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CENTRAL NEW YORK HEALTH SYSTEMS AGENCY, INC.

Company Details

Name: CENTRAL NEW YORK HEALTH SYSTEMS AGENCY, INC.
Jurisdiction: New York
Legal type: DOMESTIC NOT-FOR-PROFIT CORPORATION
Status: Inactive
Date of registration: 30 Apr 1976 (49 years ago)
Date of dissolution: 22 Sep 2015
Entity Number: 398556
County: Onondaga
Place of Formation: New York

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
5HZ16 Active Non-Manufacturer 2009-06-11 2024-03-10 No data No data

Contact Information
POC SARA WALL BOLLINGER
Phone +1 315-472-8099
Fax +1 315-472-8033
Address 109 SOUTH WARREN ST SUITE 500, SYRACUSE, ONONDAGA, NY, 13202 4733, UNITED STATES

Ownership of Offeror Information
Highest Level Owner Information not Available
Immediate Level Owner Information not Available
List of Offerors (0) Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CENTRAL NEW YORK HEALTH SYSTEMS AGENCY, INC. 2011 161064267 2015-06-02 CENTRAL NEW YORK HEALTH SYSTEMS AGENCY, INC. 9
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1975-09-01
Business code 813000
Sponsor’s telephone number 3154728099
Plan sponsor’s DBA name CNYHSA & HEALTHECONNECTIONS HSA
Plan sponsor’s address 109 SOUTH WARREN STREET, SUITE 500, SYRACUSE, NY, 13202

Plan administrator’s name and address
Administrator’s EIN 161064267
Plan administrator’s name CENTRAL NEW YORK HEALTH SYSTEMS AGENCY, INC.
Plan administrator’s address 109 SOUTH WARREN STREET, SUITE 500, SYRACUSE, NY, 13202
Administrator’s telephone number 3154728099

Signature of
Role Plan administrator
Date 2015-06-02
Name of individual signing ROB HACK
Role Employer/plan sponsor
Date 2015-06-02
Name of individual signing ROB HACK
CENTRAL NEW YORK HEALTH SYSTEMS AGENCY, INC. RETIREMENT PLAN 2011 161064267 2012-10-23 CENTRAL NEW YORK HEALTH SYSTEMS AGENCY, INC. 9
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1975-09-01
Business code 813000
Sponsor’s telephone number 3154728099
Plan sponsor’s DBA name CNYHSA & HEALTHECONNECTIONS HSA
Plan sponsor’s mailing address 109 SOUTH WARREN STREET, SUITE 500, SYRACUSE, NY, 13202
Plan sponsor’s address 109 SOUTH WARREN STREET, SUITE 500, SYRACUSE, NY, 13202

Plan administrator’s name and address
Administrator’s EIN 161064267
Plan administrator’s name DEBBIE BROWN
Plan administrator’s address 109 SOUTH WARREN STREET, SUITE 500, SYRACUSE, NY, 13202
Administrator’s telephone number 3154728099

Number of participants as of the end of the plan year
Active participants 4
Retired or separated participants receiving benefits 5

Signature of
Role Plan administrator
Date 2012-10-23
Name of individual signing DEBBIE BROWN
Valid signature Filed with authorized/valid electronic signature
CENTRAL NEW YORK HEALTH SYSTEMS AGENCY, INC. RETIREMENT PLAN 2010 161064267 2011-10-13 CENTRAL NEW YORK HEALTH SYSTEMS AGENCY, INC. 10
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1975-09-01
Business code 813000
Sponsor’s telephone number 3154728099
Plan sponsor’s DBA name CNYHSA
Plan sponsor’s mailing address 5700 COMMONS PARK DRIVE, EAST SYRACUSE, NY, 13057
Plan sponsor’s address 5700 COMMONS PARK DRIVE, EAST SYRACUSE, NY, 13057

Plan administrator’s name and address
Administrator’s EIN 161064267
Plan administrator’s name DEBBIE BROWN
Plan administrator’s address 5700 COMMONS PARK DRIVE, EAST SYRACUSE, NY, 13057
Administrator’s telephone number 3154728099

Number of participants as of the end of the plan year
Active participants 4
Retired or separated participants receiving benefits 6

Signature of
Role Plan administrator
Date 2011-10-13
Name of individual signing DEBBIE BROWN
Valid signature Filed with authorized/valid electronic signature
CENTRAL NEW YORK HEALTH SYSTEMS AGENCY, INC. RETIREMENT PLAN 2009 161064267 2011-10-13 CENTRAL NEW YORK HEALTH SYSTEMS AGENCY, INC. 5
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1975-09-01
Business code 813000
Sponsor’s telephone number 3154728099
Plan sponsor’s DBA name CNYHSA
Plan sponsor’s mailing address 5700 COMMONS PARK DRIVE, EAST SYRACUSE, NY, 13057
Plan sponsor’s address 5700 COMMONS PARK DRIVE, EAST SYRACUSE, NY, 13057

Plan administrator’s name and address
Administrator’s EIN 161064267
Plan administrator’s name CENTRAL NEW YORK HEALTH SYSTEMS AGENCY, INC.
Plan administrator’s address 5700 COMMONS PARK DRIVE, EAST SYRACUSE, NY, 13057
Administrator’s telephone number 3154728099

Number of participants as of the end of the plan year
Active participants 5

Signature of
Role Plan administrator
Date 2011-10-13
Name of individual signing DEBBIE BROWN
Valid signature Filed with authorized/valid electronic signature
CENTRAL NEW YORK HEALTH SYSTEMS AGENCY, INC. RETIREMENT PLAN 2009 161064267 2010-10-07 CENTRAL NEW YORK HEALTH SYSTEMS AGENCY, INC. 5
Three-digit plan number (PN) 004
Effective date of plan 1975-09-01
Business code 813000
Sponsor’s telephone number 3154728099
Plan sponsor’s DBA name CNYHSA
Plan sponsor’s mailing address 5700 COMMONS PARK DRIVE, EAST SYRACUSE, NY, 13057
Plan sponsor’s address 5700 COMMONS PARK DRIVE, EAST SYRACUSE, NY, 13057

Plan administrator’s name and address
Administrator’s EIN 161064267
Plan administrator’s name CENTRAL NEW YORK HEALTH SYSTEMS AGENCY, INC.
Plan administrator’s address 5700 COMMONS PARK DRIVE, EAST SYRACUSE, NY, 13057
Administrator’s telephone number 3154728099

Number of participants as of the end of the plan year
Active participants 5

Signature of
Role Plan administrator
Date 2010-10-07
Name of individual signing DEBBIE BROWN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
CENTRAL NEW YORK HEALTH SYSTEMS AGENCY, INC. Agent 647 SOUTH WARREN ST., SYRACUSE, NY, 13202

Filings

Filing Number Date Filed Type Effective Date
150922000228 2015-09-22 CERTIFICATE OF MERGER 2015-09-22
20071203016 2007-12-03 ASSUMED NAME LLC INITIAL FILING 2007-12-03
A567013-3 1979-04-10 CERTIFICATE OF AMENDMENT 1979-04-10
A311690-12 1976-04-30 CERTIFICATE OF INCORPORATION 1976-04-30

USAspending Awards. Contracts

Contract Type Award or IDV Flag PIID Start Date Current End Date Potential End Date
PO AWARD HHSN276200900779P 2009-09-24 2011-09-27 2011-09-27
Unique Award Key CONT_AWD_HHSN276200900779P_7529_-NONE-_-NONE-
Awarding Agency Department of Health and Human Services
Link View Page

Description
Title HIV/AIDS COMMUNITY INFORMATION OUTREACH PROJECT 2009
NAICS Code 624190: OTHER INDIVIDUAL AND FAMILY SERVICES
Product and Service Codes AD21: SERVICES (BASIC)

Recipient Details
Recipient CENTRAL NEW YORK HEALTH SYSTEMS AGENCY, INC.
UEI D51YJ9A8F417
Legacy DUNS 088664297
Recipient Address UNITED STATES, 5700 COMMONS PARK DR, EAST SYRACUSE, 130579822

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 18 Mar 2025

Sources: New York Secretary of State

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