THE RETIREE MEDICAL PLAN OF SOMERSET OPERATING COMPANY, LLC
|
2017
|
364731063
|
2018-10-15
|
SOMERSET OPERATING COMPANY, LLC
|
52
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2002-01-01
|
Business code |
221100
|
Sponsor’s telephone number |
7167959501
|
Plan sponsor’s mailing address |
7725 LAKE ROAD, BARKER, NY, 14012
|
Plan sponsor’s
address |
7725 LAKE ROAD, BARKER, NY, 14012
|
Number of participants as of the end of the plan year
Active participants |
0 |
Retired or separated participants receiving
benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2018-10-15 |
Name of individual signing |
JAMES NOTARIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE RETIREE MEDICAL PLAN OF SOMERSET OPERATING COMPANY, LLC
|
2016
|
364731063
|
2017-10-16
|
SOMERSET OPERATING COMPANY LLC
|
50
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2002-01-01
|
Business code |
221100
|
Sponsor’s telephone number |
7167959501
|
Plan sponsor’s mailing address |
7725 LAKE ROAD, BARKER, NY, 14012
|
Plan sponsor’s
address |
7725 LAKE ROAD, BARKER, NY, 14012
|
Number of participants as of the end of the plan year
Active participants |
42 |
Retired or separated participants receiving
benefits |
10 |
Signature of
Role |
Plan administrator |
Date |
2017-10-16 |
Name of individual signing |
JAMES NOTARIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE RETIREE MEDICAL PLAN OF SOMERSET OPERATING COMPANY, LLC
|
2015
|
364731063
|
2016-10-17
|
SOMERSET OPERATING COMPANY LLC
|
35
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2002-01-01
|
Business code |
221100
|
Sponsor’s telephone number |
7167959501
|
Plan sponsor’s mailing address |
7725 LAKE ROAD, BARKER, NY, 14012
|
Plan sponsor’s
address |
7725 LAKE ROAD, BARKER, NY, 14012
|
Number of participants as of the end of the plan year
Active participants |
40 |
Retired or separated participants receiving
benefits |
10 |
Signature of
Role |
Plan administrator |
Date |
2016-10-17 |
Name of individual signing |
JAMES NOTARIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE RETIREE MEDICAL PLAN OF SOMERSET OPERATING COMPANY, LLC
|
2014
|
364731063
|
2015-10-14
|
SOMERSET OPERATING COMPANY LLC
|
49
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2002-01-01
|
Business code |
221100
|
Sponsor’s telephone number |
7167959501
|
Plan sponsor’s mailing address |
7725 LAKE ROAD, BARKER, NY, 14012
|
Plan sponsor’s
address |
7725 LAKE ROAD, BARKER, NY, 14012
|
Number of participants as of the end of the plan year
Active participants |
23 |
Retired or separated participants receiving
benefits |
12 |
Signature of
Role |
Plan administrator |
Date |
2015-10-14 |
Name of individual signing |
JOSEPH PROVINO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-10-14 |
Name of individual signing |
JOSEPH PROVINO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE RETIREE MEDICAL PLAN OF SOMERSET OPERATING COMPANY, LLC
|
2013
|
364731063
|
2014-10-15
|
SOMERSET OPERATING COMPANY LLC
|
53
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2002-01-01
|
Business code |
221100
|
Sponsor’s telephone number |
7167959501
|
Plan sponsor’s mailing address |
7725 LAKE ROAD, BARKER, NY, 14012
|
Plan sponsor’s
address |
7725 LAKE ROAD, BARKER, NY, 14012
|
Number of participants as of the end of the plan year
Active participants |
39 |
Retired or separated participants receiving
benefits |
10 |
Signature of
Role |
Plan administrator |
Date |
2014-10-15 |
Name of individual signing |
JOSEPH PROVINO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-10-15 |
Name of individual signing |
JOSEPH PROVINO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE RETIREE MEDICAL PLAN OF SOMERSET OPERATING COMPANY, LLC
|
2012
|
364731063
|
2014-10-15
|
SOMERSET OPERATING COMPANY LLC
|
44
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2002-01-01
|
Business code |
221100
|
Sponsor’s telephone number |
7167959501
|
Plan sponsor’s mailing address |
7725 LAKE ROAD, BARKER, NY, 14012
|
Plan sponsor’s
address |
7725 LAKE ROAD, BARKER, NY, 14012
|
Number of participants as of the end of the plan year
Active participants |
40 |
Retired or separated participants receiving
benefits |
13 |
Signature of
Role |
Plan administrator |
Date |
2014-10-15 |
Name of individual signing |
JOSEPH PROVINO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-10-15 |
Name of individual signing |
JOSEPH PROVINO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE RETIREE MEDICAL PLAN OF SOMERSET OPERATING COMPANY, LLC
|
2012
|
364731063
|
2013-10-15
|
SOMERSET OPERATING COMPANY LLC
|
44
|
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2002-01-01
|
Business code |
221100
|
Sponsor’s telephone number |
7167959501
|
Plan sponsor’s mailing address |
7725 LAKE ROAD, BARKER, NY, 14012
|
Plan sponsor’s
address |
7725 LAKE ROAD, BARKER, NY, 14012
|
Number of participants as of the end of the plan year
Active participants |
40 |
Retired or separated participants receiving
benefits |
13 |
Signature of
Role |
Plan administrator |
Date |
2013-10-15 |
Name of individual signing |
JOSEPH PROVINO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-10-15 |
Name of individual signing |
JOSEPH PROVINO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE RETIREE MEDICAL PLAN OF AES SOMERSET, LLC
|
2011
|
364731063
|
2012-10-15
|
SOMERSET OPERATING COMPANY LLC
|
44
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2002-01-01
|
Business code |
221100
|
Sponsor’s telephone number |
7167959501
|
Plan sponsor’s mailing address |
7725 LAKE ROAD, BARKER, NY, 14012
|
Plan sponsor’s
address |
7725 LAKE ROAD, BARKER, NY, 14012
|
Plan administrator’s name and address
Administrator’s EIN |
364731063 |
Plan administrator’s name |
SOMERSET OPERATING COMPANY LLC |
Plan administrator’s
address |
7725 LAKE ROAD, BARKER, NY, 14012 |
Administrator’s telephone number |
7167959501 |
Number of participants as of the end of the plan year
Active participants |
33 |
Retired or separated participants receiving
benefits |
6 |
Other
retired or separated participants entitled to future benefits |
5 |
Signature of
Role |
Plan administrator |
Date |
2012-10-15 |
Name of individual signing |
JOSEPH PROVINO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|