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  5. GAYLORD HOSPITAL, INC.

GAYLORD HOSPITAL, INC.

Company Details

Entity Name: GAYLORD HOSPITAL, INC.
Jurisdiction: Connecticut
Legal type: Non-Stock
Citizenship: Domestic
Status: Active
Sub status: Annual report due
Date Formed: 17 Oct 1902
Business ALEI: 0099958
Annual report due: 17 Oct 2025
NAICS code: 622310 - Specialty (except Psychiatric and Substance Abuse) Hospitals
Business address: 50 Gaylord Farm Rd, Wallingford, CT, 06492-2828, United States
Mailing address: PO Box 400, GAYLORD FARM ROAD, WALLINGFORD, CT, United States, 06492
ZIP code: 06492
County: New Haven
Place of Formation: CONNECTICUT
E-Mail: jmace@gaylord.org

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
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
Active participants 908

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
Active participants 480

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
Active participants 465

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
Active participants 1020

Signature of
Role Plan administrator
Date 2010-07-30
Name of individual signing BRUCE DALSTROM
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Business address Phone E-Mail Residence address
SUSAN STANGO Agent 50 GAYLORD FARM ROAD, WALLINGFORD, CT, 06492, United States +1 203-258-4412 sstango@gaylord.org 52B Cedar Bark Ln, Stratford, CT, 06614-6153, United States

Officer

Name Role Business address Residence address
Michael Ivy Officer 50 Gaylord Farm Rd, Wallingford, CT, 06492-2828, United States 49 State Street, Guilford, CT, 06437, United States
Robert McHugh Officer 50 Gaylord Farm Rd, Wallingford, CT, 06492-2828, United States 37 Lantern Hill Rd, Madison, CT, 06443-2941, United States
SONJA LABARBERA Officer GAYLORD HOSPITAL, INC., P.O. BOX 400, GAYLORD FARM ROAD, WALLINGFORD, CT, 06492, United States 13 WADSWORTH LANE, WALLINGFORD, CT, 06492, United States

Director

Name Role Business address Residence address
Robert McHugh Director 50 Gaylord Farm Rd, Wallingford, CT, 06492-2828, United States 37 Lantern Hill Rd, Madison, CT, 06443-2941, United States

License

Credential Credential type Status Status reason Issue date Effective date Expiration date
LTN.0001656 TEMPORARY NONCOMMERCIAL LIQUOR PERMIT PENDING NEW APPLICATION REVIEW REQUIRED No data No data No data
LTN.0000891 TEMPORARY NONCOMMERCIAL LIQUOR PERMIT INACTIVE No data No data 2024-05-20 2024-05-20
LTB.0001601 TEMPORARY BEER INACTIVE No data No data 2018-06-23 2018-06-23
LTB.0001658 TEMPORARY BEER INACTIVE No data No data 2019-06-22 2019-06-22
LTB.0001712 TEMPORARY BEER INACTIVE No data No data 2021-06-26 2021-06-26
LCO.0009717 TEMPORARY CHARITABLE ORGANIZATION LIQUOR INACTIVE No data No data 2021-10-14 2021-10-14
LTB.0001744 TEMPORARY BEER INACTIVE No data No data 2022-06-25 2022-06-25
LCO.0009891 TEMPORARY CHARITABLE ORGANIZATION LIQUOR INACTIVE No data No data 2022-04-21 2022-04-21
LCO.0010262 TEMPORARY CHARITABLE ORGANIZATION LIQUOR INACTIVE No data No data 2022-09-29 2022-09-29
LCO.0010576 TEMPORARY CHARITABLE ORGANIZATION LIQUOR INACTIVE No data No data 2023-05-18 2023-05-18

History

Type Old value New value Date of change
Name change GAYLORD FARM ASSOCIATION THE GAYLORD HOSPITAL, INC. 1990-04-24
Name change NEW HAVEN COUNTY ANTI-TUBERCULOSIS ASSOCIATION, INCORPORATED GAYLORD FARM ASSOCIATION THE 1927-03-18

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0012043954 2024-09-19 No data Annual Report Annual Report No data
BF-0011077364 2023-10-02 No data Annual Report Annual Report No data
BF-0010282823 2022-09-29 No data Annual Report Annual Report 2022
BF-0009816524 2021-09-20 No data Annual Report Annual Report No data
0006982301 2020-09-17 No data Annual Report Annual Report 2020
0006958120 2020-08-05 2020-08-05 Change of Agent Agent Change No data
0006699485 2019-12-20 2019-12-20 Amendment Restated No data
0006651197 2019-09-27 No data Annual Report Annual Report 2019
0006261563 2018-10-19 No data Annual Report Annual Report 2018
0006125289 2018-03-15 No data Annual Report Annual Report 2017

Related by officers

SUSAN STANGO

STANGO, INC. GAYLORD FARM ASSOCIATION, INC. FARM PROPERTIES INCORPORATED GAYLORD FARMS REHABILITATION CENTER, INC. GAYLORD RESEARCH INSTITUTE, INC. THE GAYLORD FOUNDATION, INC. PICKUP PROPERTIES, LLC

Robert McHugh

GAYLORD FARM ASSOCIATION, INC. GAYLORD FARMS REHABILITATION CENTER, INC. GAYLORD RESEARCH INSTITUTE, INC. THE GAYLORD FOUNDATION, INC. VIRGINIA TRACE, LLC APEX INSURANCE SOLUTIONS, LLC

SONJA LABARBERA

GAYLORD FARM ASSOCIATION, INC. FARM PROPERTIES INCORPORATED GAYLORD FARMS REHABILITATION CENTER, INC. GAYLORD RESEARCH INSTITUTE, INC. THE GAYLORD FOUNDATION, INC.

Related by address

50 Gaylord Farm Rd, Wallingford, CT, 06492-2828, United States

GAYLORD FARM ASSOCIATION, INC. FARM PROPERTIES INCORPORATED

Date of last update: 25 Nov 2024

Sources: Connecticut's Official State Website

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