|
ADIRONDACK HEALTH WELFARE BENEFIT PLAN
|
2023
|
141731786
|
2024-07-12
|
ADIRONDACK MEDICAL CENTER
|
633
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
502
|
| Effective date of plan |
2008-01-01
|
| Business code |
622000
|
| Sponsor’s telephone number |
5188972413
|
| Plan sponsor’s mailing address |
2233 STATE ROUTE 86, PO BOX 471, SARANAC LAKE, NY, 129830471
|
| Plan sponsor’s
address |
2233 STATE ROUTE 86, PO BOX 471, SARANAC LAKE, NY, 129830471
|
Number of participants as of the end of the plan year
| Active participants |
621 |
| Retired or separated participants receiving
benefits |
3 |
Signature of
| Role |
Plan administrator |
| Date |
2024-07-12 |
| Name of individual signing |
CONNER LABAR |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2024-07-12 |
| Name of individual signing |
CONNER LABAR |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
ADIRONDACK HEALTH WELFARE BENEFIT PLAN
|
2022
|
141731786
|
2023-07-31
|
ADIRONDACK MEDICAL CENTER
|
659
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
502
|
| Effective date of plan |
2008-01-01
|
| Business code |
622000
|
| Sponsor’s telephone number |
5188972413
|
| Plan sponsor’s mailing address |
2233 STATE ROUTE 86, PO BOX 471, SARANAC LAKE, NY, 129830471
|
| Plan sponsor’s
address |
2233 STATE ROUTE 86, PO BOX 471, SARANAC LAKE, NY, 129830471
|
Number of participants as of the end of the plan year
| Active participants |
630 |
| Retired or separated participants receiving
benefits |
3 |
Signature of
| Role |
Plan administrator |
| Date |
2023-07-31 |
| Name of individual signing |
MELANIE SLEIME |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
ADIRONDACK HEALTH WELFARE BENEFIT PLAN
|
2021
|
141731786
|
2022-07-29
|
ADIRONDACK MEDICAL CENTER
|
696
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
502
|
| Effective date of plan |
2008-01-01
|
| Business code |
622000
|
| Sponsor’s telephone number |
5188972413
|
| Plan sponsor’s mailing address |
2233 STATE ROUTE 86, PO BOX 471, SARANAC LAKE, NY, 129830471
|
| Plan sponsor’s
address |
2233 STATE ROUTE 86, PO BOX 471, SARANAC LAKE, NY, 129830471
|
Number of participants as of the end of the plan year
| Active participants |
659 |
| Retired or separated participants receiving
benefits |
4 |
Signature of
| Role |
Plan administrator |
| Date |
2022-07-29 |
| Name of individual signing |
MELANIE SLEIME |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
ADIRONDACK HEALTH WELFARE BENEFIT PLAN
|
2020
|
141731786
|
2021-07-22
|
ADIRONDACK MEDICAL CENTER
|
700
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
502
|
| Effective date of plan |
2008-01-01
|
| Business code |
622000
|
| Sponsor’s telephone number |
5188972413
|
| Plan sponsor’s mailing address |
2233 STATE ROUTE 86, PO BOX 471, SARANAC LAKE, NY, 129830471
|
| Plan sponsor’s
address |
2233 STATE ROUTE 86, PO BOX 471, SARANAC LAKE, NY, 129830471
|
Number of participants as of the end of the plan year
| Active participants |
693 |
| Retired or separated participants receiving
benefits |
3 |
Signature of
| Role |
Plan administrator |
| Date |
2021-07-21 |
| Name of individual signing |
DEREK TRACY |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
ADIRONDACK HEALTH WELFARE BENEFIT PLAN
|
2019
|
141731786
|
2020-08-18
|
ADIRONDACK MEDICAL CENTER
|
630
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
502
|
| Effective date of plan |
2008-01-01
|
| Business code |
622000
|
| Sponsor’s telephone number |
5188972413
|
| Plan
sponsor’s DBA name |
ADIRONDACK HEALTH
|
| Plan sponsor’s mailing address |
PO BOX 471, 2233 STATE ROUTE 86, SARANAC LAKE, NY, 129835644
|
| Plan sponsor’s
address |
PO BOX 471, 2233 STATE ROUTE 86, SARANAC LAKE, NY, 129835644
|
Number of participants as of the end of the plan year
| Active participants |
668 |
| Retired or separated participants receiving
benefits |
3 |
| Other
retired or separated participants entitled to future benefits |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2020-08-18 |
| Name of individual signing |
DEREK TRACY |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
ADIRONDACK HEALTH WELFARE BENEFIT PLAN
|
2018
|
141731786
|
2019-08-01
|
ADIRONDACK MEDICAL CENTER
|
656
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
502
|
| Effective date of plan |
2008-01-01
|
| Business code |
622000
|
| Sponsor’s telephone number |
5188972413
|
| Plan
sponsor’s DBA name |
ADIRONDACK HEALTH
|
| Plan sponsor’s mailing address |
PO BOX 471, 2233 STATE ROUTE 86, SARANAC LAKE, NY, 129835644
|
| Plan sponsor’s
address |
PO BOX 471, 2233 STATE ROUTE 86, SARANAC LAKE, NY, 129835644
|
Number of participants as of the end of the plan year
| Active participants |
630 |
| Retired or separated participants receiving
benefits |
3 |
Signature of
| Role |
Plan administrator |
| Date |
2019-08-01 |
| Name of individual signing |
DEREK TRACY |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
ADIRONDACK HEALTH WELFARE BENEFIT PLAN
|
2017
|
141731786
|
2018-08-13
|
ADIRONDACK MEDICAL CENTER
|
618
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
502
|
| Effective date of plan |
2008-01-01
|
| Business code |
622000
|
| Sponsor’s telephone number |
5188972413
|
| Plan
sponsor’s DBA name |
ADIRONDACK HEALTH
|
| Plan sponsor’s mailing address |
PO BOX 471, 2233 STATE ROUTE 86, SARANAC LAKE, NY, 129835644
|
| Plan sponsor’s
address |
PO BOX 471, 2233 STATE ROUTE 86, SARANAC LAKE, NY, 129835644
|
Number of participants as of the end of the plan year
| Active participants |
653 |
| Retired or separated participants receiving
benefits |
3 |
Signature of
| Role |
Plan administrator |
| Date |
2018-08-13 |
| Name of individual signing |
DANA KELLERMAN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
ADIRONDACK HEALTH WELFARE BENEFIT PLAN
|
2017
|
141731786
|
2018-08-13
|
ADIRONDACK MEDICAL CENTER
|
618
|
|
| Three-digit plan number (PN) |
502
|
| Effective date of plan |
2008-01-01
|
| Business code |
622000
|
| Sponsor’s telephone number |
5188972413
|
| Plan
sponsor’s DBA name |
ADIRONDACK HEALTH
|
| Plan sponsor’s mailing address |
PO BOX 471, 2233 STATE ROUTE 86, SARANAC LAKE, NY, 129835644
|
| Plan sponsor’s
address |
PO BOX 471, 2233 STATE ROUTE 86, SARANAC LAKE, NY, 129835644
|
Number of participants as of the end of the plan year
| Active participants |
653 |
| Retired or separated participants receiving
benefits |
3 |
Signature of
| Role |
Employer/plan sponsor |
| Date |
2018-08-13 |
| Name of individual signing |
DANA KELLERMAN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
ADIRONDACK HEALTH WELFARE BENEFIT PLAN
|
2016
|
141731786
|
2017-07-31
|
ADIRONDACK MEDICAL CENTER
|
683
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
502
|
| Effective date of plan |
2008-01-01
|
| Business code |
622000
|
| Sponsor’s telephone number |
5188972413
|
| Plan
sponsor’s DBA name |
ADIRONDACK HEALTH
|
| Plan sponsor’s mailing address |
PO BOX 471, 2233 STATE ROUTE 86, SARANAC LAKE, NY, 129835644
|
| Plan sponsor’s
address |
PO BOX 471, 2233 STATE ROUTE 86, SARANAC LAKE, NY, 129835644
|
Number of participants as of the end of the plan year
| Active participants |
618 |
| Retired or separated participants receiving
benefits |
4 |
Signature of
| Role |
Plan administrator |
| Date |
2017-07-28 |
| Name of individual signing |
DANA KELLERMAN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
ADIRONDACK HEALTH WELFARE BENEFIT PLAN
|
2015
|
141731786
|
2016-07-25
|
ADIRONDACK MEDICAL CENTER
|
606
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
502
|
| Effective date of plan |
2008-01-01
|
| Business code |
622000
|
| Sponsor’s telephone number |
5188972413
|
| Plan
sponsor’s DBA name |
ADIRONDACK HEALTH
|
| Plan sponsor’s mailing address |
PO BOX 471, 2233 STATE ROUTE 86, SARANAC LAKE, NY, 129835644
|
| Plan sponsor’s
address |
PO BOX 471, 2233 STATE ROUTE 86, SARANAC LAKE, NY, 129835644
|
Number of participants as of the end of the plan year
| Active participants |
596 |
| Retired or separated participants receiving
benefits |
4 |
| Other
retired or separated participants entitled to future benefits |
0 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2016-07-25 |
| Name of individual signing |
MIKE LEE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
