s telephone number |
6315432245
|
Plan sponsor’s mailing address |
300 KENNEDY DRIVE, HAUPPAUGE, NY, 11788
|
Plan sponsor’s
address |
300 KENNEDY DRIVE, HAUPPAUGE, NY, 11788
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-09-02 |
Name of individual signing |
ALAN SEILER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-09-02 |
Name of individual signing |
ALAN SEILER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|