SYRACUSE COMMUNITY HEALTH CENTER, EMPLOYEE GROUP INSURANCE PLAN
|
2011
|
161080039
|
2013-06-04
|
SYRACUSE COMMUNITY HEALTH CENTER
|
387
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1978-07-01
|
Business code |
621498
|
Sponsor’s telephone number |
3154767921
|
Plan sponsor’s mailing address |
819 SOUTH SALINA STREET, SYRACUSE, NY, 13202
|
Plan sponsor’s
address |
819 SOUTH SALINA STREET, SYRACUSE, NY, 13202
|
Plan administrator’s name and address
Administrator’s EIN |
161080039 |
Plan administrator’s name |
SYRACUSE COMMUNITY HEALTH CENTER |
Plan administrator’s
address |
819 SOUTH SALINA STREET, SYRACUSE, NY, 13202 |
Administrator’s telephone number |
3154767921 |
Number of participants as of the end of the plan year
Active participants |
348 |
Retired or separated participants receiving
benefits |
3 |
Signature of
Role |
Plan administrator |
Date |
2013-06-04 |
Name of individual signing |
JOCELYN SHANNON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-06-04 |
Name of individual signing |
JOCELYN SHANNON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SYRACUSE COMMUNITY HEALTH CENTER, EMPLOYEE GROUP INSURANCE PLAN
|
2010
|
161080039
|
2013-01-30
|
SYRACUSE COMMUNITY HEALTH CENTER
|
371
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1978-07-01
|
Business code |
621498
|
Sponsor’s telephone number |
3154767921
|
Plan sponsor’s mailing address |
819 SOUTH SALINA STREET, SYRACUSE, NY, 13202
|
Plan sponsor’s
address |
819 SOUTH SALINA STREET, SYRACUSE, NY, 13202
|
Plan administrator’s name and address
Administrator’s EIN |
161080039 |
Plan administrator’s name |
SYRACUSE COMMUNITY HEALTH CENTER |
Plan administrator’s
address |
819 SOUTH SALINA STREET, SYRACUSE, NY, 13202 |
Administrator’s telephone number |
3154767921 |
Number of participants as of the end of the plan year
Active participants |
380 |
Retired or separated participants receiving
benefits |
7 |
Signature of
Role |
Plan administrator |
Date |
2013-01-16 |
Name of individual signing |
GERALD ALBRIGO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-01-16 |
Name of individual signing |
JOCELYN SHANNON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SYRACUSE COMMUNITY HEALTH CENTER, EMPLOYEE GROUP INSURANCE PLAN
|
2009
|
161080039
|
2011-05-26
|
SYRACUSE COMMUNITY HEALTH CENTER
|
371
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1978-07-01
|
Business code |
621498
|
Sponsor’s telephone number |
3154767921
|
Plan sponsor’s mailing address |
819 SOUTH SALINA STREET, SYRACUSE, NY, 13202
|
Plan sponsor’s
address |
819 SOUTH SALINA STREET, SYRACUSE, NY, 13202
|
Plan administrator’s name and address
Administrator’s EIN |
161080039 |
Plan administrator’s name |
SYRACUSE COMMUNITY HEALTH CENTER |
Plan administrator’s
address |
819 SOUTH SALINA STREET, SYRACUSE, NY, 13202 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2011-05-26 |
Name of individual signing |
GERALD ALBRIGO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-05-26 |
Name of individual signing |
JOCELYN SHANNON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
EMPLOYEE ASSISTANCE PLAN
|
2009
|
161080039
|
2010-07-29
|
SYRACUSE COMMUNITY HEALTH CENTER
|
0
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1985-01-01
|
Business code |
621498
|
Sponsor’s telephone number |
3154767921
|
Plan sponsor’s mailing address |
819 SOUTH SALINA STREET, SYRACUSE, NY, 13202
|
Plan sponsor’s
address |
819 SOUTH SALINA STREET, SYRACUSE, NY, 13202
|
Plan administrator’s name and address
Administrator’s EIN |
161080039 |
Plan administrator’s name |
SYRACUSE COMMUNITY HEALTH CENTER |
Plan administrator’s
address |
819 SOUTH SALINA STREET, SYRACUSE, NY, 13202 |
Administrator’s telephone number |
3154767921 |
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 |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2010-07-29 |
Name of individual signing |
GERALD ALBRIGO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FLEX SPENDING PLAN
|
2009
|
161080039
|
2010-07-29
|
SYRACUSE COMMUNITY HEALTH CENTER
|
19
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
1996-01-01
|
Business code |
621498
|
Sponsor’s telephone number |
3154767921
|
Plan sponsor’s mailing address |
819 SOUTH SALINA STREET, SYRACUSE, NY, 13202
|
Plan sponsor’s
address |
819 SOUTH SALINA STREET, SYRACUSE, NY, 13202
|
Plan administrator’s name and address
Administrator’s EIN |
161080039 |
Plan administrator’s name |
SYRACUSE COMMUNITY HEALTH CENTER |
Plan administrator’s
address |
819 SOUTH SALINA STREET, SYRACUSE, NY, 13202 |
Administrator’s telephone number |
3154767921 |
Number of participants as of the end of the plan year
Active participants |
35 |
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 |
2010-07-29 |
Name of individual signing |
GERALD ALBRIGO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|