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  5. THE MOUNT VERNON HOSPITAL

THE MOUNT VERNON HOSPITAL

Company Details

Name: THE MOUNT VERNON HOSPITAL
Jurisdiction: New York
Legal type: DOMESTIC NOT-FOR-PROFIT CORPORATION
Status: Active
Date of registration: 13 Dec 1890 (134 years ago)
Entity Number: 26420
ZIP code: 10550
County: Westchester
Place of Formation: New York
Address: C/O PRESIDENT, 12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, United States, 10550

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
THE MOUNT VERNON HOSPITAL EMPLOYEES' RETIREMENT BENEFIT PLAN 2016 131740115 2017-08-08 THE MOUNT VERNON HOSPITAL 63
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-01-01
Business code 622000
Sponsor’s telephone number 9146648000
Plan sponsor’s address 12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550

Signature of
Role Plan administrator
Date 2017-08-07
Name of individual signing MONICA TERRANO
THE MOUNT VERNON HOSPITAL EMPLOYEES' RETIREMENT BENEFIT PLAN 2015 131740115 2016-09-14 THE MOUNT VERNON HOSPITAL 88
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-01-01
Business code 622000
Sponsor’s telephone number 9146648000
Plan sponsor’s address 12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550

Signature of
Role Plan administrator
Date 2016-09-14
Name of individual signing MONICA TERRANO
THE MOUNT VERNON HOSPITAL EMPLOYEES' RETIREMENT BENEFIT PLAN 2014 131740115 2015-10-13 THE MOUNT VERNON HOSPITAL 184
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-01-01
Business code 622000
Sponsor’s telephone number 9146648000
Plan sponsor’s mailing address 12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
Plan sponsor’s address 12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550

Plan administrator’s name and address
Administrator’s EIN 131740115
Plan administrator’s name THE MOUNT VERNON HOSPITAL
Plan administrator’s address 12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
Administrator’s telephone number 9146648000

Number of participants as of the end of the plan year
Active participants 0
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 88
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 88
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2

Signature of
Role Plan administrator
Date 2015-10-12
Name of individual signing MONICA TERRANO
Valid signature Filed with authorized/valid electronic signature
THE MOUNT VERNON HOSPITAL EMPLOYEES' RETIREMENT BENEFIT PLAN 2013 131740115 2015-10-12 THE MOUNT VERNON HOSPITAL 198
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-01-01
Business code 622000
Sponsor’s telephone number 9146648000
Plan sponsor’s mailing address 12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
Plan sponsor’s address 12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550

Plan administrator’s name and address
Administrator’s EIN 131740115
Plan administrator’s name THE MOUNT VERNON HOSPITAL
Plan administrator’s address 12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
Administrator’s telephone number 9146648000

Number of participants as of the end of the plan year
Active participants 65
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 119
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 184
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 2015-10-12
Name of individual signing MONICA TERRANO
Valid signature Filed with authorized/valid electronic signature
THE MOUNT VERNON HOSPITAL EMPLOYEES' RETIREMENT BENEFIT PLAN 2012 131740115 2013-10-15 THE MOUNT VERNON HOSPITAL 213
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-01-01
Business code 622000
Sponsor’s telephone number 9146648000
Plan sponsor’s mailing address 12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
Plan sponsor’s address 12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550

Plan administrator’s name and address
Administrator’s EIN 131740115
Plan administrator’s name THE MOUNT VERNON HOSPITAL
Plan administrator’s address 12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
Administrator’s telephone number 9146648000

Number of participants as of the end of the plan year
Active participants 160
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 38
Number of participants with account balances as of the end of the plan year 198
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 2013-10-15
Name of individual signing JOHN LJULJIC
Valid signature Filed with authorized/valid electronic signature
THE MOUNT VERNON HOSPITAL HEALTH BENEFIT PLAN 2012 131740115 2013-10-14 THE MOUNT VERNON HOSPITAL 271
File View Page
Three-digit plan number (PN) 501
Effective date of plan 1981-01-01
Business code 622000
Sponsor’s telephone number 9146648000
Plan sponsor’s mailing address 12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
Plan sponsor’s address 12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550

Plan administrator’s name and address
Administrator’s EIN 131740115
Plan administrator’s name THE MOUNT VERNON HOSPITAL
Plan administrator’s address 12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
Administrator’s telephone number 9146648000

Number of participants as of the end of the plan year
Active participants 270
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

Signature of
Role Plan administrator
Date 2013-10-14
Name of individual signing JOHN LJULJIC
Valid signature Filed with authorized/valid electronic signature
MOUNT VERNON HOSPITAL HEALTH BENEFIT PLAN FOR NURSES 2012 131740115 2013-10-14 THE MOUNT VERNON HOSPITAL 196
File View Page
Three-digit plan number (PN) 502
Effective date of plan 2008-01-01
Business code 622000
Sponsor’s telephone number 9146648000
Plan sponsor’s mailing address 12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
Plan sponsor’s address 12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550

Plan administrator’s name and address
Administrator’s EIN 131740115
Plan administrator’s name THE MOUNT VERNON HOSPITAL
Plan administrator’s address 12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
Administrator’s telephone number 9146648000

Number of participants as of the end of the plan year
Active participants 89
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

Signature of
Role Plan administrator
Date 2013-10-14
Name of individual signing JOHN LJULJIC
Valid signature Filed with authorized/valid electronic signature
THE HEALTH BENEFIT PLAN FOR THE MOUNT VERNON HOSPITAL 2012 131740115 2013-10-14 THE MOUNT VERNON HOSPITAL 33
File View Page
Three-digit plan number (PN) 503
Effective date of plan 2008-01-01
Business code 622000
Sponsor’s telephone number 9146648000
Plan sponsor’s mailing address 12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
Plan sponsor’s address 12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550

Plan administrator’s name and address
Administrator’s EIN 131740115
Plan administrator’s name THE MOUNT VERNON HOSPITAL
Plan administrator’s address 12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
Administrator’s telephone number 9146648000

Number of participants as of the end of the plan year
Active participants 32
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

Signature of
Role Plan administrator
Date 2013-10-14
Name of individual signing JOHN LJULJIC
Valid signature Filed with authorized/valid electronic signature
MOUNT VERNON HOSPITAL FLEXIBLE SPENDING PLAN 2012 131740115 2013-10-14 THE MOUNT VERNON HOSPITAL 14
File View Page
Three-digit plan number (PN) 504
Effective date of plan 2008-01-01
Business code 622000
Sponsor’s telephone number 9146648000
Plan sponsor’s mailing address 12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
Plan sponsor’s address 12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550

Plan administrator’s name and address
Administrator’s EIN 131740115
Plan administrator’s name THE MOUNT VERNON HOSPITAL
Plan administrator’s address 12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
Administrator’s telephone number 9146648000

Number of participants as of the end of the plan year
Active participants 10
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

Signature of
Role Plan administrator
Date 2013-10-14
Name of individual signing JOHN LJULJIC
Valid signature Filed with authorized/valid electronic signature
MOUNT VERNON HOSPITAL HEALTH PLAN FOR PHYSICIANS AND EXEMPT EMPLOYEES 2012 131740115 2013-10-14 THE MOUNT VERNON HOSPITAL 48
File View Page
Three-digit plan number (PN) 505
Effective date of plan 2009-10-01
Business code 622000
Sponsor’s telephone number 9146648000
Plan sponsor’s mailing address 12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
Plan sponsor’s address 12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550

Plan administrator’s name and address
Administrator’s EIN 131740115
Plan administrator’s name THE MOUNT VERNON HOSPITAL
Plan administrator’s address 12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550
Administrator’s telephone number 9146648000

Number of participants as of the end of the plan year
Active participants 48
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

Signature of
Role Plan administrator
Date 2013-10-14
Name of individual signing JOHN LJULJIC
Valid signature Filed with authorized/valid electronic signature

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent C/O PRESIDENT, 12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, United States, 10550

History

Start date End date Type Value
1998-04-02 1999-11-30 Address C/O PRESIDENT, 12 NORTH SEVENTH AVENUE, MOUNT VERNON, NY, 10550, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
20100729025 2010-07-29 ASSUMED NAME CORP AMENDMENT 2010-07-29
991130000141 1999-11-30 CERTIFICATE OF AMENDMENT 1999-11-30
C262732-2 1998-07-27 ASSUMED NAME CORP INITIAL FILING 1998-07-27
980402000638 1998-04-02 CERTIFICATE OF AMENDMENT 1998-04-02
392210 1963-08-05 CERTIFICATE OF AMENDMENT 1963-08-05
6EX-166 1950-12-27 CERTIFICATE OF AMENDMENT 1950-12-27
480Q-40 1947-03-11 CERTIFICATE OF AMENDMENT 1947-03-11
39P-108 1890-12-13 CERTIFICATE OF INCORPORATION 1890-12-13

Related by officers

THE CORPORATION

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Related by address

No related companies by address

Date of last update: 22 Dec 2024

Sources: New York Secretary of State

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