|
CHENANGO MEMORIAL HOSPITAL EMPLOYEES' PENSION PLAN
|
2023
|
150532180
|
2024-10-15
|
CHENANGO MEMORIAL HOSPITAL
|
761
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1969-01-01
|
| Business code |
622000
|
| Sponsor’s telephone number |
6073374111
|
| Plan sponsor’s mailing address |
179 NORTH BROAD STREET, NORWICH, NY, 138151019
|
| Plan sponsor’s
address |
179 NORTH BROAD STREET, NORWICH, NY, 138151019
|
Number of participants as of the end of the plan year
| Active participants |
107 |
| Retired or separated participants receiving
benefits |
326 |
| Other
retired or separated participants entitled to future benefits |
287 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
30 |
Signature of
| Role |
Plan administrator |
| Date |
2024-10-12 |
| Name of individual signing |
JENNIFER BAGGERMAN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CHENANGO MEMORIAL HOSPITAL EMPLOYEES' PENSION PLAN
|
2022
|
150532180
|
2023-10-16
|
CHENANGO MEMORIAL HOSPITAL
|
770
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1969-01-01
|
| Business code |
622000
|
| Sponsor’s telephone number |
6073374111
|
| Plan sponsor’s mailing address |
179 NORTH BROAD STREET, NORWICH, NY, 138151019
|
| Plan sponsor’s
address |
179 NORTH BROAD STREET, NORWICH, NY, 138151019
|
Number of participants as of the end of the plan year
| Active participants |
124 |
| Retired or separated participants receiving
benefits |
319 |
| Other
retired or separated participants entitled to future benefits |
284 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
34 |
Signature of
| Role |
Plan administrator |
| Date |
2023-10-04 |
| Name of individual signing |
SHERI A. LAMOUREUX |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CHENANGO MEMORIAL HOSPITAL EMPLOYEES' PENSION PLAN
|
2021
|
150532180
|
2022-10-14
|
CHENANGO MEMORIAL HOSPITAL
|
784
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1969-01-01
|
| Business code |
622000
|
| Sponsor’s telephone number |
6073374111
|
| Plan sponsor’s mailing address |
179 NORTH BROAD STREET, NORWICH, NY, 138151019
|
| Plan sponsor’s
address |
179 NORTH BROAD STREET, NORWICH, NY, 138151019
|
Number of participants as of the end of the plan year
| Active participants |
145 |
| Retired or separated participants receiving
benefits |
311 |
| Other
retired or separated participants entitled to future benefits |
286 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
28 |
Signature of
| Role |
Plan administrator |
| Date |
2022-10-06 |
| Name of individual signing |
SHERI A. LAMOUREUX |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CHENANGO MEMORIAL HOSPITAL EMPLOYEES' PENSION PLAN
|
2020
|
150532180
|
2021-10-14
|
CHENANGO MEMORIAL HOSPITAL
|
786
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1969-01-01
|
| Business code |
622000
|
| Sponsor’s telephone number |
6073374111
|
| Plan sponsor’s mailing address |
179 NORTH BROAD STREET, NORWICH, NY, 138151019
|
| Plan sponsor’s
address |
179 NORTH BROAD STREET, NORWICH, NY, 138151019
|
Number of participants as of the end of the plan year
| Active participants |
164 |
| Retired or separated participants receiving
benefits |
297 |
| Other
retired or separated participants entitled to future benefits |
297 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
26 |
Signature of
| Role |
Plan administrator |
| Date |
2021-10-13 |
| Name of individual signing |
SHERI A. LAMOUREUX |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CHENANGO MEMORIAL HOSPITAL EMPLOYEES' PENSION PLAN
|
2019
|
150532180
|
2020-10-15
|
CHENANGO MEMORIAL HOSPITAL
|
791
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1969-01-01
|
| Business code |
622000
|
| Sponsor’s telephone number |
6073374111
|
| Plan sponsor’s mailing address |
179 NORTH BROAD STREET, NORWICH, NY, 138151019
|
| Plan sponsor’s
address |
179 NORTH BROAD STREET, NORWICH, NY, 138151019
|
Number of participants as of the end of the plan year
| Active participants |
173 |
| Retired or separated participants receiving
benefits |
282 |
| Other
retired or separated participants entitled to future benefits |
306 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
25 |
Signature of
| Role |
Plan administrator |
| Date |
2020-09-10 |
| Name of individual signing |
SHERI A. LAMOUREUX |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
CHENANGO MEMORIAL HOSPITAL EMPLOYEES' PENSION PLAN
|
2018
|
150532180
|
2019-10-15
|
CHENANGO MEMORIAL HOSPITAL
|
797
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
1969-01-01
|
| Business code |
622000
|
| Sponsor’s telephone number |
6073374111
|
| Plan sponsor’s mailing address |
179 NORTH BROAD STREET, NORWICH, NY, 138151019
|
| Plan sponsor’s
address |
179 NORTH BROAD STREET, NORWICH, NY, 138151019
|
Number of participants as of the end of the plan year
| Active participants |
206 |
| Retired or separated participants receiving
benefits |
269 |
| Other
retired or separated participants entitled to future benefits |
294 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
22 |
| Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
1 |
Signature of
| Role |
Plan administrator |
| Date |
2019-10-15 |
| Name of individual signing |
SHERI A. LAMOUREUX |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
GROUP HEALTH INSURANCE PLAN FOR ALL EMPLOYEES OF CHENANGO MEMORIAL HOSPITAL
|
2010
|
150532180
|
2011-06-16
|
CHENANGO MEMORIAL HOSPITAL, INC.
|
343
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
504
|
| Effective date of plan |
1943-07-20
|
| Business code |
622000
|
| Sponsor’s telephone number |
6073374111
|
| Plan sponsor’s mailing address |
179 NORTH BROAD STREET, NORWICH, NY, 13815
|
| Plan sponsor’s
address |
179 NORTH BROAD STREET, NORWICH, NY, 13815
|
Plan administrator’s name and address
| Administrator’s EIN |
150532180 |
| Plan administrator’s name |
CHENANGO MEMORIAL HOSPITAL, INC. |
| Plan administrator’s
address |
179 NORTH BROAD STREET, NORWICH, NY, 13815 |
| Administrator’s telephone number |
6073374111 |
Number of participants as of the end of the plan year
| Active participants |
377 |
| Retired or separated participants receiving
benefits |
8 |
Signature of
| Role |
Plan administrator |
| Date |
2011-06-14 |
| Name of individual signing |
KATHERINE DIAZ |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2011-06-16 |
| Name of individual signing |
DRAKE LAMEN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
GROUP HEALTH INSURANCE PLAN FOR ALL EMPLOYEES OF CHENANGO MEMORIAL HOSPITAL
|
2009
|
150532180
|
2010-07-30
|
CHENANGO MEMORIAL HOSPITAL, INC.
|
313
|
|
| Three-digit plan number (PN) |
504
|
| Effective date of plan |
1943-07-20
|
| Business code |
622000
|
| Sponsor’s telephone number |
6073374111
|
| Plan sponsor’s mailing address |
179 NORTH BROAD STREET, NORWICH, NY, 13815
|
| Plan sponsor’s
address |
179 NORTH BROAD STREET, NORWICH, NY, 13815
|
Plan administrator’s name and address
| Administrator’s EIN |
150532180 |
| Plan administrator’s name |
CHENANGO MEMORIAL HOSPITAL, INC. |
| Plan administrator’s
address |
179 NORTH BROAD STREET, NORWICH, NY, 13815 |
| Administrator’s telephone number |
6073374111 |
Number of participants as of the end of the plan year
| Active participants |
338 |
| Retired or separated participants receiving
benefits |
5 |
Signature of
| Role |
Employer/plan sponsor |
| Date |
2010-07-30 |
| Name of individual signing |
DRAKE LAMEN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
GROUP HEALTH INSURANCE PLAN FOR ALL EMPLOYEES OF CHENANGO MEMORIAL HOSPITAL
|
2009
|
150532180
|
2010-07-30
|
CHENANGO MEMORIAL HOSPITAL, INC.
|
313
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
504
|
| Effective date of plan |
1943-07-20
|
| Business code |
622000
|
| Sponsor’s telephone number |
6073374111
|
| Plan sponsor’s mailing address |
179 NORTH BROAD STREET, NORWICH, NY, 13815
|
| Plan sponsor’s
address |
179 NORTH BROAD STREET, NORWICH, NY, 13815
|
Plan administrator’s name and address
| Administrator’s EIN |
150532180 |
| Plan administrator’s name |
CHENANGO MEMORIAL HOSPITAL, INC. |
| Plan administrator’s
address |
179 NORTH BROAD STREET, NORWICH, NY, 13815 |
| Administrator’s telephone number |
6073374111 |
Number of participants as of the end of the plan year
| Active participants |
338 |
| Retired or separated participants receiving
benefits |
5 |
Signature of
| Role |
Plan administrator |
| Date |
2010-07-30 |
| Name of individual signing |
KATHERINE DIAZ |
| Valid signature |
Filed with authorized/valid electronic signature |
|
| Role |
Employer/plan sponsor |
| Date |
2010-07-30 |
| Name of individual signing |
DRAKE LAMEN |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
