MERIDIAN BEHAVIORAL HEALTH WELFARE BENEFITS
|
2016
|
205394048
|
2017-10-17
|
MERIDIAN BEHAVIORAL HEALTH, LLC
|
254
|
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2016-01-01
|
Business code |
621420
|
Sponsor’s telephone number |
6123267555
|
Plan
sponsor’s DBA name |
MERIDIAN BEHAVIORAL HEALTH, LLC
|
Plan sponsor’s mailing address |
550 MAIN ST STE 230, NEW BRIGHTON, MN, 551123274
|
Plan sponsor’s
address |
550 MAIN ST STE 230, NEW BRIGHTON, MN, 551123274
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-10-16 |
Name of individual signing |
AMBER ASMUS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-10-16 |
Name of individual signing |
AMBER ASMUS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MERDIAN BEHAVIORAL HEALTH WELFARE BENEFITS
|
2016
|
205394048
|
2017-10-17
|
MERIDIAN BEHAVIORAL HEALTH, LLC
|
45
|
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2016-01-01
|
Business code |
621420
|
Sponsor’s telephone number |
6124542014
|
Plan
sponsor’s DBA name |
MERIDIAN BEHAVIORAL HEALTH, LLC
|
Plan sponsor’s mailing address |
550 MAIN ST STE 230, NEW BRIGHTON, MN, 551123274
|
Plan sponsor’s
address |
550 MAIN ST STE 230, NEW BRIGHTON, MN, 551123274
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-10-16 |
Name of individual signing |
AMBER ASMUS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-10-16 |
Name of individual signing |
AMBER ASMUS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MERIDIAN BEHAVIORAL HEALTH WELFARE BENEFITS
|
2016
|
205394048
|
2017-10-17
|
MERIDIAN BEHAVIORAL HEALTH, LLC
|
632
|
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2016-01-01
|
Business code |
621420
|
Sponsor’s telephone number |
6124542014
|
Plan
sponsor’s DBA name |
MERIDIAN BEHAVIORAL HEALTH, LLC
|
Plan sponsor’s mailing address |
550 MAIN ST STE 230, NEW BRIGHTON, MN, 551123274
|
Plan sponsor’s
address |
550 MAIN ST STE 230, NEW BRIGHTON, MN, 551123274
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-10-16 |
Name of individual signing |
AMBER ASMUS |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-10-16 |
Name of individual signing |
AMBER ASMUS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MERIDIAN BEHAVIORAL HEALTH WELFARE BENEFITS
|
2015
|
205394048
|
2016-11-11
|
MERIDIAN BEHAVIORAL HEALTH, LLC
|
247
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2012-01-01
|
Business code |
621420
|
Sponsor’s telephone number |
6123267555
|
Plan sponsor’s mailing address |
550 MAIN ST STE 230, NEW BRIGHTON, MN, 551123274
|
Plan sponsor’s
address |
550 MAIN ST STE 230, NEW BRIGHTON, MN, 551123274
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-11-11 |
Name of individual signing |
PAULA NELSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-11-11 |
Name of individual signing |
PAULA NELSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MERIDIAN BEHAVIORAL HEALTH WELFARE BENEFITS
|
2014
|
205394048
|
2015-10-13
|
MERIDIAN BEHAVIORAL HEALTH, LLC
|
169
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2012-01-01
|
Business code |
621420
|
Sponsor’s telephone number |
6123267555
|
Plan sponsor’s mailing address |
550 MAIN ST. SUITE 230, NEW BRIGHTON, MN, 55112
|
Plan sponsor’s
address |
550 MAIN ST. SUITE 230, NEW BRIGHTON, MN, 55112
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-10-13 |
Name of individual signing |
PAULA NELSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-10-13 |
Name of individual signing |
PAULA NELSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MERIDIAN BEHAVIORAL HEALTH WELFARE BENEFITS
|
2014
|
205394048
|
2015-10-13
|
MERIDIAN BEHAVIORAL HEALTH. LLC
|
228
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2012-01-01
|
Business code |
621420
|
Sponsor’s telephone number |
6123267555
|
Plan sponsor’s mailing address |
550 MAIN ST. SUITE 230, NEW BRIGHTON, MN, 55112
|
Plan sponsor’s
address |
550 MAIN ST. SUITE 230, NEW BRIGHTON, MN, 55112
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-10-13 |
Name of individual signing |
PAULA NELSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-10-13 |
Name of individual signing |
PAULA NELSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MERIDIAN BEHAVIORAL HEALTH WELFARE BENEFITS
|
2013
|
205394048
|
2014-10-14
|
MERIDIAN BEHAVIORAL HEALTH, LLC
|
179
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2012-01-01
|
Business code |
621420
|
Sponsor’s telephone number |
6123267555
|
Plan sponsor’s mailing address |
550 MAIN ST. SUITE 230, NEW BRIGHTON, MN, 55112
|
Plan sponsor’s
address |
550 MAIN ST. SUITE 230, NEW BRIGHTON, MN, 55112
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-10-14 |
Name of individual signing |
PAULA NELSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MERIDIAN BEHAVIORAL HEALTH WELFARE BENEFITS
|
2013
|
205394048
|
2014-10-14
|
MERIDIAN BEHAVIORAL HEALTH, LLC
|
164
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2013-01-01
|
Business code |
621420
|
Sponsor’s telephone number |
6123267555
|
Plan sponsor’s mailing address |
550 MAIN ST. SUITE 230, NEW BRIGHTON, MN, 55112
|
Plan sponsor’s
address |
550 MAIN ST. SUITE 230, NEW BRIGHTON, MN, 55112
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-10-14 |
Name of individual signing |
PAULA NELSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MERIDIAN BEHAVIORAL HEALTH WELFARE BENEFITS
|
2013
|
205394048
|
2014-10-14
|
MERIDIAN BEHAVIORAL HEALTH, LLC
|
157
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2012-01-01
|
Business code |
621420
|
Sponsor’s telephone number |
6123267555
|
Plan sponsor’s mailing address |
550 MAIN ST. SUITE 230, NEW BRIGHTON, MN, 55112
|
Plan sponsor’s
address |
550 MAIN ST. SUITE 230, NEW BRIGHTON, MN, 55112
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-10-14 |
Name of individual signing |
PAULA NELSON |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MERIDIAN BEHAVIORAL HEALTH WELFARE BENEFITS
|
2012
|
205394048
|
2014-08-13
|
MERIDIAN BEHAVIORAL HEALTH, LLC
|
270
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2012-01-01
|
Business code |
621420
|
Sponsor’s telephone number |
6123267555
|
Plan sponsor’s mailing address |
550 MAIN ST. SUITE 230, NEW BRIGHTON, MN, 55112
|
Plan sponsor’s
address |
550 MAIN ST. SUITE 230, NEW BRIGHTON, MN, 55112
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-08-13 |
Name of individual signing |
PATRICIA WANOUS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|