| Plan Name | LIFE INSURANCE |
| Plan identification number | 504 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | UMASS MEMORIAL HEALTHALLIANCE CLINTON HOSPITAL |
| Employer identification number (EIN): | 042103555 |
| NAIC Classification: | 622000 |
| NAIC Description: | Hospitals |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 504 | 2021-01-01 | ||||
| 504 | 2021-01-01 | DIANE SARKISIAN | |||
| 504 | 2020-01-01 | ||||
| 504 | 2019-01-01 | ||||
| 504 | 2018-01-01 | ||||
| 504 | 2017-01-01 | JOHN BRONHARD | JOHN BRONHARD | 2018-10-05 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) | |
| Policy contract number | 52886 |
| Policy instance | 1 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) | |
| Policy contract number | 52886 |
| Policy instance | 1 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) | |
| Policy contract number | 52886 |
| Policy instance | 1 |
| PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 ) | |
| Policy contract number | 52886 |
| Policy instance | 1 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) | |
| Policy contract number | 649336 |
| Policy instance | 1 |