|
MAPLE HEALTH GROUP
|
2023
|
474634880
|
2025-01-31
|
MAPLE HEALTH GROUP
|
8
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2020-01-01
|
| Business code |
541600
|
| Sponsor’s telephone number |
6178235996
|
| Plan sponsor’s
address |
142 WEST 57TH STREET, 11TH FLOOR, NEW YORK, NY, 10019
|
Signature of
| Role |
Plan administrator |
| Date |
2025-01-31 |
| Name of individual signing |
ERIN GARNEY |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
MAPLE HEALTH GROUP
|
2022
|
474634880
|
2023-06-02
|
MAPLE HEALTH GROUP
|
9
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2020-01-01
|
| Business code |
541600
|
| Sponsor’s telephone number |
6178235996
|
| Plan sponsor’s
address |
1740 BROADWAY, FLOOR 15, NEW YORK, NY, 10019
|
Signature of
| Role |
Plan administrator |
| Date |
2023-06-02 |
| Name of individual signing |
ERIN GARNEY |
|
|
|
MAPLE HEALTH GROUP
|
2021
|
474634880
|
2022-05-27
|
MAPLE HEALTH GROUP
|
7
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2020-01-01
|
| Business code |
541600
|
| Sponsor’s telephone number |
6178235996
|
| Plan sponsor’s
address |
1740 BROADWAY, SUITE 15, NEW YORK, NY, 10019
|
Signature of
| Role |
Plan administrator |
| Date |
2022-05-27 |
| Name of individual signing |
KELLY HERRERA-SURNAMER |
|
|
|
MAPLE HEALTH GROUP
|
2020
|
474634880
|
2021-10-15
|
MAPLE HEALTH GROUP
|
4
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
001
|
| Effective date of plan |
2020-01-01
|
| Business code |
541600
|
| Sponsor’s telephone number |
9175205505
|
| Plan sponsor’s
address |
1740 BROADWAY, 15TH FLOOR, NEW YORK, NY, 02199
|
Signature of
| Role |
Plan administrator |
| Date |
2021-10-15 |
| Name of individual signing |
KELLY HERRERA-SURNAMER |
|
|
