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CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.

Company Details

Name: CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.
Jurisdiction: New York
Legal type: DOMESTIC NOT-FOR-PROFIT CORPORATION
Status: Active
Date of registration: 13 Apr 1984 (41 years ago)
Entity Number: 909378
County: Albany
Place of Formation: New York
Address: 6 wellness way, LATHAM, NY, United States, 12110
Address ZIP Code: 12110

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
G8TQAV42WM26 2024-07-04 500 PATROON CREEK BLVD., ALBANY, NY, 12206, 1057, USA 500 PATROON CREEK BLVD, ALBANY, NY, 12206, 5006, USA

Business Information
URL www.cdphp.com
Congressional District 20
State/Country of Incorporation NY, USA
Activation Date 2023-07-06
Initial Registration Date 2016-12-01
Entity Start Date 1984-04-13
Fiscal Year End Close Date Dec 31

Service Classifications
NAICS Codes 524114

Points of Contacts
Electronic Business
Title PRIMARY POC
Name TAMMY REHM
Role SVP AUDIT AND ASSURANCE
Address 500 PATROON CREEK BLVD, ALBANY, NY, 12206, 5006, USA
Government Business
Title PRIMARY POC
Name SHEILA NELSON
Role SVP COMPLIANCE
Address 500 PATROON CREEK BLVD, ALBANY, NY, 12206, USA
Past Performance Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CDPHP WELFARE AND FRINGE BENEFITS PLAN 2022 141641028 2023-07-12 CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. 1444
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2007-01-01
Business code 524140
Sponsor’s telephone number 5186413000
Plan sponsor’s mailing address 500 PATROON CREEK BLVD, ALBANY, NY, 122065006
Plan sponsor’s address 500 PATROON CREEK BLVD, ALBANY, NY, 122065006

Plan administrator’s name and address
Administrator’s EIN 141641028
Plan administrator’s name LORI CAMMETT
Plan administrator’s address 500 PATROON CREEK BLVD, ALBANY, NY, 122065006
Administrator’s telephone number 5186413000

Number of participants as of the end of the plan year
Active participants 1422

Signature of
Role Plan administrator
Date 2023-07-12
Name of individual signing LORI CAMMETT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-07-12
Name of individual signing LORI CAMMETT
Valid signature Filed with authorized/valid electronic signature
CDPHP WELFARE AND FRINGE BENEFITS PLAN 2021 141641028 2022-07-12 CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. 1330
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2007-01-01
Business code 524140
Sponsor’s telephone number 5186413000
Plan sponsor’s mailing address 500 PATROON CREEK BLVD, ALBANY, NY, 12206
Plan sponsor’s address 500 PATROON CREEK BLVD, ALBANY, NY, 12206

Plan administrator’s name and address
Administrator’s EIN 141641028
Plan administrator’s name LORI CAMMETT
Plan administrator’s address 500 PATROON CREEK BLVD, ALBANY, NY, 122065006
Administrator’s telephone number 5186413000

Number of participants as of the end of the plan year
Active participants 1444

Signature of
Role Plan administrator
Date 2022-07-12
Name of individual signing LORI CAMMETT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-07-12
Name of individual signing LORI CAMMETT
Valid signature Filed with authorized/valid electronic signature
CDPHP WELFARE AND FRINGE BENEFITS PLAN 2020 141641028 2021-07-14 CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN 1120
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2007-01-01
Business code 524140
Sponsor’s telephone number 5186413000
Plan sponsor’s mailing address 500 PATROON CREEK BLVD, ALBANY, NY, 122065006
Plan sponsor’s address 500 PATROON CREEK BLVD, ALBANY, NY, 122065006

Plan administrator’s name and address
Administrator’s EIN 141641028
Plan administrator’s name LORI CAMMETT
Plan administrator’s address 500 PATROON CREEK BLVD, ALBANY, NY, 122065006
Administrator’s telephone number 5186413000

Number of participants as of the end of the plan year
Active participants 1330

Signature of
Role Plan administrator
Date 2021-07-14
Name of individual signing LORI CAMMETT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-07-14
Name of individual signing LORI CAMMETT
Valid signature Filed with authorized/valid electronic signature
CDPHP WELFARE AND FRINGE BENEFITS PLAN 2019 141641028 2020-07-14 CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. 1082
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2007-01-01
Business code 524140
Sponsor’s telephone number 5186413000
Plan sponsor’s mailing address 500 PATROON CREEK BLVD, ALBANY, NY, 122065006
Plan sponsor’s address 500 PATROON CREEK BLVD, ALBANY, NY, 122065006

Plan administrator’s name and address
Administrator’s EIN 141641028
Plan administrator’s name LORI CAMMETT
Plan administrator’s address 500 PATROON CREEK BLVD, ALBANY, NY, 122065006
Administrator’s telephone number 5186413000

Number of participants as of the end of the plan year
Active participants 1120

Signature of
Role Plan administrator
Date 2020-07-14
Name of individual signing LORI CAMMETT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-14
Name of individual signing LORI CAMMETT
Valid signature Filed with authorized/valid electronic signature
CDPHP WELFARE AND FRINGE BENEFIT PLAN 2018 141641028 2019-07-02 CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. 1068
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2007-01-01
Business code 524140
Sponsor’s telephone number 5186413000
Plan sponsor’s mailing address 500 PATROON CREEK BLVD, ALBANY, NY, 122065006
Plan sponsor’s address 500 PATROON CREEK BLVD, ALBANY, NY, 122065006

Plan administrator’s name and address
Administrator’s EIN 141641028
Plan administrator’s name LORI CAMMETT
Plan administrator’s address 500 PATROON CREEK BLVD, ALBANY, NY, 122065006
Administrator’s telephone number 5186413000

Number of participants as of the end of the plan year
Active participants 1082

Signature of
Role Plan administrator
Date 2019-07-02
Name of individual signing LORI CAMMETT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-07-02
Name of individual signing LORI CAMMETT
Valid signature Filed with authorized/valid electronic signature
CDPHP WELFARE AND FRINGE BENEFIT PLAN 2017 141641028 2018-07-23 CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN 1058
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2007-01-01
Business code 524140
Sponsor’s telephone number 5186413000
Plan sponsor’s mailing address 500 PATROON CREEK BLVD, ALBANY, NY, 122065006
Plan sponsor’s address 500 PATROON CREEK BLVD, ALBANY, NY, 122065006

Plan administrator’s name and address
Administrator’s EIN 141641028
Plan administrator’s name CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN
Plan administrator’s address 500 PATROON CREEK BLVD, ALBANY, NY, 122065006
Administrator’s telephone number 5186413000

Number of participants as of the end of the plan year
Active participants 1068

Signature of
Role Plan administrator
Date 2018-07-23
Name of individual signing LORI CAMMETT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-07-23
Name of individual signing LORI CAMMETT
Valid signature Filed with authorized/valid electronic signature
CDPHP WELFARE AND FRINGE BENEFIT PLAN 2016 141641028 2017-07-11 CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN 1018
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2007-01-01
Business code 524140
Sponsor’s telephone number 5186413000
Plan sponsor’s mailing address 500 PATROON CREEK BLVD, ALBANY, NY, 122065006
Plan sponsor’s address 500 PATROON CREEK BLVD, ALBANY, NY, 122065006

Plan administrator’s name and address
Administrator’s EIN 141641028
Plan administrator’s name CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN
Plan administrator’s address 500 PATROON CREEK BLVD, ALBANY, NY, 122065006
Administrator’s telephone number 5186413000

Number of participants as of the end of the plan year
Active participants 1058

Signature of
Role Plan administrator
Date 2017-07-11
Name of individual signing LORI CAMMETT
Valid signature Filed with authorized/valid electronic signature
CDPHP WELFARE AND FRINGE BENEFIT PLAN 2015 141641028 2016-07-29 CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN 1066
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2007-01-01
Business code 524140
Sponsor’s telephone number 5186413000
Plan sponsor’s mailing address 500 PATROON CREEK BLVD, ALBANY, NY, 122065006
Plan sponsor’s address 500 PATROON CREEK BLVD, ALBANY, NY, 122065006

Plan administrator’s name and address
Administrator’s EIN 141641028
Plan administrator’s name CAPITAL DISTRICT PHYSICIANS 'HEALTH PLAN
Plan administrator’s address 500 PATROON CREEK BLVD, ALBANY, NY, 122065006
Administrator’s telephone number 5186413000

Number of participants as of the end of the plan year
Active participants 1018

Signature of
Role Plan administrator
Date 2016-07-29
Name of individual signing LORI CAMMETT
Valid signature Filed with authorized/valid electronic signature
CDPHP WELFARE AND FRINGE BENEFIT PLAN 2011 141641028 2012-10-10 CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN 812
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2007-01-01
Business code 524140
Sponsor’s telephone number 5186413000
Plan sponsor’s mailing address 500 PATROON CREEK BLVD, ALBANY, NY, 12206
Plan sponsor’s address 500 PATROON CREEK BLVD, ALBANY, NY, 12206

Plan administrator’s name and address
Administrator’s EIN 141641028
Plan administrator’s name LORI CAMMETT
Plan administrator’s address 500 PATROON CREEK BLVD, ALBANY, NY, 12206
Administrator’s telephone number 5186413000

Number of participants as of the end of the plan year
Active participants 871

Signature of
Role Plan administrator
Date 2012-10-10
Name of individual signing LORI CAMMETT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-10
Name of individual signing SCOTT KLENK
Valid signature Filed with authorized/valid electronic signature
CDPHP WELFARE AND FRINGE BENEFIT PLAN 2010 141641028 2012-10-10 CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN 778
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2007-01-01
Business code 524140
Sponsor’s telephone number 5186413000
Plan sponsor’s mailing address 500 PATROON CREEK BLVD, ALBANY, NY, 12206
Plan sponsor’s address 500 PATROON CREEK BLVD, ALBANY, NY, 12206

Plan administrator’s name and address
Administrator’s EIN 141641028
Plan administrator’s name CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN
Plan administrator’s address 500 PATROON CREEK BLVD, ALBANY, NY, 12206
Administrator’s telephone number 5186413000

Number of participants as of the end of the plan year
Active participants 812
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2011-10-13
Name of individual signing LORI CAMMETT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-10-17
Name of individual signing SCOTT KLENK
Valid signature Filed with authorized/valid electronic signature

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 6 wellness way, LATHAM, NY, United States, 12110

History

Start date End date Type Value
2024-04-23 2024-05-09 Address 6 wellness way, LATHAM, NY, 12110, USA (Type of address: Service of Process)
2021-07-06 2024-04-23 Address 500 PATROON CREEK BLVD., ALBANY, NY, 12206, 1057, USA (Type of address: Service of Process)
2006-03-15 2021-07-06 Address 500 PATROON CREEK BLVD., ALBANY, NY, 12206, 1057, USA (Type of address: Service of Process)
2001-07-18 2006-03-15 Address PATROON CREEK CORPORATE CENTER, 1223 WASHINGTON AVENUE, ALBANY, NY, 12206, 1057, USA (Type of address: Service of Process)
1998-02-13 2001-07-18 Address 17 COLUMBIA CIRCLE, ALBANY, NY, 12203, 5190, USA (Type of address: Service of Process)
1996-08-06 1998-02-13 Address 17 COLUMBIA CIRCLE, ALBANY, NY, 12203, 5190, USA (Type of address: Service of Process)
1995-08-09 1996-08-06 Address 17 COLUMBIA CIRCLE, ALBANY, NY, 12203, USA (Type of address: Service of Process)
1987-09-18 1995-08-09 Address 5 WASHINGTON SQUARE, ALBANY, NY, 12205, USA (Type of address: Service of Process)
1984-04-13 1987-09-18 Address 301 S. ALLEN STREET, ALBANY, NY, 12208, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
240509002585 2024-05-09 RESTATED CERTIFICATE 2024-05-09
240423002937 2024-04-22 CERTIFICATE OF CHANGE BY ENTITY 2024-04-22
210706000871 2021-07-02 CERTIFICATE OF AMENDMENT 2021-07-02
060315001277 2006-03-15 CERTIFICATE OF CHANGE 2006-03-15
010718000741 2001-07-18 CERTIFICATE OF CHANGE 2001-07-18
980213000194 1998-02-13 CERTIFICATE OF AMENDMENT 1998-02-13
960806000617 1996-08-06 CERTIFICATE OF AMENDMENT 1996-08-06
950809000063 1995-08-09 CERTIFICATE OF CHANGE 1995-08-09
B545613-5 1987-09-18 CERTIFICATE OF AMENDMENT 1987-09-18
B090846-12 1984-04-13 CERTIFICATE OF INCORPORATION 1984-04-13

Related by officers

THE CORPORATION

ARSHIA DESIGNS INC. AAA VACUUM CORP. ATLANTICA TELECOM, INC. MISTY SPORTSWEAR, INC. INRACKS, INC. FAT JAMS ELECTRONICS INC. CROQUEMBOUCHE, INC. LONG BEACH PEDIATRIC GROUP, P.C. LAW OFFICES OF JOSEPH A. GRECO, P.C. TEREZ, INC.

Related by address

6 wellness way, LATHAM, NY, United States, 12110

CAPITAL DISTRICT PHYSICIANS' HEALTHCARE NETWORK, INC. CDPHP FOUNDATION, INC. CDPHP UNIVERSAL BENEFITS, INC. CONNECTRX LATHAM, LLC EXCELSIOR HEALTH, INC. EXCELSIOR PRACTICE SERVICES, LLC

Date of last update: 28 Oct 2024

Sources: New York Secretary of State

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