PRIME HEALTHCARE, P.C. WELFARE BENEFIT PLAN
|
2023
|
061472180
|
2024-07-28
|
PRIME HEALTHCARE, P.C.
|
217
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1997-12-01
|
Business code |
621111
|
Sponsor’s telephone number |
8602630253
|
Plan sponsor’s mailing address |
30 JORDAN LN, WETHERSFIELD, CT, 061091278
|
Plan sponsor’s
address |
30 JORDAN LN, WETHERSFIELD, CT, 061091278
|
Number of participants as of the end of the plan year
Active participants |
225 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2024-07-28 |
Name of individual signing |
SUSAN ALBANO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRIME HEALTHCARE, P.C. WELFARE BENEFIT PLAN
|
2022
|
061472180
|
2024-07-28
|
PRIME HEALTHCARE, P.C.
|
193
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1997-12-01
|
Business code |
621111
|
Sponsor’s telephone number |
8602630253
|
Plan sponsor’s mailing address |
30 JORDAN LN, WETHERSFIELD, CT, 061091278
|
Plan sponsor’s
address |
30 JORDAN LN, WETHERSFIELD, CT, 061091278
|
Number of participants as of the end of the plan year
Active participants |
217 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2024-07-28 |
Name of individual signing |
SUSAN ALBANO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRIME HEALTHCARE, P.C. WELFARE BENEFIT PLAN
|
2021
|
061472180
|
2022-11-07
|
PRIME HEALTHCARE, P.C.
|
177
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1997-12-01
|
Business code |
621111
|
Sponsor’s telephone number |
8602630253
|
Plan sponsor’s mailing address |
30 JORDAN LN, WETHERSFIELD, CT, 061091278
|
Plan sponsor’s
address |
30 JORDAN LN, WETHERSFIELD, CT, 061091278
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2022-11-04 |
Name of individual signing |
SUSAN ALBANO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-11-04 |
Name of individual signing |
SUSAN ALBANO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRIME HEALTHCARE P.C. WELFARE BENEFIT PLAN
|
2019
|
061472180
|
2020-07-30
|
PRIME HEALTHCARE, P.C.
|
146
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1997-12-01
|
Business code |
621111
|
Sponsor’s telephone number |
8602630253
|
Plan sponsor’s mailing address |
30 JORDAN LN, WETHERSFIELD, CT, 061091278
|
Plan sponsor’s
address |
30 JORDAN LN, WETHERSFIELD, CT, 061091278
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2020-07-29 |
Name of individual signing |
SUSAN ALBANO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-07-29 |
Name of individual signing |
SUSAN ALBANO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRIME HEALTHCARE, P.C. WELFARE BENEFIT PLAN
|
2018
|
061472180
|
2019-07-29
|
PRIME HEALTHCARE, P.C.
|
154
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1997-12-01
|
Business code |
621111
|
Sponsor’s telephone number |
8602630253
|
Plan sponsor’s mailing address |
30 JORDAN LN, WETHERSFIELD, CT, 061091278
|
Plan sponsor’s
address |
30 JORDAN LN, WETHERSFIELD, CT, 061091278
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-07-29 |
Name of individual signing |
SUSAN ALBANO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-07-29 |
Name of individual signing |
SUSAN ALBANO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRIME HEALTHCARE, P.C. WELFARE BENEFIT PLAN
|
2016
|
061472180
|
2017-07-26
|
PRIME HEALTHCARE, P.C.
|
151
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1997-12-01
|
Business code |
621111
|
Sponsor’s telephone number |
8602630253
|
Plan sponsor’s mailing address |
30 JORDAN LANE, WETHERSFIELD, CT, 06109
|
Plan sponsor’s
address |
30 JORDAN LANE, WETHERSFIELD, CT, 06109
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-07-26 |
Name of individual signing |
SUSAN ALBANO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-07-26 |
Name of individual signing |
SUSAN ALBANO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRIME HEALTHCARE, P.C. WELFARE BENEFIT PLAN
|
2015
|
061472180
|
2016-09-21
|
PRIME HEALTHCARE, P.C.
|
145
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1997-12-01
|
Business code |
621111
|
Sponsor’s telephone number |
8602630253
|
Plan sponsor’s mailing address |
30 JORDAN LN, WETHERSFIELD, CT, 061091278
|
Plan sponsor’s
address |
30 JORDAN LN, WETHERSFIELD, CT, 061091278
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-09-21 |
Name of individual signing |
SUSAN ALBANO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-09-21 |
Name of individual signing |
SUSAN ALBANO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRIME HEALTHCARE, P.C. WELFARE BENEFIT PLAN
|
2012
|
061472180
|
2013-06-27
|
PRIME HEALTHCARE, P.C.
|
175
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1997-12-01
|
Business code |
621111
|
Sponsor’s telephone number |
8602630253
|
Plan sponsor’s mailing address |
30 JORDAN LANE, WETHERSFIELD, CT, 06109
|
Plan sponsor’s
address |
30 JORDAN LANE, WETHERSFIELD, CT, 06109
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-06-26 |
Name of individual signing |
SUSAN ALBANO |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-06-26 |
Name of individual signing |
SUSAN ALBANO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRIME HEALTHCARE, P.C. WELFARE BENEFIT PLAN
|
2011
|
061472180
|
2012-07-26
|
PRIME HEALTHCARE, P.C.
|
183
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1997-12-01
|
Business code |
621111
|
Sponsor’s telephone number |
8602630253
|
Plan sponsor’s mailing address |
30 JORDAN LANE, WETHERSFIELD, CT, 06109
|
Plan sponsor’s
address |
30 JORDAN LANE, WETHERSFIELD, CT, 06109
|
Plan administrator’s name and address
Administrator’s EIN |
061472180 |
Plan administrator’s name |
PRIME HEALTHCARE, P.C. |
Plan administrator’s
address |
30 JORDAN LANE, WETHERSFIELD, CT, 06109 |
Administrator’s telephone number |
8602630253 |
Number of participants as of the end of the plan year
Active participants |
175 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2012-07-26 |
Name of individual signing |
SUSAN ALBANO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PRIME HEALTHCARE, P.C. WELFARE BENEFIT PLAN
|
2011
|
061472180
|
2012-07-26
|
PRIME HEALTHCARE, P.C.
|
100
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1997-12-01
|
Business code |
621111
|
Sponsor’s telephone number |
8602630253
|
Plan sponsor’s mailing address |
30 JORDAN LANE, WETHERSFIELD, CT, 06109
|
Plan sponsor’s
address |
30 JORDAN LANE, WETHERSFIELD, CT, 06109
|
Plan administrator’s name and address
Administrator’s EIN |
061472180 |
Plan administrator’s name |
PRIME HEALTHCARE, P.C. |
Plan administrator’s
address |
30 JORDAN LANE, WETHERSFIELD, CT, 06109 |
Administrator’s telephone number |
8602630253 |
Number of participants as of the end of the plan year
Active participants |
191 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2012-07-26 |
Name of individual signing |
SUSAN ALBANO |
Valid signature |
Filed with authorized/valid electronic signature |
|
|