|
GLENCOE REGIONAL HEALTH SERVICES EMPLOYEE GROUP WELFARE INSURANCE PLAN
|
2011
|
411949230
|
2012-07-02
|
GLENCOE REGIONAL HEALTH SERVICES
|
333
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
502
|
| Effective date of plan |
2000-05-01
|
| Business code |
622000
|
| Sponsor’s telephone number |
3208643121
|
| Plan sponsor’s mailing address |
1805 HENNEPIN AVENUE NORTH, GLENCOE, MN, 55336
|
| Plan sponsor’s
address |
1805 HENNEPIN AVENUE NORTH, GLENCOE, MN, 55336
|
Plan administrator’s name and address
| Administrator’s EIN |
411949230 |
| Plan administrator’s name |
GLENCOE REGIONAL HEALTH SERVICES |
| Plan administrator’s
address |
1805 HENNEPIN AVENUE NORTH, GLENCOE, MN, 55336 |
| Administrator’s telephone number |
3208643121 |
Number of participants as of the end of the plan year
| Active participants |
313 |
| Retired or separated participants receiving
benefits |
12 |
| Other
retired or separated participants entitled to future benefits |
15 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
1 |
Signature of
| Role |
Plan administrator |
| Date |
2012-07-02 |
| Name of individual signing |
LISA STROBEL |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
GLENCOE REGIONAL HEALTH SERVICES EMPLOYEE GROUP WELFARE INSURANCE PLAN
|
2010
|
411949230
|
2011-05-27
|
GLENCOE REGIONAL HEALTH SERVICES
|
322
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
502
|
| Effective date of plan |
2000-05-01
|
| Business code |
622000
|
| Sponsor’s telephone number |
3208643121
|
| Plan sponsor’s mailing address |
1805 HENNEPIN AVENUE NORTH, GLENCOE, MN, 55336
|
| Plan sponsor’s
address |
1805 HENNEPIN AVENUE NORTH, GLENCOE, MN, 55336
|
Plan administrator’s name and address
| Administrator’s EIN |
411949230 |
| Plan administrator’s name |
GLENCOE REGIONAL HEALTH SERVICES |
| Plan administrator’s
address |
1805 HENNEPIN AVENUE NORTH, GLENCOE, MN, 55336 |
| Administrator’s telephone number |
3208643121 |
Number of participants as of the end of the plan year
| Active participants |
313 |
| Retired or separated participants receiving
benefits |
11 |
| Other
retired or separated participants entitled to future benefits |
9 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2011-05-26 |
| Name of individual signing |
LISA STROBEL |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
GLENCOE REGIONAL HEALTH SERVICES EMPLOYEE GROUP WELFARE INSURANCE PLAN
|
2009
|
411949230
|
2010-06-24
|
GLENCOE REGIONAL HEALTH SERVICES
|
400
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
502
|
| Effective date of plan |
2000-05-01
|
| Business code |
622000
|
| Sponsor’s telephone number |
3208643121
|
| Plan sponsor’s mailing address |
1805 HENNEPIN AVENUE NORTH, GLENCOE, MN, 55336
|
| Plan sponsor’s
address |
1805 HENNEPIN AVENUE NORTH, GLENCOE, MN, 55336
|
Plan administrator’s name and address
| Administrator’s EIN |
411949230 |
| Plan administrator’s name |
GLENCOE REGIONAL HEALTH SERVICES |
| Plan administrator’s
address |
1805 HENNEPIN AVENUE NORTH, GLENCOE, MN, 55336 |
| Administrator’s telephone number |
3208643121 |
Number of participants as of the end of the plan year
| Active participants |
295 |
| Retired or separated participants receiving
benefits |
14 |
| Other
retired or separated participants entitled to future benefits |
13 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Signature of
| Role |
Plan administrator |
| Date |
2010-06-24 |
| Name of individual signing |
LISA STROBEL |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
GLENCOE REGIONAL HEALTH SERVICES EMPLOYEE GROUP WELFARE INSURANCE PLAN
|
2009
|
411949230
|
2010-06-21
|
GLENCOE REGIONAL HEALTH SERVICES
|
400
|
|
| Three-digit plan number (PN) |
502
|
| Effective date of plan |
2000-05-01
|
| Business code |
622000
|
| Sponsor’s telephone number |
3208643121
|
| Plan sponsor’s mailing address |
1805 HENNEPIN AVENUE NORTH, GLENCOE, MN, 55336
|
| Plan sponsor’s
address |
1805 HENNEPIN AVENUE NORTH, GLENCOE, MN, 55336
|
Plan administrator’s name and address
| Administrator’s EIN |
411949230 |
| Plan administrator’s name |
GLENCOE REGIONAL HEALTH SERVICES |
| Plan administrator’s
address |
1805 HENNEPIN AVENUE NORTH, GLENCOE, MN, 55336 |
| Administrator’s telephone number |
3208643121 |
Number of participants as of the end of the plan year
| Active participants |
295 |
| Retired or separated participants receiving
benefits |
14 |
| Other
retired or separated participants entitled to future benefits |
13 |
| Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Signature of
| Role |
Employer/plan sponsor |
| Date |
2010-06-21 |
| Name of individual signing |
LISA STROBEL |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
