PRIME GROUP HOLDINGS HEALTH BENEFIT PLAN
|
2021
|
463002962
|
2022-07-11
|
PRIME GROUP HOLDINGS, LLC
|
307
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2017-08-01
|
Business code |
721210
|
Sponsor’s telephone number |
5854199630
|
Plan sponsor’s mailing address |
85 RAILROAD PL, SARATOGA SPRINGS, NY, 128662124
|
Plan sponsor’s
address |
85 RAILROAD PL, SARATOGA SPRINGS, NY, 128662124
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2022-07-08 |
Name of individual signing |
TAMMI STEINBERG |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-07-08 |
Name of individual signing |
TAMMI STEINBERG |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRIME GROUP HOLDINGS HEALTH BENEFIT PLAN
|
2020
|
463002962
|
2021-07-22
|
PRIME GROUP HOLDINGS, LLC
|
277
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2017-08-01
|
Business code |
721210
|
Sponsor’s telephone number |
5854199630
|
Plan sponsor’s mailing address |
85 RAILROAD PL, SARATOGA SPRINGS, NY, 128662124
|
Plan sponsor’s
address |
85 RAILROAD PL, SARATOGA SPRINGS, NY, 128662124
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-07-22 |
Name of individual signing |
KATHLEEN OCCHIOGROSSO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-07-22 |
Name of individual signing |
KATHLEEN OCCHIOGROSSO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRIME GROUP HOLDINGS HEALTH BENEFIT PLAN
|
2019
|
463002962
|
2020-07-27
|
PRIME GROUP HOLDINGS, LLC
|
233
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2017-08-01
|
Business code |
721210
|
Sponsor’s telephone number |
5854199630
|
Plan sponsor’s mailing address |
85 RAILROAD PL, SARATOGA SPRINGS, NY, 128662124
|
Plan sponsor’s
address |
85 RAILROAD PL, SARATOGA SPRINGS, NY, 128662124
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2020-07-25 |
Name of individual signing |
ANGELA EVANS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRIME GROUP HOLDINGS ANCILLARY BENEFIT PLAN
|
2019
|
463002962
|
2020-07-27
|
PRIME GROUP HOLDINGS, LLC
|
236
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2017-08-01
|
Business code |
721210
|
Sponsor’s telephone number |
5854199630
|
Plan sponsor’s mailing address |
85 RAILROAD PL, SARATOGA SPRINGS, NY, 128662124
|
Plan sponsor’s
address |
85 RAILROAD PL, SARATOGA SPRINGS, NY, 128662124
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2020-07-25 |
Name of individual signing |
ANGELA EVANS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRIME GROUP HOLDINGS ANCILLARY BENEFIT PLAN
|
2018
|
463002962
|
2019-07-24
|
PRIME GROUP HOLDINGS, LLC
|
162
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2017-08-01
|
Business code |
721210
|
Sponsor’s telephone number |
5854199630
|
Plan sponsor’s mailing address |
85 RAILROAD PL, SARATOGA SPRINGS, NY, 128662124
|
Plan sponsor’s
address |
85 RAILROAD PL, SARATOGA SPRINGS, NY, 128662124
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-07-23 |
Name of individual signing |
ANGELA EVANS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-07-23 |
Name of individual signing |
ANGELA EVANS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRIME GROUP HOLDINGS HEALTH BENEFIT PLAN
|
2018
|
463002962
|
2019-07-24
|
PRIME GROUP HOLDINGS, LLC
|
208
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2017-08-01
|
Business code |
721210
|
Sponsor’s telephone number |
5854199630
|
Plan sponsor’s mailing address |
85 RAILROAD PL, SARATOGA SPRINGS, NY, 128662124
|
Plan sponsor’s
address |
85 RAILROAD PL, SARATOGA SPRINGS, NY, 128662124
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-07-23 |
Name of individual signing |
ANGELA EVANS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-07-23 |
Name of individual signing |
ANGELA EVANS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRIME GROUP HOLDINGS ANCILLARY BENEFIT PLAN
|
2017
|
463002962
|
2019-02-27
|
PRIME GROUP HOLDINGS, LLC
|
116
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2017-08-01
|
Business code |
721210
|
Sponsor’s telephone number |
5854199630
|
Plan sponsor’s mailing address |
85 RAILROAD PL, SARATOGA SPRINGS, NY, 128662124
|
Plan sponsor’s
address |
85 RAILROAD PL, SARATOGA SPRINGS, NY, 128662124
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-02-27 |
Name of individual signing |
ANGELA EVANS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRIME GROUP HOLDINGS HEALTH BENEFIT PLAN
|
2017
|
463002962
|
2019-02-27
|
PRIME GROUP HOLDINGS, LLC
|
147
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2017-08-01
|
Business code |
721210
|
Sponsor’s telephone number |
5854199630
|
Plan sponsor’s mailing address |
85 RAILROAD PL, SARATOGA SPRINGS, NY, 128662124
|
Plan sponsor’s
address |
85 RAILROAD PL, SARATOGA SPRINGS, NY, 128662124
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-02-27 |
Name of individual signing |
ANGELA EVANS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRIME GROUP HOLDINGS, LLC RETIREMENT TRUST
|
2016
|
463002962
|
2017-07-28
|
PRIME GROUP HOLDINGS, LLC
|
92
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
721210
|
Sponsor’s telephone number |
5186150552
|
Plan sponsor’s
address |
PO BOX 480, SARATOGA, NY, 12866
|
Signature of
Role |
Plan administrator |
Date |
2017-07-28 |
Name of individual signing |
TAMMI STEINBERG |
|
|
THREE LAKES RV PARK LLC RETIREMENT TRUST
|
2015
|
463002962
|
2016-07-29
|
PRIME GROUP HOLDINGS, LLC
|
68
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2007-01-01
|
Business code |
721210
|
Sponsor’s telephone number |
5186150552
|
Plan sponsor’s
address |
PO BOX 480, SARATOGA, NY, 12866
|
Signature of
Role |
Plan administrator |
Date |
2016-07-29 |
Name of individual signing |
TAMMI STEINBERG |
|
|