THE MOUNT VERNON HOSPITAL EMPLOYEES' RETIREMENT BENEFIT PLAN
|
2016
|
131740115
|
2017-08-08
|
THE MOUNT VERNON HOSPITAL
|
63
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1997-01-01
|
Business code |
622000
|
Sponsor’s telephone number |
9146648000
|
Plan sponsor’s
address |
12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
|
Signature of
Role |
Plan administrator |
Date |
2017-08-07 |
Name of individual signing |
MONICA TERRANO |
|
|
THE MOUNT VERNON HOSPITAL EMPLOYEES' RETIREMENT BENEFIT PLAN
|
2015
|
131740115
|
2016-09-14
|
THE MOUNT VERNON HOSPITAL
|
88
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1997-01-01
|
Business code |
622000
|
Sponsor’s telephone number |
9146648000
|
Plan sponsor’s
address |
12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
|
Signature of
Role |
Plan administrator |
Date |
2016-09-14 |
Name of individual signing |
MONICA TERRANO |
|
|
THE MOUNT VERNON HOSPITAL EMPLOYEES' RETIREMENT BENEFIT PLAN
|
2014
|
131740115
|
2015-10-13
|
THE MOUNT VERNON HOSPITAL
|
184
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1997-01-01
|
Business code |
622000
|
Sponsor’s telephone number |
9146648000
|
Plan sponsor’s mailing address |
12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
|
Plan sponsor’s
address |
12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
|
Plan administrator’s name and address
Administrator’s EIN |
131740115 |
Plan administrator’s name |
THE MOUNT VERNON HOSPITAL |
Plan administrator’s
address |
12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550 |
Administrator’s telephone number |
9146648000 |
Number of participants as of the end of the plan year
Active participants |
0 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
88 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
88 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
2 |
Signature of
Role |
Plan administrator |
Date |
2015-10-12 |
Name of individual signing |
MONICA TERRANO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE MOUNT VERNON HOSPITAL EMPLOYEES' RETIREMENT BENEFIT PLAN
|
2013
|
131740115
|
2015-10-12
|
THE MOUNT VERNON HOSPITAL
|
198
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1997-01-01
|
Business code |
622000
|
Sponsor’s telephone number |
9146648000
|
Plan sponsor’s mailing address |
12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
|
Plan sponsor’s
address |
12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
|
Plan administrator’s name and address
Administrator’s EIN |
131740115 |
Plan administrator’s name |
THE MOUNT VERNON HOSPITAL |
Plan administrator’s
address |
12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550 |
Administrator’s telephone number |
9146648000 |
Number of participants as of the end of the plan year
Active participants |
65 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
119 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
184 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-10-12 |
Name of individual signing |
MONICA TERRANO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE MOUNT VERNON HOSPITAL EMPLOYEES' RETIREMENT BENEFIT PLAN
|
2012
|
131740115
|
2013-10-15
|
THE MOUNT VERNON HOSPITAL
|
213
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1997-01-01
|
Business code |
622000
|
Sponsor’s telephone number |
9146648000
|
Plan sponsor’s mailing address |
12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
|
Plan sponsor’s
address |
12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
|
Plan administrator’s name and address
Administrator’s EIN |
131740115 |
Plan administrator’s name |
THE MOUNT VERNON HOSPITAL |
Plan administrator’s
address |
12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550 |
Administrator’s telephone number |
9146648000 |
Number of participants as of the end of the plan year
Active participants |
160 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
38 |
Number of
participants
with
account balances as of the end of the plan year |
198 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2013-10-15 |
Name of individual signing |
JOHN LJULJIC |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE MOUNT VERNON HOSPITAL HEALTH BENEFIT PLAN
|
2012
|
131740115
|
2013-10-14
|
THE MOUNT VERNON HOSPITAL
|
271
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1981-01-01
|
Business code |
622000
|
Sponsor’s telephone number |
9146648000
|
Plan sponsor’s mailing address |
12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
|
Plan sponsor’s
address |
12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
|
Plan administrator’s name and address
Administrator’s EIN |
131740115 |
Plan administrator’s name |
THE MOUNT VERNON HOSPITAL |
Plan administrator’s
address |
12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550 |
Administrator’s telephone number |
9146648000 |
Number of participants as of the end of the plan year
Active participants |
270 |
Retired or separated participants receiving
benefits |
0 |
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 |
2013-10-14 |
Name of individual signing |
JOHN LJULJIC |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MOUNT VERNON HOSPITAL HEALTH BENEFIT PLAN FOR NURSES
|
2012
|
131740115
|
2013-10-14
|
THE MOUNT VERNON HOSPITAL
|
196
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2008-01-01
|
Business code |
622000
|
Sponsor’s telephone number |
9146648000
|
Plan sponsor’s mailing address |
12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
|
Plan sponsor’s
address |
12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
|
Plan administrator’s name and address
Administrator’s EIN |
131740115 |
Plan administrator’s name |
THE MOUNT VERNON HOSPITAL |
Plan administrator’s
address |
12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550 |
Administrator’s telephone number |
9146648000 |
Number of participants as of the end of the plan year
Active participants |
89 |
Retired or separated participants receiving
benefits |
0 |
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 |
2013-10-14 |
Name of individual signing |
JOHN LJULJIC |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE HEALTH BENEFIT PLAN FOR THE MOUNT VERNON HOSPITAL
|
2012
|
131740115
|
2013-10-14
|
THE MOUNT VERNON HOSPITAL
|
33
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2008-01-01
|
Business code |
622000
|
Sponsor’s telephone number |
9146648000
|
Plan sponsor’s mailing address |
12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
|
Plan sponsor’s
address |
12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
|
Plan administrator’s name and address
Administrator’s EIN |
131740115 |
Plan administrator’s name |
THE MOUNT VERNON HOSPITAL |
Plan administrator’s
address |
12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550 |
Administrator’s telephone number |
9146648000 |
Number of participants as of the end of the plan year
Active participants |
32 |
Retired or separated participants receiving
benefits |
0 |
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 |
2013-10-14 |
Name of individual signing |
JOHN LJULJIC |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MOUNT VERNON HOSPITAL FLEXIBLE SPENDING PLAN
|
2012
|
131740115
|
2013-10-14
|
THE MOUNT VERNON HOSPITAL
|
14
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2008-01-01
|
Business code |
622000
|
Sponsor’s telephone number |
9146648000
|
Plan sponsor’s mailing address |
12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
|
Plan sponsor’s
address |
12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
|
Plan administrator’s name and address
Administrator’s EIN |
131740115 |
Plan administrator’s name |
THE MOUNT VERNON HOSPITAL |
Plan administrator’s
address |
12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550 |
Administrator’s telephone number |
9146648000 |
Number of participants as of the end of the plan year
Active participants |
10 |
Retired or separated participants receiving
benefits |
0 |
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 |
2013-10-14 |
Name of individual signing |
JOHN LJULJIC |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MOUNT VERNON HOSPITAL HEALTH PLAN FOR PHYSICIANS AND EXEMPT EMPLOYEES
|
2012
|
131740115
|
2013-10-14
|
THE MOUNT VERNON HOSPITAL
|
48
|
|
File |
View Page
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
2009-10-01
|
Business code |
622000
|
Sponsor’s telephone number |
9146648000
|
Plan sponsor’s mailing address |
12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
|
Plan sponsor’s
address |
12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
|
Plan administrator’s name and address
Administrator’s EIN |
131740115 |
Plan administrator’s name |
THE MOUNT VERNON HOSPITAL |
Plan administrator’s
address |
12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550 |
Administrator’s telephone number |
9146648000 |
Number of participants as of the end of the plan year
Active participants |
48 |
Retired or separated participants receiving
benefits |
0 |
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 |
2013-10-14 |
Name of individual signing |
JOHN LJULJIC |
Valid signature |
Filed with authorized/valid electronic signature |
|
|