| Entity Name: | WESTERN CONNECTICUT HEALTH NETWORK, INC. |
| Jurisdiction: | Connecticut |
| Legal type: | Non-Stock |
| Citizenship: | Domestic |
| Status: | Active |
| Date Formed: | 15 Feb 1985 (Companies founded in February 1985) |
| Business ALEI: | 0166052 |
| Annual report due: | 15 Feb 2025 |
| NAICS code: | 621111 - Offices of Physicians (except Mental Health Specialists) |
| Business address: | 24 HOSPITAL AVENUE, DANBURY, CT, 06810, United States |
| Mailing address: | 24 HOSPITAL AVENUE, DANBURY, CT, United States, 06810 |
| ZIP code: | 06810 (Companies in Fairfield, 06810) |
| County: | Fairfield |
| Place of Formation: | CONNECTICUT |
| E-Mail: | CLS-CTARMSevidence@wolterskluwer.com |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WESTERN CONNECTICUT HEALTH NETWORK 403((B) PLAN | 2014 | 222594977 | 2015-10-15 | WESTERN CONNECTICUT HEALTH NETWORK, INC. | 1194 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Administrator’s EIN | 222594977 |
| Plan administrator’s name | WESTERN CONNECTICUT HEALTH NETWORK, INC. |
| Plan administrator’s address | 24 HOSPITAL AVENUE, DANBURY, CT, 06810 |
| Administrator’s telephone number | 2037397047 |
Number of participants as of the end of the plan year
| Active participants | 1008 |
| Retired or separated participants receiving benefits | 0 |
| Other retired or separated participants entitled to future benefits | 149 |
| 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 | 1157 |
| 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 | 2015-10-15 |
| Name of individual signing | VALERIE JACK |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2015-10-15 |
| Name of individual signing | VALERIE JACK |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Business address | Residence address |
|---|---|---|---|
| Mark Gudis | Director | 24 Hospital Ave, Danbury, CT, 06810-6099, United States | 24 Hospital Ave, Danbury, CT, 06810-6099, United States |
| Steven V. Lant | Director | 24 Hospital Ave, Danbury, CT, 06810-6099, United States | 24 Hospital Ave, Danbury, CT, 06810-6099, United States |
| Anne Roby | Director | 24 Hospital Ave, Danbury, CT, 06810-6099, United States | 24 Hospital Ave, Danbury, CT, 06810-6099, United States |
| Donald Jones | Director | 24 Hospital Ave, Danbury, CT, 06810-6099, United States | 10120 Orchid Ridge Ln, Estero, FL, 34135-2040, United States |
| Elizabeth Bradley PhD | Director | 24 Hospital Ave, Danbury, CT, 06810-6099, United States | 24 Hospital Ave, Danbury, CT, 06810-6099, United States |
| Salvatore Calta Jr. | Director | 24 Hospital Ave, Danbury, CT, 06810-6099, United States | 24 Hospital Ave, Danbury, CT, 06810-6099, United States |
| S. Javed Shahid MD | Director | 24 Hospital Ave, Danbury, CT, 06810-6099, United States | 24 Hospital Ave, Danbury, CT, 06810-6099, United States |
| Gregory Rakow | Director | 24 Hospital Ave, Danbury, CT, 06810-6099, United States | 24 Hospital Ave, Danbury, CT, 06810-6099, United States |
| Richard Jabara | Director | 24 Hospital Ave, Danbury, CT, 06810-6099, United States | 24 Hospital Ave, Danbury, CT, 06810-6099, United States |
| Joseph DiVestea | Director | 24 Hospital Ave, Danbury, CT, 06810-6099, United States | 263 Peaceable Street, Ridgefield, CT, 06877, United States |
| Name | Role | Business address | Residence address |
|---|---|---|---|
| John M. Murphy MD | Officer | 24 Hospital Ave, Danbury, CT, 06810-6099, United States | 24 Hospital Ave, Danbury, CT, 06810-6099, United States |
| Brian Wyatt | Officer | 24 Hospital Ave, Danbury, CT, 06810-6099, United States | 24 HOSPITAL AVENUE, DANBURY, CT, 06810, United States |
| Daniel DeBarba | Officer | 24 Hospital Ave, Danbury, CT, 06810-6099, United States | 24 HOSPITAL AVENUE, DANBURY, CT, 06810, United States |
| Type | Old value | New value | Date of change |
|---|---|---|---|
| Name change | WESTERN CONNECTICUT HEALTHCARE, INC. | WESTERN CONNECTICUT HEALTH NETWORK, INC. | 2011-09-15 |
| Name change | DANBURY HEALTH SYSTEMS, INC. | WESTERN CONNECTICUT HEALTHCARE, INC. | 2010-09-30 |
| Name change | DAN-HOSP CORPORATION | DANBURY HEALTH SYSTEMS, INC. | 1990-01-30 |
| Filing number | Filing date | Effective date | Filing category | Filing type | Report year |
|---|---|---|---|---|---|
| BF-0012050121 | 2024-01-16 | No data | Annual Report | Annual Report | No data |
| BF-0011079530 | 2023-02-01 | No data | Annual Report | Annual Report | No data |
| BF-0010356115 | 2022-02-03 | No data | Annual Report | Annual Report | 2022 |
| 0007346844 | 2021-05-19 | No data | Annual Report | Annual Report | 2021 |
| 0007326068 | 2021-04-28 | 2021-04-28 | Change of Agent | Agent Change | No data |
| 0006915562 | 2020-06-01 | No data | Annual Report | Annual Report | 2020 |
| 0006514656 | 2019-04-01 | 2019-04-01 | Amendment | Restated | No data |
| 0006471951 | 2019-03-18 | No data | Annual Report | Annual Report | 2019 |
| 0006244755 | 2018-09-11 | No data | Annual Report | Annual Report | 2018 |
| 0005955793 | 2017-10-27 | No data | Annual Report | Annual Report | 2017 |
Date of last update: 04 Nov 2024
Sources: Connecticut's Official State Website
