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ASYLUM HILL FAMILY MEDICINE CENTER, INC.

Company Details

Entity Name: ASYLUM HILL FAMILY MEDICINE CENTER, INC.
Jurisdiction: Connecticut
Legal type: Non-Stock
Citizenship: Domestic
Status: Active
Date Formed: 25 Mar 1996 (Companies founded in March 1996)
Business ALEI: 0533378
Annual report due: 25 Mar 2025
NAICS code: 621112 - Offices of Physicians, Mental Health Specialists
Business address: 114 WOODLAND STREET, HARTFORD, CT, 06105, United States
Mailing address: 114 WOODLAND STREET, LEGAL DEPARTMENT, HARTFORD, CT, United States, 06105
ZIP code: 06105 (Companies in Hartford, 06105)
County: Hartford
Place of Formation: CONNECTICUT
E-Mail: LEGALDEPARTMENT@TRINITYHEALTHOFNE.ORG

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ASYLUM HILL FAMILY MEDICINE CENTER, INC. TAX-DEFERRED ANNUITY PLAN 2015 061450170 2017-07-17 ASYLUM HILL FAMILY MEDICINE CENTER, INC. 50
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-10-01
Business code 611000
Sponsor’s telephone number 8607146523
Plan sponsor’s address 99 WOODLAND ST, HARTFORD, CT, 06105

Signature of

Role Plan administrator
Date 2017-07-17
Name of individual signing WENDY WIGGLESWORTH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-07-17
Name of individual signing WENDY WIGGLESWORTH
Valid signature Filed with authorized/valid electronic signature
ASYLUM HILL FAMILY MEDICINE CENTER, INC. DEFINED CONTRIBUTION RETIREMENT PLAN 2015 061450170 2017-07-17 ASYLUM HILL FAMILY MEDICINE CENTER, INC. 50
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-10-01
Business code 611000
Sponsor’s telephone number 8607146523
Plan sponsor’s address 99 WOODLAND ST, HARTFORD, CT, 06105

Signature of

Role Plan administrator
Date 2017-07-17
Name of individual signing WENDY WIGGLESWORTH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-07-17
Name of individual signing WENDY WIGGLESWORTH
Valid signature Filed with authorized/valid electronic signature
ASYLUM HILL FAMILY MEDICINE CENTER, INC. TAX-DEFERRED ANNUITY PLAN 2014 061450170 2016-07-08 ASYLUM HILL FAMILY MEDICINE CENTER, INC. 51
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-10-01
Business code 611000
Sponsor’s telephone number 8607146523
Plan sponsor’s address 99 WOODLAND ST, HARTFORD, CT, 06105

Signature of

Role Plan administrator
Date 2016-07-08
Name of individual signing ROBERT CUSHMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-07-08
Name of individual signing ROBERT CUSHMAN
Valid signature Filed with authorized/valid electronic signature
ASYLUM HILL FAMILY MEDICINE CENTER, INC. DEFINED CONTRIBUTION RETIREMENT PLAN 2014 061450170 2016-07-08 ASYLUM HILL FAMILY MEDICINE CENTER, INC. 47
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-10-01
Business code 611000
Sponsor’s telephone number 8607146523
Plan sponsor’s address 99 WOODLAND ST, HARTFORD, CT, 06105

Signature of

Role Plan administrator
Date 2016-07-08
Name of individual signing ROBERT CUSHMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-07-08
Name of individual signing ROBERT CUSHMAN
Valid signature Filed with authorized/valid electronic signature
ASYLUM HILL FAMILY MEDICINE CENTER, INC. TAX-DEFERRED ANNUITY PLAN 2013 061450170 2015-07-14 ASYLUM HILL FAMILY MEDICINE CENTER, INC. 52
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-10-01
Business code 611000
Sponsor’s telephone number 8607146523
Plan sponsor’s address 99 WOODLAND ST, HARTFORD, CT, 06105

Signature of

Role Plan administrator
Date 2015-07-14
Name of individual signing ROBERT CUSHMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-14
Name of individual signing ROBERT CUSHMAN
Valid signature Filed with authorized/valid electronic signature
ASYLUM HILL FAMILY MEDICINE CENTER, INC. DEFINED CONTRIBUTION RETIREMENT PLAN 2013 061450170 2015-07-14 ASYLUM HILL FAMILY MEDICINE CENTER, INC. 46
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-10-01
Business code 611000
Sponsor’s telephone number 8607146523
Plan sponsor’s address 99 WOODLAND ST, HARTFORD, CT, 06105

Signature of

Role Plan administrator
Date 2015-07-14
Name of individual signing ROBERT CUSHMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-14
Name of individual signing ROBERT CUSHMAN
Valid signature Filed with authorized/valid electronic signature
ASYLUM HILL FAMILY MEDICINE CENTER, INC. DEFINED CONTRIBUTION RETIREMENT PLAN 2012 061450170 2014-04-29 ASYLUM HILL FAMILY MEDICINE CENTER, INC. 42
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-10-01
Business code 611000
Sponsor’s telephone number 8607144129
Plan sponsor’s address 99 WOODLAND ST, HARTFORD, CT, 06105

Plan administrator’s name and address

Administrator’s EIN 141906528
Plan administrator’s name JAMES M HAFFORD
Administrator’s telephone number 8607146523

Signature of

Role Plan administrator
Date 2014-04-29
Name of individual signing JAMES HAFFORD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-04-29
Name of individual signing ROBERT CUSHMAN
Valid signature Filed with authorized/valid electronic signature
ASYLUM HILL FAMILY MEDICINE CENTER, INC. TAX-DEFERRED ANNUITY PLAN 2012 061450170 2014-04-29 ASYLUM HILL FAMILY MEDICINE CENTER, INC. 55
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-10-01
Business code 611000
Sponsor’s telephone number 8607144129
Plan sponsor’s address 99 WOODLAND ST, HARTFORD, CT, 06105

Plan administrator’s name and address

Administrator’s EIN 141906528
Plan administrator’s name JAMES M HAFFORD
Administrator’s telephone number 8607146523

Signature of

Role Plan administrator
Date 2014-04-29
Name of individual signing JAMES HAFFORD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-04-29
Name of individual signing ROBERT CUSHMAN
Valid signature Filed with authorized/valid electronic signature
ASYLUM HILL FAMILY MEDICINE CENTER, INC. TAX DEFERRED ANNUITY PLAN 2011 061450170 2013-07-15 ASYLUM HILL FAMILY MEDICINE CENTER, INC. 57
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-10-01
Business code 611000
Sponsor’s telephone number 8607144129
Plan sponsor’s address 99 WOODLAND ST, HARTFORD, CT, 06105

Plan administrator’s name and address

Administrator’s EIN 141906528
Plan administrator’s name JAMES M HAFFORD
Plan administrator’s address 99 WOODLAND ST, HARTFORD, CT, 06105
Administrator’s telephone number 8607146523

Signature of

Role Plan administrator
Date 2013-07-15
Name of individual signing JAMES HAFFORD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-07-15
Name of individual signing ROBERT CUSHMAN
Valid signature Filed with authorized/valid electronic signature
ASYLUM HILL FAMILY MEDICINE CENTER, INC. DEFINED CONTRIBUTION RETIREMENT PLAN 2011 061450170 2013-07-15 ASYLUM HILL FAMILY MEDICINE CENTER, INC. 41
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-10-01
Business code 611000
Sponsor’s telephone number 8607144129
Plan sponsor’s address 99 WOODLAND ST, HARTFORD, CT, 06105

Plan administrator’s name and address

Administrator’s EIN 141906528
Plan administrator’s name JAMES M HAFFORD
Plan administrator’s address 99 WOODLAND ST, HARTFORD, CT, 06105
Administrator’s telephone number 8607146523

Signature of

Role Plan administrator
Date 2013-07-15
Name of individual signing JAMES HAFFORD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-07-15
Name of individual signing ROBERT CUSHMAN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role
C T CORPORATION SYSTEM Agent

Officer

Name Role Business address Residence address
Thomas Agresta Officer 99 Woodland St, Hartford, CT, 06105-1207, United States 99 Woodland St, Hartford, CT, 06105-1207, United States
JAMES HARRIS Officer 114 WOODLAND STREET, HARTFORD, CT, 06105, United States 61 TIMBER TRAIL, TOLLAND, CT, 06084, United States
Deborah Bitsoli Officer 271 Carew Street, Springfield, MA, 01104, United States 271 Carew St, Springfield, MA, 01104-2377, United States

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0012293243 2024-06-10 No data Annual Report Annual Report No data
BF-0011258345 2023-03-24 No data Annual Report Annual Report No data
BF-0010192559 2022-02-24 No data Annual Report Annual Report 2022
0007184929 2021-02-23 No data Annual Report Annual Report 2021
0006765037 2020-02-20 No data Annual Report Annual Report 2020
0006463037 2019-03-14 No data Annual Report Annual Report 2019
0006136083 2018-03-23 No data Annual Report Annual Report 2018
0005803741 2017-03-29 No data Annual Report Annual Report 2017
0005570596 2016-05-20 No data Annual Report Annual Report 2016
0005403536 2015-09-29 2015-10-01 Amendment Restated No data

Date of last update: 04 Nov 2024

Sources: Connecticut's Official State Website