MONTEFIORE NYACK HOSPITAL NEW YORK RETIREE MEDICAL PLAN VEBA AND TRUST VEBA AND TRUST
|
2023
|
874774733
|
2024-10-16
|
MONTEFIORE NYACK HOSPITAL
|
17
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2022-12-02
|
Business code |
622000
|
Sponsor’s telephone number |
8007227214
|
Plan sponsor’s
address |
131 WEST 33RD STREET, NEW YORK, NY, 10001
|
Plan administrator’s name and address
Administrator’s EIN |
874774733 |
Plan administrator’s name |
BD OF TRUSTEES MONTEFIORE NYACK HOS |
Plan administrator’s
address |
131 WEST 33RD STREET, NEW YORK, NY, 10001 |
Administrator’s telephone number |
8007227214 |
|
NYACK HOSPITAL GROUP LIFE INSURANCE PLAN
|
2020
|
131740119
|
2021-11-02
|
MONTEFIORE NYACK HOSPITAL
|
634
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
1992-10-01
|
Business code |
622000
|
Sponsor’s telephone number |
8453482000
|
Plan sponsor’s mailing address |
160 N MIDLAND AVE, NYACK, NY, 109601912
|
Plan sponsor’s
address |
160 N MIDLAND AVE, NYACK, NY, 109601912
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-08-13 |
Name of individual signing |
MARY SHINICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NYACK HOSPITAL HEALTH & DENTAL PLAN
|
2020
|
131740119
|
2021-11-02
|
MONTEFIORE NYACK HOSPITAL
|
1181
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1981-05-01
|
Business code |
622000
|
Sponsor’s telephone number |
8453482000
|
Plan sponsor’s mailing address |
160 N MIDLAND AVE, NYACK, NY, 109601912
|
Plan sponsor’s
address |
160 N MIDLAND AVE, NYACK, NY, 109601912
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-08-13 |
Name of individual signing |
MARY SHINICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NYACK HOSPITAL GROUP LIFE INSURANCE PLAN
|
2019
|
131740119
|
2020-08-31
|
MONTEFIORE NYACK HOSPITAL
|
852
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
1992-10-01
|
Business code |
622000
|
Sponsor’s telephone number |
8453482000
|
Plan sponsor’s mailing address |
160 N MIDLAND AVE, NYACK, NY, 109601912
|
Plan sponsor’s
address |
160 N MIDLAND AVE, NYACK, NY, 109601912
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2020-08-31 |
Name of individual signing |
MARY SHINICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-08-31 |
Name of individual signing |
MARY SHINICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NYACK HOSPITAL HEALTH & DENTAL PLAN
|
2019
|
131740119
|
2020-08-31
|
MONTEFIORE NYACK HOSPITAL
|
1111
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1981-05-01
|
Business code |
622000
|
Sponsor’s telephone number |
8453482000
|
Plan sponsor’s mailing address |
160 N MIDLAND AVE, NYACK, NY, 109601912
|
Plan sponsor’s
address |
160 N MIDLAND AVE, NYACK, NY, 109601912
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2020-08-31 |
Name of individual signing |
MARY SHINICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-08-31 |
Name of individual signing |
MARY SHINICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NYACK HOSPITAL HEALTH & DENTAL PLAN
|
2018
|
131740119
|
2019-08-22
|
MONTEFIORE NYACK HOSPITAL
|
1150
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1981-05-01
|
Business code |
622000
|
Sponsor’s telephone number |
8453482000
|
Plan sponsor’s mailing address |
160 N MIDLAND AVE, NYACK, NY, 109601912
|
Plan sponsor’s
address |
160 N MIDLAND AVE, NYACK, NY, 109601912
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-08-20 |
Name of individual signing |
MARY SHINICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-08-20 |
Name of individual signing |
JOHN BURKE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
NYACK HOSPITAL GROUP LIFE INSURANCE PLAN
|
2018
|
131740119
|
2019-08-28
|
MONTEFIORE NYACK HOSPITAL
|
686
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
1992-10-01
|
Business code |
622000
|
Sponsor’s telephone number |
8453482000
|
Plan sponsor’s mailing address |
160 N MIDLAND AVE, NYACK, NY, 109601912
|
Plan sponsor’s
address |
160 N MIDLAND AVE, NYACK, NY, 109601912
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-08-22 |
Name of individual signing |
MARY SHINICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-08-27 |
Name of individual signing |
JOHN BURKE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|