MAYO PAID DISABILITY INCOME
|
2018
|
416011702
|
2020-07-16
|
MAYO CLINIC
|
65435
|
|
File |
View Page
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
1957-09-01
|
Business code |
621112
|
Sponsor’s telephone number |
9999999999
|
Plan sponsor’s mailing address |
200 FIRST STREET SW, ROCHESTER, MN, 55905
|
Plan sponsor’s
address |
200 FIRST STREET SW, ROCHESTER, MN, 55905
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2020-07-16 |
Name of individual signing |
WILLIAM BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-07-16 |
Name of individual signing |
WILLIAM BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MAYO PAID DISABILITY INCOME
|
2018
|
416011702
|
2019-06-14
|
MAYO CLINIC
|
65435
|
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
1957-09-01
|
Business code |
621112
|
Sponsor’s telephone number |
9999999999
|
Plan sponsor’s mailing address |
200 FIRST STREET SW, ROCHESTER, MN, 55905
|
Plan sponsor’s
address |
200 FIRST STREET SW, ROCHESTER, MN, 55905
|
Number of participants as of the end of the plan year
Active participants |
67392 |
Signature of
Role |
Plan administrator |
Date |
2019-06-14 |
Name of individual signing |
WILLIAM BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-06-14 |
Name of individual signing |
WILLIAM BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MAYO PAID DISABILITY INCOME
|
2016
|
416011702
|
2017-06-07
|
MAYO CLINIC
|
56869
|
|
File |
View Page
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
1957-09-01
|
Business code |
621112
|
Sponsor’s telephone number |
9999999999
|
Plan sponsor’s mailing address |
200 FIRST STREET SW, ROCHESTER, MN, 55905
|
Plan sponsor’s
address |
200 FIRST STREET SW, ROCHESTER, MN, 55905
|
Number of participants as of the end of the plan year
Active participants |
59410 |
Signature of
Role |
Plan administrator |
Date |
2017-06-07 |
Name of individual signing |
WILLIAM BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-06-07 |
Name of individual signing |
WILLIAM BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MAYO CLINIC ACCIDENTAL DEATH & DISMEMBERMENT
|
2016
|
416011702
|
2017-06-07
|
MAYO CLINIC
|
57067
|
|
File |
View Page
|
Three-digit plan number (PN) |
508
|
Effective date of plan |
1962-09-01
|
Business code |
621112
|
Sponsor’s telephone number |
9999999999
|
Plan sponsor’s mailing address |
200 FIRST STREET SW, ROCHESTER, MN, 55905
|
Plan sponsor’s
address |
200 FIRST STREET SW, ROCHESTER, MN, 55905
|
Number of participants as of the end of the plan year
Active participants |
59391 |
Signature of
Role |
Plan administrator |
Date |
2017-06-06 |
Name of individual signing |
WILLIAM BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-06-06 |
Name of individual signing |
WILLIAM BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FELLOWS GROUP TERM LIFE INSURANCE & DISABILITY INCOME
|
2016
|
416011702
|
2017-06-07
|
MAYO CLINIC
|
3017
|
|
File |
View Page
|
Three-digit plan number (PN) |
507
|
Effective date of plan |
1961-09-01
|
Business code |
621112
|
Sponsor’s telephone number |
9999999999
|
Plan sponsor’s mailing address |
200 FIRST STREET SW, ROCHESTER, MN, 55905
|
Plan sponsor’s
address |
200 FIRST STREET SW, ROCHESTER, MN, 55905
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-06-06 |
Name of individual signing |
WILLIAM BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-06-06 |
Name of individual signing |
WILLIAM BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VOLUNTARY GROUP TERM AND UNIVERSAL LIFE
|
2016
|
416011702
|
2017-06-07
|
MAYO CLINIC
|
69370
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
1950-11-01
|
Business code |
621112
|
Sponsor’s telephone number |
9999999999
|
Plan sponsor’s mailing address |
200 FIRST STREET SW, ROCHESTER, MN, 55905
|
Plan sponsor’s
address |
200 FIRST STREET SW, ROCHESTER, MN, 55905
|
Number of participants as of the end of the plan year
Active participants |
69715 |
Signature of
Role |
Plan administrator |
Date |
2017-06-06 |
Name of individual signing |
WILLIAM BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-06-06 |
Name of individual signing |
WILLIAM BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP LIFE INSURANCE PLAN (EMPLOYER PAID)
|
2016
|
416011702
|
2017-06-07
|
MAYO CLINIC
|
67356
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
1922-12-26
|
Business code |
621112
|
Sponsor’s telephone number |
5075380733
|
Plan sponsor’s mailing address |
200 FIRST STREET SW, ROCHESTER, MN, 55905
|
Plan sponsor’s
address |
200 FIRST STREET SW, ROCHESTER, MN, 55905
|
Number of participants as of the end of the plan year
Active participants |
69031 |
Signature of
Role |
Plan administrator |
Date |
2017-06-06 |
Name of individual signing |
WILLIAM BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-06-06 |
Name of individual signing |
WILLIAM BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FELLOWS GROUP TERM LIFE INSURANCE & DISABILITY INCOME
|
2015
|
416011702
|
2016-06-15
|
MAYO CLINIC
|
3233
|
|
File |
View Page
|
Three-digit plan number (PN) |
507
|
Effective date of plan |
1961-09-01
|
Business code |
621112
|
Sponsor’s telephone number |
9999999999
|
Plan sponsor’s mailing address |
200 FIRST STREET SW, ROCHESTER, MN, 55905
|
Plan sponsor’s
address |
200 FIRST STREET SW, ROCHESTER, MN, 55905
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-06-15 |
Name of individual signing |
WILLIAM BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-06-15 |
Name of individual signing |
WILLIAM BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
MAYO PAID DISABILITY INCOME
|
2015
|
416011702
|
2016-06-15
|
MAYO CLINIC
|
43760
|
|
File |
View Page
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
1957-09-01
|
Business code |
621112
|
Sponsor’s telephone number |
9999999999
|
Plan sponsor’s mailing address |
200 FIRST STREET SW, ROCHESTER, MN, 55905
|
Plan sponsor’s
address |
200 FIRST STREET SW, ROCHESTER, MN, 55905
|
Number of participants as of the end of the plan year
Active participants |
56869 |
Signature of
Role |
Plan administrator |
Date |
2016-06-15 |
Name of individual signing |
WILLIAM BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-06-15 |
Name of individual signing |
WILLIAM BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VOLUNTARY GROUP TERM AND UNIVERSAL LIFE
|
2015
|
416011702
|
2016-06-15
|
MAYO CLINIC
|
56414
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
1950-11-01
|
Business code |
621112
|
Sponsor’s telephone number |
9999999999
|
Plan sponsor’s mailing address |
200 FIRST STREET SW, ROCHESTER, MN, 55905
|
Plan sponsor’s
address |
200 FIRST STREET SW, ROCHESTER, MN, 55905
|
Number of participants as of the end of the plan year
Active participants |
69370 |
Signature of
Role |
Plan administrator |
Date |
2016-06-15 |
Name of individual signing |
WILLIAM BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-06-15 |
Name of individual signing |
WILLIAM BROWN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|