MASONIC CARE COMMUNITY OF NEW YORK - HEALTH PLAN
|
2014
|
135563012
|
2015-08-25
|
TRUSTEES OF THE MASONIC HALL AND ASYLUM FUND
|
418
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1968-01-01
|
Business code |
623000
|
Sponsor’s telephone number |
3157984882
|
Plan
sponsor’s DBA name |
MASONIC CARE COMMUNITY OF NEW YORK
|
Plan sponsor’s mailing address |
2150 BLEECKER STREET, UTICA, NY, 13501
|
Plan sponsor’s
address |
2150 BLEECKER STREET, UTICA, NY, 13501
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-08-25 |
Name of individual signing |
ROBERT RAFFLE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MASONIC CARE COMMUNITY OF NEW YORK - GROUP LIFE & DISABILITY INSURANCE PLAN
|
2014
|
135563012
|
2015-08-25
|
TRUSTEES OF THE MASONIC HALL AND ASYLUM FUND
|
941
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2001-01-01
|
Business code |
623000
|
Sponsor’s telephone number |
3157984882
|
Plan
sponsor’s DBA name |
MASONIC CARE COMMUNITY OF NEW YORK
|
Plan sponsor’s mailing address |
215 BLEECKER STREET, UTICA, NY, 13501
|
Plan sponsor’s
address |
215 BLEECKER STREET, UTICA, NY, 13501
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-08-25 |
Name of individual signing |
ROBERT RAFFLE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL INSURANCE PLAN OF THE MASONIC CARE COMMUNITY
|
2014
|
135563012
|
2015-08-25
|
TRUSTEES OF THE MASONIC HALL AND ASYLUM FUND
|
451
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
1992-01-01
|
Business code |
623000
|
Sponsor’s telephone number |
3157984882
|
Plan
sponsor’s DBA name |
MASONIC CARE COMMUNITY OF NEW YORK
|
Plan sponsor’s mailing address |
2150 BLEECKER STREET, UTICA, NY, 13501
|
Plan sponsor’s
address |
2150 BLEECKER STREET, UTICA, NY, 13501
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-08-25 |
Name of individual signing |
ROBERT RAFFLE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MASONIC CARE COMMUNITY OF NEW YORK - HEALTH PLAN
|
2013
|
135563012
|
2014-08-15
|
TRUSTEES OF THE MASONIC HALL AND ASYLUM FUND
|
422
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1968-01-01
|
Business code |
623000
|
Sponsor’s telephone number |
3157984909
|
Plan
sponsor’s DBA name |
MASONIC CARE COMMUNITY OF NEW YORK
|
Plan sponsor’s mailing address |
2150 BLEECKER STREET, UTICA, NY, 13501
|
Plan sponsor’s
address |
2150 BLEECKER STREET, UTICA, NY, 13501
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-08-14 |
Name of individual signing |
ROBERT RAFFLE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL INSURANCE PLAN OF THE MASONIC CARE COMMUNITY OF NEW YORK
|
2013
|
135563012
|
2014-08-15
|
TRUSTEES OF THE MASONIC HALL AND ASYLUM FUND
|
551
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
1992-01-01
|
Business code |
623000
|
Sponsor’s telephone number |
3157984909
|
Plan
sponsor’s DBA name |
MASONIC CARE COMMUNITY OF NEW YORK
|
Plan sponsor’s mailing address |
2150 BLEECKER STREET, UTICA, NY, 13501
|
Plan sponsor’s
address |
2150 BLEECKER STREET, UTICA, NY, 13501
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-08-14 |
Name of individual signing |
ROBERT RAFFLE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MASONIC CARE COMMUNITY OF NEW YORK - GROUP LIFE & DISABILITY INSURANCE PLAN
|
2013
|
135563012
|
2014-08-15
|
TRUSTEES OF THE MASONIC HALL AND ASYLUM FUND
|
909
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2001-01-01
|
Business code |
623000
|
Sponsor’s telephone number |
3157984909
|
Plan
sponsor’s DBA name |
MASONIC CARE COMMUNITY OF NEW YORK
|
Plan sponsor’s mailing address |
2150 BLEECKER STREET, UTICA, NY, 13501
|
Plan sponsor’s
address |
2150 BLEECKER STREET, UTICA, NY, 13501
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-08-14 |
Name of individual signing |
ROBERT RAFFLE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL INSURANCE PLAN OF THE MASONIC CARE COMMUNITY OF NEW YORK
|
2012
|
135563012
|
2013-07-11
|
TRUSTEES OF THE MASONIC HALL AND ASYLUM FUND
|
168
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
1992-01-01
|
Business code |
623000
|
Sponsor’s telephone number |
3157984858
|
Plan
sponsor’s DBA name |
MASONIC CARE COMMUNITY OF NEW YORK
|
Plan sponsor’s mailing address |
2150 BLEECKER STREET, UTICA, NY, 13501
|
Plan sponsor’s
address |
2150 BLEECKER STREET, UTICA, NY, 13501
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-07-11 |
Name of individual signing |
ROBERT RAFFLE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MASONIC CARE COMMUNITY OF NEW YORK - GROUP LIFE & DISABILITY INSURANCE PLAN
|
2012
|
135563012
|
2013-07-11
|
TRUSTEES OF THE MASONIC HALL AND ASYLUM FUND
|
897
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2001-01-01
|
Business code |
623000
|
Sponsor’s telephone number |
3157984858
|
Plan
sponsor’s DBA name |
MASONIC CARE COMMUNITY OF NEW YORK
|
Plan sponsor’s mailing address |
2150 BLEECKER STREET, UTICA, NY, 13501
|
Plan sponsor’s
address |
2150 BLEECKER STREET, UTICA, NY, 13501
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-07-11 |
Name of individual signing |
ROBERT RAFFLE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MASONIC CARE COMMUNITY OF NEW YORK - HEALTH PLAN
|
2012
|
135563012
|
2013-07-11
|
TRUSTEES OF THE MASONIC HALL AND ASYLUM FUND
|
457
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1968-01-01
|
Business code |
623000
|
Sponsor’s telephone number |
3157984858
|
Plan
sponsor’s DBA name |
MASONIC CARE COMMUNITY OF NEW YORK
|
Plan sponsor’s mailing address |
2150 BLEECKER STREET, UTICA, NY, 13501
|
Plan sponsor’s
address |
2150 BLEECKER STREET, UTICA, NY, 13501
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-07-11 |
Name of individual signing |
ROBERT RAFFLE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL INSURANCE PLAN OF THE MASONIC CARE COMMUNITY OF NEW YORK
|
2011
|
135563012
|
2012-07-31
|
TRUSTEES OF THE MASONIC HALL AND ASYLUM FUND
|
167
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
1992-01-01
|
Business code |
623000
|
Sponsor’s telephone number |
3157984811
|
Plan
sponsor’s DBA name |
MASONIC CARE COMMUNITY OF NEW YORK
|
Plan sponsor’s mailing address |
2150 BLEECKER STREET, UTICA, NY, 13501
|
Plan sponsor’s
address |
2150 BLEECKER STREET, UTICA, NY, 13501
|
Plan administrator’s name and address
Administrator’s EIN |
135563012 |
Plan administrator’s name |
TRUSTEES OF THE MASONIC HALL AND ASYLUM FUND |
Plan administrator’s
address |
2150 BLEECKER STREET, UTICA, NY, 13501 |
Administrator’s telephone number |
3157984811 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-07-31 |
Name of individual signing |
ROBERT RAFFLE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|