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  5. CAREFIRST NY, INC.

CAREFIRST NY, INC.

Company Details

Name: CAREFIRST NY, INC.
Jurisdiction: New York
Legal type: DOMESTIC NOT-FOR-PROFIT CORPORATION
Status: Active
Date of registration: 31 Mar 1982 (43 years ago)
Entity Number: 761006
ZIP code: 14830
County: Chemung
Place of Formation: New York
Address: 11751 EAST CORNING ROAD, CORNING, NY, United States, 14830

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CAYUGA COUNTY CHAMBER OF COMMERCE INC. 401(K) PLAN 2023 222416679 2024-10-04 CAREFIRST NY, INC. 99
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2016-04-29
Business code 621610
Sponsor’s telephone number 6079624100
Plan sponsor’s address 3805 MEADS CREEK ROAD, PAINTED POST, NY, 14870

Plan administrator’s name and address
Administrator’s EIN 454813650
Plan administrator’s name 3(16) FIDUCIARY SERVICES CORPORATION
Plan administrator’s address 6234 OLD HIGHWAY 5 STE D9 #508, WOODSTOCK, GA, 30188
Administrator’s telephone number 5614402139

Signature of
Role Plan administrator
Date 2024-10-03
Name of individual signing CAITLIN WEST
Valid signature Filed with authorized/valid electronic signature
CAYUGA COUNTY CHAMBER OF COMMERCE INC. 401(K) PLAN 2022 222416679 2023-10-17 CAREFIRST NY, INC. 92
Three-digit plan number (PN) 002
Effective date of plan 2016-04-29
Business code 621610
Sponsor’s telephone number 6079624100
Plan sponsor’s address 3805 MEADS CREEK ROAD, PAINTED POST, NY, 14870

Plan administrator’s name and address
Administrator’s EIN 454813650
Plan administrator’s name 3(16) FIDUCIARY SERVICES CORPORATION
Plan administrator’s address 6234 OLD HIGHWAY 5 STE D9 #508, WOODSTOCK, GA, 30188
Administrator’s telephone number 5614402139

Signature of
Role Plan administrator
Date 2023-10-16
Name of individual signing DONAL K FORD
CAYUGA COUNTY CHAMBER OF COMMERCE INC. 401(K) PLAN 2021 222416679 2022-09-27 CAREFIRST NY, INC. 85
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2016-04-29
Business code 621610
Sponsor’s telephone number 6079624100
Plan sponsor’s address 3805 MEADS CREEK ROAD, PAINTED POST, NY, 14870

Plan administrator’s name and address
Administrator’s EIN 454813650
Plan administrator’s name 3(16) FIDUCIARY SERVICES CORPORATION
Plan administrator’s address 6234 OLD HIGHWAY 5 STE D9 #508, WOODSTOCK, GA, 30188
Administrator’s telephone number 5614402139

Signature of
Role Plan administrator
Date 2022-09-25
Name of individual signing DONAL K FORD
CAYUGA COUNTY CHAMBER OF COMMERCE INC. 401(K) PLAN 2020 222416679 2021-08-17 CAREFIRST NY, INC. 88
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2016-04-29
Business code 621610
Sponsor’s telephone number 6079624100
Plan sponsor’s address 3805 MEADS CREEK ROAD, PAINTED POST, NY, 14870

Plan administrator’s name and address
Administrator’s EIN 454813650
Plan administrator’s name 3(16) FIDUCIARY SERVICES CORPORATION
Plan administrator’s address 6234 OLD HIGHWAY 5 STE D9 #508, WOODSTOCK, GA, 30188
Administrator’s telephone number 5614402139

Signature of
Role Plan administrator
Date 2021-08-17
Name of individual signing DONAL K FORD
CAYUGA COUNTY CHAMBER OF COMMERCE INC. 401(K) PLAN 2019 222416679 2020-10-05 CAREFIRST NY, INC. 82
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2016-04-29
Business code 621610
Sponsor’s telephone number 6079624100
Plan sponsor’s address 3805 MEADS CREEK ROAD, PAINTED POST, NY, 14870

Plan administrator’s name and address
Administrator’s EIN 454813650
Plan administrator’s name 3(16) FIDUCIARY SERVICES CORPORATION
Plan administrator’s address 6234 OLD HIGHWAY 5 STE D9 #508, WOODSTOCK, GA, 30188
Administrator’s telephone number 5614402139

Signature of
Role Plan administrator
Date 2020-10-05
Name of individual signing DONAL K FORD
CAREFIRST NY, INC. RETIREMENT SAVINGS PLAN 2015 222416679 2016-02-23 CAREFIRST NY, INC. 92
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1982-03-01
Business code 621399
Sponsor’s telephone number 6079623100
Plan sponsor’s address 3805 MEADS CREEK ROAD, PAINTED POST, NY, 14870

Signature of
Role Plan administrator
Date 2016-02-23
Name of individual signing STACEY LEE
CAREFIRST NY, INC. RETIREMENT SAVINGS PLAN 2015 222416679 2016-12-13 CAREFIRST NY, INC. 82
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1982-03-01
Business code 621399
Sponsor’s telephone number 6079623100
Plan sponsor’s address 3805 MEADS CREEK ROAD, PAINTED POST, NY, 14870

Signature of
Role Plan administrator
Date 2016-12-13
Name of individual signing STACEY LEE
CAREFIRST NY, INC. RETIREMENT SAVINGS PLAN 2014 222416679 2015-04-07 CAREFIRST NY, INC. 100
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1982-03-01
Business code 621399
Sponsor’s telephone number 6079623100
Plan sponsor’s address 11751 E. CORNING ROAD, CORNING, NY, 14830

Signature of
Role Plan administrator
Date 2015-04-07
Name of individual signing STACEY LEE
CAREFIRST NY, INC. RETIREMENT SAVINGS PLAN 2013 222416679 2014-09-29 CAREFIRST NY, INC. 106
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1982-03-01
Business code 621399
Sponsor’s telephone number 6079623100
Plan sponsor’s address 11751 E. CORNING ROAD, CORNING, NY, 14830

Signature of
Role Plan administrator
Date 2014-09-29
Name of individual signing STACEY LEE
CAREFIRST NY, INC. RETIREMENT SAVINGS PLAN 2012 222416679 2013-09-26 CAREFIRST NY, INC. 63
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1982-03-01
Business code 621399
Sponsor’s telephone number 6079623100
Plan sponsor’s address 11751 E. CORNING ROAD, CORNING, NY, 14830

Signature of
Role Plan administrator
Date 2013-09-26
Name of individual signing STACEY LEE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 11751 EAST CORNING ROAD, CORNING, NY, United States, 14830

History

Start date End date Type Value
2002-06-07 2012-08-01 Name SOUTHERN TIER HOSPICE AND PALLIATIVE CARE
2002-06-07 2012-08-01 Address 11751 EAST CORNING ROAD, CORNING, NY, 14830, USA (Type of address: Service of Process)
1986-06-09 2002-06-07 Name SOUTHERN TIER HOSPICE CORPORATION
1982-03-31 1986-06-09 Name SOUTHERN TIER HOSPICARE CORPORATION
1982-03-31 2002-06-07 Address 175 GRAND CENTRAL AVE., ELMIRA HEIGHTS, NY, 14903, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
120801000297 2012-08-01 CERTIFICATE OF AMENDMENT 2012-08-01
020607000108 2002-06-07 CERTIFICATE OF AMENDMENT 2002-06-07
B367614-9 1986-06-09 CERTIFICATE OF AMENDMENT 1986-06-09
A855012-11 1982-03-31 CERTIFICATE OF INCORPORATION 1982-03-31

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Related by address

11751 EAST CORNING ROAD, CORNING, NY, United States, 14830

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Date of last update: 16 Nov 2024

Sources: New York Secretary of State

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