GAYLORD HOSPITAL 403(B) PLAN
|
2023
|
060646649
|
2024-10-11
|
GAYLORD HOSPITAL, INC.
|
851
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2005-01-01
|
Business code |
622000
|
Sponsor’s telephone number |
2032842834
|
Plan sponsor’s
address |
P.O. BOX 400, 52 GAYLORD FARMS ROAD, WALLINGFORD, CT, 06942
|
Signature of
Role |
Plan administrator |
Date |
2024-10-11 |
Name of individual signing |
MITCH PODOB |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GAYLORD HOSPITAL GROUP DENTAL MEDICAL HOSPITAL PLAN
|
2010
|
060646649
|
2011-10-18
|
GAYLORD HOSPITAL, INC
|
1020
|
|
File |
View Page
|
Three-digit plan number (PN) |
513
|
Effective date of plan |
2010-01-01
|
Business code |
622000
|
Sponsor’s telephone number |
2032842832
|
Plan sponsor’s mailing address |
P O BOX 400, WALLINGFORD, CT, 06492
|
Plan sponsor’s
address |
P O BOX 400, WALLINGFORD, CT, 06492
|
Plan administrator’s name and address
Administrator’s EIN |
060646649 |
Plan administrator’s name |
GAYLORD HOSPITAL, INC |
Plan administrator’s
address |
P O BOX 400, WALLINGFORD, CT, 06492 |
Administrator’s telephone number |
2032842832 |
Number of participants as of the end of the plan year
Signature of
Role |
Employer/plan sponsor |
Date |
2011-10-17 |
Name of individual signing |
WALTER HARPER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GARYLORD HOSPITAL GROUP LIFE AND ADD PLAN
|
2010
|
060646649
|
2011-10-18
|
GAYLORD HOSPITAL, INC
|
480
|
|
File |
View Page
|
Three-digit plan number (PN) |
511
|
Effective date of plan |
1986-06-01
|
Business code |
622000
|
Sponsor’s telephone number |
2032842832
|
Plan sponsor’s mailing address |
P.O. BOX 400, WALLINGFORD, CT, 06492
|
Plan sponsor’s
address |
P.O. BOX 400, WALLINGFORD, CT, 06492
|
Plan administrator’s name and address
Administrator’s EIN |
060646649 |
Plan administrator’s name |
GAYLORD HOSPITAL, INC |
Plan administrator’s
address |
P.O. BOX 400, WALLINGFORD, CT, 06492 |
Administrator’s telephone number |
2032842832 |
Number of participants as of the end of the plan year
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
460 |
Signature of
Role |
Employer/plan sponsor |
Date |
2011-10-17 |
Name of individual signing |
WALTER HARPER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GAYLORD HOSPITAL 401K PLAN
|
2009
|
060646649
|
2010-10-15
|
GAYLORD HOSPITAL
|
680
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
2005-01-01
|
Business code |
622000
|
Sponsor’s telephone number |
2032842834
|
Plan sponsor’s mailing address |
P. O. BOX 400, WALLINGFORD, CT, 06492
|
Plan sponsor’s
address |
GAYLORD FARM ROAD, WALLINGFORD, CT, 06492
|
Plan administrator’s name and address
Administrator’s EIN |
060646649 |
Plan administrator’s name |
GAYLORD HOSPITAL |
Plan administrator’s
address |
P. O. BOX 400, WALLINGFORD, CT, 06492 |
Administrator’s telephone number |
2032842834 |
Number of participants as of the end of the plan year
Active participants |
554 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
98 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
642 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
2 |
Signature of
Role |
Plan administrator |
Date |
2010-10-15 |
Name of individual signing |
WALTER G. HARPER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GAYLORD HOSPITAL 403(B) PLAN
|
2009
|
060646649
|
2010-10-15
|
GAYLORD HOSPITAL
|
680
|
|
File |
View Page
|
Three-digit plan number (PN) |
003
|
Effective date of plan |
2005-01-01
|
Business code |
622000
|
Sponsor’s telephone number |
2032842834
|
Plan sponsor’s mailing address |
P.O. BOX 400, WALLINGFORD, CT, 06492
|
Plan sponsor’s
address |
GAYLORD FARM ROAD, WALLINGFORD, CT, 06492
|
Plan administrator’s name and address
Administrator’s EIN |
060646649 |
Plan administrator’s name |
GAYLORD HOSPITAL |
Plan administrator’s
address |
P.O. BOX 400, WALLINGFORD, CT, 06492 |
Administrator’s telephone number |
2032842834 |
Number of participants as of the end of the plan year
Active participants |
554 |
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 |
Number of
participants
with
account balances as of the end of the plan year |
43 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2010-10-15 |
Name of individual signing |
WALTER G. HARPER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GAYLORD HOSPITAL GROUP LIFE AND ADD PLAN
|
2009
|
060646649
|
2010-07-30
|
GAYLORD HOSPITAL, INC.
|
482
|
|
File |
View Page
|
Three-digit plan number (PN) |
511
|
Effective date of plan |
1986-06-01
|
Business code |
622000
|
Sponsor’s telephone number |
2032842832
|
Plan sponsor’s mailing address |
P O BOX 400, WALLINGFORD, CT, 06492
|
Plan sponsor’s
address |
P O BOX 400, WALLINGFORD, CT, 06492
|
Plan administrator’s name and address
Administrator’s EIN |
060646649 |
Plan administrator’s name |
GAYLORD HOSPITAL, INC. |
Plan administrator’s
address |
P O BOX 400, WALLINGFORD, CT, 06492 |
Administrator’s telephone number |
2032842832 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2010-07-30 |
Name of individual signing |
BRUCE DALSTROM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GAYLORD HOSPITAL GROUP LONG TERM DISABILITY PLAN
|
2009
|
060646649
|
2010-07-30
|
GAYLORD HOSPITAL, INC
|
482
|
|
File |
View Page
|
Three-digit plan number (PN) |
509
|
Effective date of plan |
1984-09-01
|
Business code |
622000
|
Sponsor’s telephone number |
2032842832
|
Plan sponsor’s mailing address |
P O BOX 400, WALLINGFORD, CT, 06492
|
Plan sponsor’s
address |
P O BOX 400, WALLINGFORD, CT, 06492
|
Plan administrator’s name and address
Administrator’s EIN |
060646649 |
Plan administrator’s name |
GAYLORD HOSPITAL, INC |
Plan administrator’s
address |
P O BOX 400, WALLINGFORD, CT, 06492 |
Administrator’s telephone number |
2032842832 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2010-07-30 |
Name of individual signing |
BRUCE DALSTROM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GAYLORD HOSPITAL GROUP DENTAL MEDICAL HOSPITAL PLAN
|
2009
|
060646649
|
2010-07-30
|
GAYLORD HOSPITAL, INC
|
986
|
|
File |
View Page
|
Three-digit plan number (PN) |
513
|
Effective date of plan |
1984-09-01
|
Business code |
622000
|
Sponsor’s telephone number |
2032842832
|
Plan sponsor’s mailing address |
P O BOX 400, WALLINGFORD, CT, 06492
|
Plan sponsor’s
address |
P O BOX 400, WALLINGFORD, CT, 06492
|
Plan administrator’s name and address
Administrator’s EIN |
060646649 |
Plan administrator’s name |
GAYLORD HOSPITAL, INC |
Plan administrator’s
address |
P O BOX 400, WALLINGFORD, CT, 06492 |
Administrator’s telephone number |
2032842832 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2010-07-30 |
Name of individual signing |
BRUCE DALSTROM |
Valid signature |
Filed with authorized/valid electronic signature |
|
|