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  5. CONNECTICUT ASSOCIATION FOR HEALTHCARE AT HOME, INC.

CONNECTICUT ASSOCIATION FOR HEALTHCARE AT HOME, INC.

Company Details

Entity Name: CONNECTICUT ASSOCIATION FOR HEALTHCARE AT HOME, INC.
Jurisdiction: Connecticut
Legal type: Non-Stock
Citizenship: Domestic
Status: Active
Sub status: Annual report due
Date Formed: 19 Mar 1962
Business ALEI: 0061838
Annual report due: 19 Mar 2025
NAICS code: 621610 - Home Health Care Services
Business address: 110 BARNES RD, WALLINGFORD, CT, 06492, United States
Mailing address: P.O. BOX 90 110 BARNES RD. ATTN: TRACY WODATCH, WALLINGFORD, CT, United States, 06492
ZIP code: 06492
County: New Haven
Place of Formation: CONNECTICUT
E-Mail: clark@cthealthcareathome.org

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
FDN6S6TV67G1 2024-06-06 110 BARNES RD, WALLINGFORD, CT, 06492, 1802, USA 110 BARNES RD, WALLINGFORD, CT, 06492, 1802, USA

Business Information
Congressional District 03
State/Country of Incorporation CT, USA
Activation Date 2023-06-09
Initial Registration Date 2019-05-29
Entity Start Date 1984-08-17
Fiscal Year End Close Date Jun 30

Service Classifications
NAICS Codes 813920

Points of Contacts
Electronic Business
Title PRIMARY POC
Name COURTNEY VERISSIMO
Address 110 BARNES RD, WALLINGFORD, CT, 06492, 0812, USA
Government Business
Title PRIMARY POC
Name COURTNEY VERISSIMO
Address 110 BARNES RD, WALLINGFORD, CT, 06492, 0812, USA
Past Performance
Title PRIMARY POC
Name COURTNEY VERISSIMO
Address 110 BARNES RD, WALLINGFORD, CT, 06492, USA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
TAX DEFERRED ANNUITY PLAN OF CONNECTICUT ASSOCIATION FOR HEALTHCARE AT HOME, INC. 2021 060867238 2022-03-28 CONNECTICUT ASSOCIATION FOR HEALTHCARE AT HOME, INC. 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1982-06-01
Business code 621399
Sponsor’s telephone number 2032659931
Plan sponsor’s address PO BOX 90, WALLINGFORD, CT, 064920090

Signature of
Role Plan administrator
Date 2022-03-28
Name of individual signing ALISON CLARK-TALBURTT
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF CONNECTICUT ASSOCIATION FOR HEALTHCARE AT HOME, INC. 2021 060867238 2022-03-28 CONNECTICUT ASSOCIATION FOR HEALTHCARE AT HOME, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-10-01
Business code 621399
Sponsor’s telephone number 2032659931
Plan sponsor’s address PO BOX 90, WALLINGFORD, CT, 064920090

Signature of
Role Plan administrator
Date 2022-03-28
Name of individual signing ALISON CLARK-TALBURTT
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF CONNECTICUT ASSOCIATION FOR HEALTHCARE AT HOME, INC. 2020 060867238 2021-04-01 CONNECTICUT ASSOCIATION FOR HEALTHCARE AT HOME, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-10-01
Business code 621399
Sponsor’s telephone number 2032659931
Plan sponsor’s address PO BOX 90, WALLINGFORD, CT, 064920090

Signature of
Role Plan administrator
Date 2021-04-01
Name of individual signing ALISON CLARK-TALBURTT
Valid signature Filed with authorized/valid electronic signature
TAX DEFERRED ANNUITY PLAN OF CONNECTICUT ASSOCIATION FOR HEALTHCARE AT HOME, INC. 2020 060867238 2021-03-29 CONNECTICUT ASSOCIATION FOR HEALTHCARE AT HOME, INC. 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1982-06-01
Business code 621399
Sponsor’s telephone number 2032659931
Plan sponsor’s address PO BOX 90, WALLINGFORD, CT, 064920090

Signature of
Role Plan administrator
Date 2021-03-29
Name of individual signing ALISON CLARK-TALBURTT
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF CONNECTICUT ASSOCIATION FOR HEALTHCARE AT HOME, INC. 2019 060867238 2020-05-26 CONNECTICUT ASSOCIATION FOR HEALTHCARE AT HOME, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-10-01
Business code 621399
Sponsor’s telephone number 2032659931
Plan sponsor’s address PO BOX 90, WALLINGFORD, CT, 064920090

Signature of
Role Plan administrator
Date 2020-05-26
Name of individual signing ALISON CLARK-TALBURTT
Valid signature Filed with authorized/valid electronic signature
TAX DEFERRED ANNUITY PLAN OF CONNECTICUT ASSOCIATION FOR HEALTHCARE AT HOME, INC. 2019 060867238 2020-06-15 CONNECTICUT ASSOCIATION FOR HEALTHCARE AT HOME, INC. 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1982-06-01
Business code 621399
Sponsor’s telephone number 2032659931
Plan sponsor’s address PO BOX 90, WALLINGFORD, CT, 064920090

Signature of
Role Plan administrator
Date 2020-06-15
Name of individual signing ALISON CLARK-TALBURTT
Valid signature Filed with authorized/valid electronic signature
TAX DEFERRED ANNUITY PLAN OF CONNECTICUT ASSOCIATION FOR HEALTHCARE AT HOME, INC 2018 060867238 2019-05-20 CONNECTICUT ASSOCIATION FOR HEALTHCARE AT HOME, INC 10
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1982-06-01
Business code 813000
Plan sponsor’s address PO BOX 90, 110 BARNES RD, WALLINGFORD, CT, 064921802

Signature of
Role Plan administrator
Date 2019-05-20
Name of individual signing ALISON CLARK-TALBURTT
Valid signature Filed with authorized/valid electronic signature
TAX DEFERRED ANNUITY PLAN OF CONNECTICUT ASSOCIATION FOR HEALTHCARE AT HOME, INC 2018 060867238 2019-05-20 CONNECTICUT ASSOCIATION FOR HEALTHCARE AT HOME, INC 10
Three-digit plan number (PN) 002
Effective date of plan 1982-06-01
Business code 813000
Plan sponsor’s address PO BOX 90, 110 BARNES RD, WALLINGFORD, CT, 064921802

Signature of
Role Plan administrator
Date 2019-05-20
Name of individual signing ALISON CLARK-TALBURTT
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF CONNECTICUT ASSOCIATION FOR HEALTHCARE AT HOME, INC. 2018 060867238 2019-05-20 CONNECTICUT ASSOCIATION FOR HEALTHCARE AT HOME, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-10-01
Business code 621399
Sponsor’s telephone number 2032659931
Plan sponsor’s address 110 BARNES RD, PO BOX 90, WALLINGFORD, CT, 064920090

Signature of
Role Plan administrator
Date 2019-05-20
Name of individual signing ALISON CLARK-TALBURTT
Valid signature Filed with authorized/valid electronic signature
TAX DEFERRED ANNUITY PLAN OF CONNECTICUT ASSOCIATION FOR HEALTHCARE AT HOME, INC 2017 060867238 2018-05-31 CONNECTICUT ASSOCIATION FOR HEALTHCARE AT HOME, INC 10
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1982-06-01
Business code 813000
Plan sponsor’s address PO BOX 90, 110 BARNES RD, WALLINGFORD, CT, 064921802

Signature of
Role Plan administrator
Date 2018-05-31
Name of individual signing ALISON CLARK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-05-31
Name of individual signing ALISON CLARK
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Business address Phone E-Mail Residence address
TRACY WODATCH Agent 110 BARNES ROAD, WALLINGFORD, CT, 06492, United States +1 203-314-4105 wodatch@cthealthcareathome.org 5 FAIRLAWN DRIVE, WALLINGFORD, CT, 06492, United States

Officer

Name Role Business address Phone E-Mail Residence address
Coco Sellman Officer 675 West Johnson Rd, Cheshire, CT, 06410, United States No data No data 190 Island Trl, Morris, CT, 06763-1230, United States
Adam Axelrad Officer No data No data No data 17 E Hill Rd, Canton, CT, 06019-2418, United States
Alyson Blanck Officer 100 Saw Mill Rd, Danbury, CT, 06810-5106, United States No data No data 100 SAW MILL ROAD, DANBURY, CT, 06810, United States
TRACY WODATCH Officer 110 BARNES RD, WALLINGFORD, CT, 06492, United States +1 203-314-4105 wodatch@cthealthcareathome.org 5 FAIRLAWN DRIVE, WALLINGFORD, CT, 06492, United States

License

Credential Credential type Status Status reason Issue date Effective date Expiration date
CHR.0054091-EXEMPT PUBLIC CHARITY-EXEMPT FROM FINANCIAL REQUIREMENTS ACTIVE No data 2010-01-28 No data No data

History

Type Old value New value Date of change
Name change CONNECTICUT ASSOCIATION FOR HOME CARE AND HOSPICE, INC. CONNECTICUT ASSOCIATION FOR HEALTHCARE AT HOME, INC. 2012-12-28
Name change CONNECTICUT ASSOCIATION FOR HOME CARE, INC. CONNECTICUT ASSOCIATION FOR HOME CARE AND HOSPICE, INC. 2007-12-27
Name change ASSOCIATION OF COMMUNITY HEALTH SERVICE AGENCIES, INC. THE CONNECTICUT ASSOCIATION FOR HOME CARE, INC. 1984-03-08
Name change BOARD MEMBERS' ORGANIZATION OF CONNECTICUT PUBLIC HEALTH NURSING AGENCIES, INCORPORATED THE ASSOCIATION OF COMMUNITY HEALTH SERVICE AGENCIES, INC. THE 1970-02-05

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0012046706 2024-03-13 No data Annual Report Annual Report No data
BF-0011085254 2023-03-08 No data Annual Report Annual Report No data
BF-0010592010 2022-05-13 2022-05-13 Interim Notice Interim Notice No data
BF-0010511762 2022-03-17 2022-03-17 Change of Agent Agent Change No data
BF-0010237763 2022-02-23 No data Annual Report Annual Report 2022
0007214871 2021-03-10 No data Annual Report Annual Report 2021
0006795445 2020-02-28 No data Annual Report Annual Report 2020
0006632073 2019-08-21 2019-08-21 Interim Notice Interim Notice No data
0006427829 2019-03-06 No data Annual Report Annual Report 2019
0006157807 2018-04-10 No data Annual Report Annual Report 2018

Related by officers

Alyson Blanck

WESTERN CONNECTICUT HOME CARE, INC. WESTERN CONNECTICUT HEALTH NETWORK PHYSICIAN HOSPITAL ORGANIZATION, INC. WESTERN CONNECTICUT HEALTH NETWORK PHYSICIAN HOSPITAL ORGANIZATION ACO, INC.

Related by address

110 BARNES RD, WALLINGFORD, CT, 06492, United States

CHIME, INC.

Date of last update: 25 Nov 2024

Sources: Connecticut's Official State Website

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