KIONIX DENTAL AND VISION
|
2012
|
522281536
|
2013-10-15
|
KIONIX, INC.
|
198
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2002-01-01
|
Business code |
334410
|
Sponsor’s telephone number |
6072571080
|
Plan
sponsor’s DBA name |
KIONIX, INC.
|
Plan sponsor’s mailing address |
36 THORNWOOD DRIVE, ITHACA, NY, 14850
|
Plan sponsor’s
address |
36 THORNWOOD DRIVE, ITHACA, NY, 14850
|
Plan administrator’s name and address
Administrator’s EIN |
522281536 |
Plan administrator’s name |
KIONIX, INC. |
Plan administrator’s
address |
36 THORNWOOD DRIVE, ITHACA, NY, 14850 |
Administrator’s telephone number |
6072571080 |
Number of participants as of the end of the plan year
Active participants |
208 |
Retired or separated participants receiving
benefits |
2 |
Signature of
Role |
Plan administrator |
Date |
2013-10-15 |
Name of individual signing |
KEVIN KERSEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-10-15 |
Name of individual signing |
KEVIN KERSEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
KIONIX HEALTH REIMBURSEMENT ACCOUNT AND HIGH DEDUCTIBLE HEALTH PLAN
|
2012
|
522281536
|
2013-10-15
|
KIONIX, INC.
|
198
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2002-03-01
|
Business code |
334410
|
Plan sponsor’s mailing address |
36 THORNWOOD DRIVE, ITHACA, NY, 14850
|
Plan sponsor’s
address |
36 THORNWOOD DRIVE, ITHACA, NY, 14850
|
Number of participants as of the end of the plan year
Active participants |
208 |
Retired or separated participants receiving
benefits |
4 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2013-10-14 |
Name of individual signing |
KEVIN KERSEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
KIONIX LONG TERM DISABILITY PLAN
|
2012
|
522281536
|
2013-10-15
|
KIONIX, INC.
|
198
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
1998-10-01
|
Business code |
334410
|
Plan sponsor’s mailing address |
36 THORNWOOD DRIVE, ITHACA, NY, 14850
|
Plan sponsor’s
address |
36 THORNWOOD DRIVE, ITHACA, NY, 14850
|
Plan administrator’s name and address
Administrator’s EIN |
042845273 |
Plan administrator’s name |
SUN LIFE INSURANCE AND ANNUITY COMPANY OF NY |
Plan administrator’s
address |
ONE SUN LIFE EXECUTIVE PARK, WELLESLEY, MA, 02481 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-10-15 |
Name of individual signing |
KEVIN KERSEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
KIONIX FLEXIBLE SPENDING ACCOUNTS PLAN
|
2012
|
522281536
|
2013-10-15
|
KIONIX, INC.
|
198
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2001-01-01
|
Business code |
334410
|
Plan sponsor’s mailing address |
36 THORNWOOD DRIVE, ITHACA, NY, 14850
|
Plan sponsor’s
address |
36 THORNWOOD DRIVE, ITHACA, NY, 14850
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-10-15 |
Name of individual signing |
KEVIN KERSEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-10-15 |
Name of individual signing |
KEVIN KERSEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
KIONIX DENTAL AND VISION
|
2011
|
522281536
|
2012-08-17
|
KIONIX, INC.
|
160
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2002-01-01
|
Business code |
334410
|
Sponsor’s telephone number |
6072571080
|
Plan
sponsor’s DBA name |
KIONIX, INC.
|
Plan sponsor’s mailing address |
36 THORNWOOD DRIVE, ITHACA, NY, 14850
|
Plan sponsor’s
address |
36 THORNWOOD DRIVE, ITHACA, NY, 14850
|
Plan administrator’s name and address
Administrator’s EIN |
522281536 |
Plan administrator’s name |
KIONIX, INC. |
Plan administrator’s
address |
36 THORNWOOD DRIVE, ITHACA, NY, 14850 |
Administrator’s telephone number |
6072571080 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-08-17 |
Name of individual signing |
KEVIN KERSEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
KIONIX LONG TERM DISABILITY PLAN
|
2011
|
522281536
|
2012-08-17
|
KIONIX, INC.
|
160
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
1998-10-01
|
Business code |
334410
|
Plan
sponsor’s DBA name |
KIONIX, INC.
|
Plan sponsor’s mailing address |
36 THORNWOOD DRIVE, ITHACA, NY, 14850
|
Plan sponsor’s
address |
36 THORNWOOD DRIVE, ITHACA, NY, 14850
|
Plan administrator’s name and address
Administrator’s EIN |
522281536 |
Plan administrator’s name |
KIONIX, INC. |
Plan administrator’s
address |
36 THORNWOOD DRIVE, ITHACA, NY, 14850 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-08-17 |
Name of individual signing |
KEVIN KERSEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
KIONIX FLEXIBLE SPENDING ACCOUNTS PLAN
|
2011
|
522281536
|
2012-08-17
|
KIONIX, INC.
|
160
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2001-01-01
|
Business code |
334410
|
Plan
sponsor’s DBA name |
KIONIX, INC.
|
Plan sponsor’s mailing address |
36 THORNWOOD DRIVE, ITHACA, NY, 14850
|
Plan sponsor’s
address |
36 THORNWOOD DRIVE, ITHACA, NY, 14850
|
Plan administrator’s name and address
Administrator’s EIN |
522281536 |
Plan administrator’s name |
KIONIX, INC. |
Plan administrator’s
address |
36 THORNWOOD DRIVE, ITHACA, NY, 14850 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-08-17 |
Name of individual signing |
KEVIN KERSEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
KIONIX HEALTH REIMBURSEMENT ACCOUNT AND HIGH DEDUCTIBLE HEALTH PLAN
|
2011
|
522281536
|
2012-08-17
|
KIONIX, INC.
|
160
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2002-03-01
|
Business code |
334410
|
Plan
sponsor’s DBA name |
KIONIX, INC
|
Plan sponsor’s mailing address |
36 THORNWOOD DRIVE, ITHACA, NY, 14850
|
Plan sponsor’s
address |
36 THORNWOOD DRIVE, ITHACA, NY, 14850
|
Plan administrator’s name and address
Administrator’s EIN |
522281536 |
Plan administrator’s name |
KIONIX, INC. |
Plan administrator’s
address |
36 THORNWOOD DRIVE, ITHACA, NY, 14850 |
Number of participants as of the end of the plan year
Active participants |
197 |
Retired or separated participants receiving
benefits |
1 |
Signature of
Role |
Plan administrator |
Date |
2012-08-17 |
Name of individual signing |
KEVIN KERSEY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HEALTH REIMBURSEMENT ACCOUNT AND HIGH DEDUCTIBLE HEALTH PLAN
|
2010
|
522281536
|
2011-10-10
|
KIONIX, INC.
|
147
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2002-03-01
|
Business code |
334410
|
Sponsor’s telephone number |
6072571080
|
Plan
sponsor’s DBA name |
KIONIX, INC.
|
Plan sponsor’s mailing address |
36 THORNWOOD DRIVE, ITHACA, NY, 14850
|
Plan sponsor’s
address |
36 THORNWOOD DRIVE, ITHACA, NY, 14850
|
Plan administrator’s name and address
Administrator’s EIN |
522281536 |
Plan administrator’s name |
KIONIX, INC. |
Plan administrator’s
address |
36 THORNWOOD DRIVE, ITHACA, NY, 14850 |
Administrator’s telephone number |
6072571080 |
Number of participants as of the end of the plan year
Active participants |
160 |
Retired or separated participants receiving
benefits |
2 |
Signature of
Role |
Plan administrator |
Date |
2011-10-10 |
Name of individual signing |
DEBBIE CHADWICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FLEXIBLE SPENDING ACCOUNTS PLAN
|
2010
|
522281536
|
2011-10-10
|
KIONIX, INC.
|
147
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2001-01-01
|
Business code |
334410
|
Sponsor’s telephone number |
6072571080
|
Plan
sponsor’s DBA name |
KIONIX, INC.
|
Plan sponsor’s mailing address |
36 THORNWWOD DRIVE, ITHACA, NY, 14850
|
Plan sponsor’s
address |
36 THORNWWOD DRIVE, ITHACA, NY, 14850
|
Plan administrator’s name and address
Administrator’s EIN |
522281536 |
Plan administrator’s name |
KIONIX, INC. |
Plan administrator’s
address |
36 THORNWWOD DRIVE, ITHACA, NY, 14850 |
Administrator’s telephone number |
6072571080 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2011-10-10 |
Name of individual signing |
DEBBIE CHADWICK |
Valid signature |
Filed with authorized/valid electronic signature |
|
|