COMMUNITY HEALTHCARE NETWORK GROUP MEDICAL AND DENTAL
|
2015
|
133083068
|
2016-10-14
|
COMMUNITY HEALTHCARE NETWORK
|
757
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1993-09-01
|
Business code |
621498
|
Sponsor’s telephone number |
2125452481
|
Plan sponsor’s mailing address |
60 MADISON AVENUE, 5TH FLOOR, NEW YORK, NY, 10010
|
Plan sponsor’s
address |
60 MADISON AVENUE, 5TH FLOOR, NEW YORK, NY, 10010
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-10-14 |
Name of individual signing |
ALAN WENGROFSKY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
COMMUNITY HEALTHCARE NETWORK GROUP LIFE INSURANCE
|
2015
|
133083068
|
2016-10-14
|
COMMUNITY HEALTHCARE NETWORK
|
453
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
1988-03-01
|
Business code |
621498
|
Sponsor’s telephone number |
2125452481
|
Plan sponsor’s mailing address |
60 MADISON AVENUE, 5TH FLOOR, NEW YORK, NY, 10010
|
Plan sponsor’s
address |
60 MADISON AVENUE, 5TH FLOOR, NEW YORK, NY, 10010
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-10-14 |
Name of individual signing |
ALAN WENGROFSKY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
COMMUNITY HEALTHCARE NETWORK LTD
|
2015
|
133083068
|
2016-10-14
|
COMMUNITY HEALTHCARE NETWORK
|
451
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1989-01-01
|
Business code |
621498
|
Sponsor’s telephone number |
2125452481
|
Plan sponsor’s mailing address |
60 MADISON AVENUE, 5TH FLOOR, NEW YORK, NY, 10010
|
Plan sponsor’s
address |
60 MADISON AVENUE, 5TH FLOOR, NEW YORK, NY, 10010
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-10-14 |
Name of individual signing |
ALAN WENGROFSKY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
COMMUNITY HEALTHCARE NETWORK GROUP LIFE INSURANCE
|
2014
|
133083068
|
2015-10-16
|
COMMUNITY HEALTHCARE NETWORK
|
418
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
1988-03-01
|
Business code |
621498
|
Sponsor’s telephone number |
2125452481
|
Plan sponsor’s mailing address |
60 MADISON AVENUE, 5TH FLOOR, NEW YORK, NY, 10010
|
Plan sponsor’s
address |
60 MADISON AVENUE, 5TH FLOOR, NEW YORK, NY, 10010
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-10-15 |
Name of individual signing |
ALAN WENGROFSKY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
COMMUNITY HEALTHCARE NETWORK GROUP MEDICAL AND DENTAL
|
2014
|
133083068
|
2015-10-16
|
COMMUNITY HEALTHCARE NETWORK
|
427
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1993-09-01
|
Business code |
621498
|
Sponsor’s telephone number |
2125452481
|
Plan sponsor’s mailing address |
60 MADISON AVENUE, 5TH FLOOR, NEW YORK, NY, 10010
|
Plan sponsor’s
address |
60 MADISON AVENUE, 5TH FLOOR, NEW YORK, NY, 10010
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-10-15 |
Name of individual signing |
ALAN WENGROFSKY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
COMMUNITY HEALTHCARE NETWORK LTD
|
2014
|
133083068
|
2015-10-16
|
COMMUNITY HEALTHCARE NETWORK
|
420
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1989-01-01
|
Business code |
621498
|
Sponsor’s telephone number |
2125452481
|
Plan sponsor’s mailing address |
60 MADISON AVENUE, 5TH FLOOR, NEW YORK, NY, 10010
|
Plan sponsor’s
address |
60 MADISON AVENUE, 5TH FLOOR, NEW YORK, NY, 10010
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-10-16 |
Name of individual signing |
ALAN WENGROFSKY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
COMMUNITY HEALTHCARE NETWORK, INC. GROUP LIFE INSURANCE
|
2013
|
133083068
|
2014-10-15
|
COMMUNITY HEALTHCARE NETWORK, INC.
|
396
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
1988-03-01
|
Business code |
621498
|
Sponsor’s telephone number |
2125452481
|
Plan sponsor’s mailing address |
60 MADISON AVENUE, 5TH FLOOR, NEW YORK, NY, 10010
|
Plan sponsor’s
address |
60 MADISON AVENUE, 5TH FLOOR, NEW YORK, NY, 10010
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-10-15 |
Name of individual signing |
ALAN WENGROFSKY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
COMMUNITY HEALTHCARE NETWORK, INC. GROUP MEDICAL & DENTAL
|
2013
|
133083068
|
2014-10-15
|
COMMUNITY HEALTHCARE NETWORK, INC.
|
578
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1993-09-01
|
Business code |
621498
|
Sponsor’s telephone number |
2125452481
|
Plan sponsor’s mailing address |
60 MADISON AVENUE, 5TH FLOOR, NEW YORK, NY, 10010
|
Plan sponsor’s
address |
60 MADISON AVENUE, 5TH FLOOR, NEW YORK, NY, 10010
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-10-15 |
Name of individual signing |
ALAN WENGROFSKY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-10-15 |
Name of individual signing |
ALAN WENGROFSKY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
COMMUNITY HEALTHCARE NETWORK, INC. LONG TERM DISABILITY
|
2013
|
133083068
|
2014-10-15
|
COMMUNITY HEALTHCARE NETWORK, INC.
|
396
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1989-01-01
|
Business code |
621498
|
Sponsor’s telephone number |
2125452481
|
Plan sponsor’s mailing address |
60 MADISON AVENUE, 5TH FLOOR, NEW YORK, NY, 10010
|
Plan sponsor’s
address |
60 MADISON AVENUE, 5TH FLOOR, NEW YORK, NY, 10010
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-10-15 |
Name of individual signing |
ALAN WENGROFSKY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
COMMUNITY HEALTHCARE NETWORK, INC. LONG TERM DISABILITY
|
2012
|
133083068
|
2013-10-15
|
COMMUNITY HEALTHCARE NETWORK, INC.
|
372
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1989-01-01
|
Business code |
621498
|
Sponsor’s telephone number |
2125452481
|
Plan sponsor’s mailing address |
60 MADISON AVENUE, 5TH FLOOR, NEW YORK, NY, 10010
|
Plan sponsor’s
address |
60 MADISON AVENUE, 5TH FLOOR, NEW YORK, NY, 10010
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-10-15 |
Name of individual signing |
ALAN WENGROFSKY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|