THIRD SALINA INSURANCE FUND
|
2023
|
161332576
|
2024-07-15
|
EMPLOYEE BENEFITS PLUS, INC.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1989-07-01
|
Business code |
524210
|
Sponsor’s telephone number |
3154741400
|
Plan sponsor’s mailing address |
5795 WIDEWATERS PKWY STE 2, SYRACUSE, NY, 132141846
|
Plan sponsor’s
address |
5795 WIDEWATERS PKWY STE 2, SYRACUSE, NY, 132141846
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2024-07-15 |
Name of individual signing |
STEVEN WLADIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2024-07-15 |
Name of individual signing |
STEVEN WLADIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HERKIMER COUNTY CHAMBER OF COMMERCE DENTAL PLAN
|
2023
|
161332576
|
2024-03-27
|
EMPLOYEE BENEFITS PLUS, INC.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
1994-01-01
|
Business code |
524210
|
Sponsor’s telephone number |
3154741400
|
Plan sponsor’s mailing address |
5795 WIDEWATERS PKWY STE 2, SYRACUSE, NY, 132141846
|
Plan sponsor’s
address |
5795 WIDEWATERS PKWY STE 2, SYRACUSE, NY, 132141846
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2024-03-27 |
Name of individual signing |
STEVEN WLADIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2024-03-27 |
Name of individual signing |
STEVEN WLADIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WARREN JEFFERSON INSURANCE FUND
|
2023
|
161332576
|
2024-03-27
|
EMPLOYEE BENEFITS PLUS, INC.
|
55
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1988-10-01
|
Business code |
524210
|
Sponsor’s telephone number |
3154741400
|
Plan sponsor’s mailing address |
5795 WIDEWATERS PKWY STE 2, SYRACUSE, NY, 132141846
|
Plan sponsor’s
address |
5795 WIDEWATERS PKWY STE 2, SYRACUSE, NY, 132141846
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2024-03-27 |
Name of individual signing |
STEVEN WLADIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2024-03-27 |
Name of individual signing |
STEVEN WLADIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROOME INSURANCE FUND
|
2023
|
161332576
|
2024-03-26
|
EMPLOYEE BENEFITS PLUS, INC.
|
2
|
|
File |
View Page
|
Three-digit plan number (PN) |
507
|
Effective date of plan |
2000-06-01
|
Business code |
524210
|
Sponsor’s telephone number |
3154741400
|
Plan sponsor’s mailing address |
5795 WIDEWATERS PKWY STE 2, SYRACUSE, NY, 132141846
|
Plan sponsor’s
address |
5795 WIDEWATERS PKWY STE 2, SYRACUSE, NY, 132141846
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2024-03-26 |
Name of individual signing |
STEVEN WLADIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2024-03-26 |
Name of individual signing |
STEVEN WLADIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THIRD SALINA INSURANCE FUND
|
2022
|
161332576
|
2023-07-19
|
EMPLOYEE BENEFITS PLUS, INC.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1989-07-01
|
Business code |
524210
|
Sponsor’s telephone number |
3154741400
|
Plan sponsor’s mailing address |
5795 WIDEWATERS PKWY STE 2, SYRACUSE, NY, 132141846
|
Plan sponsor’s
address |
5795 WIDEWATERS PKWY STE 2, SYRACUSE, NY, 132141846
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-07-19 |
Name of individual signing |
KELLY DAVIDSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-07-19 |
Name of individual signing |
KELLY DAVIDSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
WARREN JEFFERSON INSURANCE FUND
|
2022
|
161332576
|
2023-03-27
|
EMPLOYEE BENEFITS PLUS, INC.
|
69
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1988-10-01
|
Business code |
524210
|
Sponsor’s telephone number |
3154741400
|
Plan sponsor’s mailing address |
528 PLUM ST, SYRACUSE, NY, 132041430
|
Plan sponsor’s
address |
528 PLUM ST, SYRACUSE, NY, 132041430
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-03-27 |
Name of individual signing |
STEVEN WLADIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-03-27 |
Name of individual signing |
STEVEN WLADIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HERKIMER COUNTY CHAMBER OF COMMERCE DENTAL PLAN
|
2022
|
161332576
|
2023-03-27
|
EMPLOYEE BENEFITS PLUS, INC.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
1994-01-01
|
Business code |
524210
|
Sponsor’s telephone number |
3154741400
|
Plan sponsor’s mailing address |
528 PLUM ST, SYRACUSE, NY, 132041430
|
Plan sponsor’s
address |
528 PLUM ST, SYRACUSE, NY, 132041430
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-03-27 |
Name of individual signing |
STEVEN WLADIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-03-27 |
Name of individual signing |
STEVEN WLADIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BROOME INSURANCE FUND
|
2022
|
161332576
|
2023-03-13
|
EMPLOYEE BENEFITS PLUS, INC.
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
507
|
Effective date of plan |
2000-06-01
|
Business code |
524210
|
Sponsor’s telephone number |
3154741400
|
Plan sponsor’s mailing address |
528 PLUM ST, SYRACUSE, NY, 132041430
|
Plan sponsor’s
address |
528 PLUM ST, SYRACUSE, NY, 132041430
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-03-13 |
Name of individual signing |
STEVEN WLADIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-03-13 |
Name of individual signing |
STEVEN WLADIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THIRD SALINA INSURANCE FUND
|
2021
|
161332576
|
2022-07-27
|
EMPLOYEE BENEFITS PLUS, INC.
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1989-07-01
|
Business code |
524210
|
Sponsor’s telephone number |
3154741400
|
Plan sponsor’s mailing address |
528 PLUM ST STE 250, SYRACUSE, NY, 132041477
|
Plan sponsor’s
address |
528 PLUM ST STE 250, SYRACUSE, NY, 132041477
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2022-07-27 |
Name of individual signing |
KELLY DAVIDSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-07-27 |
Name of individual signing |
KELLY DAVIDSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HERKIMER COUNTY CHAMBER OF COMMERCE DENTAL PLAN
|
2021
|
161332576
|
2022-04-06
|
EMPLOYEE BENEFITS PLUS, INC.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
1994-01-01
|
Business code |
524210
|
Sponsor’s telephone number |
3154741400
|
Plan sponsor’s mailing address |
528 PLUM ST, SYRACUSE, NY, 132041430
|
Plan sponsor’s
address |
528 PLUM ST, SYRACUSE, NY, 132041430
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2022-04-06 |
Name of individual signing |
STEVEN WLADIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-04-06 |
Name of individual signing |
STEVEN WLADIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|