LONG TERM DISABILITY
|
2014
|
133491053
|
2015-11-24
|
DONCASTERS, INC.
|
1429
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
1990-03-01
|
Business code |
332900
|
Sponsor’s telephone number |
8606771376
|
Plan sponsor’s mailing address |
36 SPRING LANE, FARMINGTON, CT, 06032
|
Plan sponsor’s
address |
36 SPRING LANE, FARMINGTON, CT, 06032
|
Number of participants as of the end of the plan year
Active participants |
0 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-11-24 |
Name of individual signing |
CRAIG MACINTYRE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LIFEADD
|
2014
|
133491053
|
2015-11-24
|
DONCASTERS, INC
|
1159
|
|
File |
View Page
|
Three-digit plan number (PN) |
512
|
Effective date of plan |
1997-02-03
|
Business code |
332900
|
Sponsor’s telephone number |
8606771376
|
Plan sponsor’s mailing address |
36 SPRING LANE, FARMINGTON, CT, 06032
|
Plan sponsor’s
address |
36 SPRING LANE, FARMINGTON, CT, 06032
|
Number of participants as of the end of the plan year
Active participants |
0 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-11-24 |
Name of individual signing |
CRAIG MACINTYRE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MEDICAL / VISION PLAN
|
2014
|
133491053
|
2015-11-24
|
DONCASTERS, INC.
|
1242
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1990-03-01
|
Business code |
332900
|
Sponsor’s telephone number |
8606771376
|
Plan sponsor’s mailing address |
36 SPRING LANE, FARMINGTON, CT, 06032
|
Plan sponsor’s
address |
36 SPRING LANE, FARMINGTON, CT, 06032
|
Number of participants as of the end of the plan year
Active participants |
0 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-11-24 |
Name of individual signing |
CRAIG MACINTYRE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL PLAN
|
2014
|
133491053
|
2015-11-24
|
DONCASTERS, INC.
|
1288
|
|
File |
View Page
|
Three-digit plan number (PN) |
513
|
Effective date of plan |
1990-03-01
|
Business code |
332900
|
Sponsor’s telephone number |
8606771376
|
Plan sponsor’s mailing address |
36 SPRING LANE, FARMINGTON, CT, 06032
|
Plan sponsor’s
address |
36 SPRING LANE, FARMINGTON, CT, 06032
|
Number of participants as of the end of the plan year
Active participants |
0 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-11-24 |
Name of individual signing |
CRAIG MACINTYRE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MEDICAL / VISION PLAN
|
2013
|
133491053
|
2015-02-17
|
DONCASTERS, INC.
|
1242
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1990-03-01
|
Business code |
332900
|
Sponsor’s telephone number |
8606771376
|
Plan sponsor’s mailing address |
36 SPRING LANE, FARMINGTON, CT, 06032
|
Plan sponsor’s
address |
36 SPRING LANE, FARMINGTON, CT, 06032
|
Number of participants as of the end of the plan year
Active participants |
1193 |
Retired or separated participants receiving
benefits |
49 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-02-17 |
Name of individual signing |
CRAIG MACINTYRE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LONG TERM DISABILITY
|
2013
|
133491053
|
2015-02-17
|
DONCASTERS, INC.
|
1159
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
1990-03-01
|
Business code |
332900
|
Sponsor’s telephone number |
8606771376
|
Plan sponsor’s mailing address |
36 SPRING LANE, FARMINGTON, CT, 06032
|
Plan sponsor’s
address |
36 SPRING LANE, FARMINGTON, CT, 06032
|
Number of participants as of the end of the plan year
Active participants |
1429 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-02-17 |
Name of individual signing |
CRAIG MACINTYRE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LIFEADD
|
2013
|
133491053
|
2015-02-17
|
DONCASTERS, INC
|
1536
|
|
File |
View Page
|
Three-digit plan number (PN) |
512
|
Effective date of plan |
1997-02-03
|
Business code |
332900
|
Sponsor’s telephone number |
8606771376
|
Plan sponsor’s mailing address |
36 SPRING LANE, FARMINGTON, CT, 06032
|
Plan sponsor’s
address |
36 SPRING LANE, FARMINGTON, CT, 06032
|
Plan administrator’s name and address
Administrator’s EIN |
133491053 |
Plan administrator’s name |
DONCASTERS, INC |
Plan administrator’s
address |
36 SPRING LANE, FARMINGTON, CT, 06032 |
Administrator’s telephone number |
8606771376 |
Number of participants as of the end of the plan year
Active participants |
1159 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-02-17 |
Name of individual signing |
CRAIG MACINTYRE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL PLAN
|
2013
|
133491053
|
2015-02-17
|
DONCASTERS, INC.
|
1445
|
|
File |
View Page
|
Three-digit plan number (PN) |
513
|
Effective date of plan |
1990-03-01
|
Business code |
332900
|
Sponsor’s telephone number |
8606771376
|
Plan sponsor’s mailing address |
36 SPRING LANE, FARMINGTON, CT, 06032
|
Plan sponsor’s
address |
36 SPRING LANE, FARMINGTON, CT, 06032
|
Number of participants as of the end of the plan year
Active participants |
1252 |
Retired or separated participants receiving
benefits |
36 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-02-17 |
Name of individual signing |
CRAIG MACINTYRE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
2012 LIFEADD 512
|
2012
|
133491053
|
2013-11-26
|
DONCASTERS, INC
|
1475
|
|
File |
View Page
|
Three-digit plan number (PN) |
512
|
Effective date of plan |
1997-02-03
|
Business code |
332900
|
Sponsor’s telephone number |
8606771376
|
Plan sponsor’s mailing address |
36 SPRING LANE, FARMINGTON, CT, 06032
|
Plan sponsor’s
address |
36 SPRING LANE, FARMINGTON, CT, 06032
|
Plan administrator’s name and address
Administrator’s EIN |
133491053 |
Plan administrator’s name |
DONCASTERS, INC |
Plan administrator’s
address |
36 SPRING LANE, FARMINGTON, CT, 06032 |
Administrator’s telephone number |
8606771376 |
Number of participants as of the end of the plan year
Active participants |
1429 |
Retired or separated participants receiving
benefits |
107 |
Signature of
Role |
Plan administrator |
Date |
2013-11-26 |
Name of individual signing |
CRAIG MACINTYRE |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-11-26 |
Name of individual signing |
CRAIG MACINTYRE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
2011 LONG TERM DISABILITY
|
2012
|
133491053
|
2013-11-26
|
DONCASTERS, INC.
|
1164
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
1990-03-01
|
Business code |
332900
|
Sponsor’s telephone number |
8606771376
|
Plan sponsor’s mailing address |
36 SPRING LANE, FARMINGTON, CT, 06032
|
Plan sponsor’s
address |
36 SPRING LANE, FARMINGTON, CT, 06032
|
Number of participants as of the end of the plan year
Active participants |
1159 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2013-11-26 |
Name of individual signing |
CRAIG MACINTYRE |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-11-26 |
Name of individual signing |
CRAIG MACINTYRE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|