| Plan Name | PRIMARY CARE ASSOCIATES OF NEW LEBANON SOCA BENEFIT PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | PCA OF NEW LEBANON |
| Employer identification number (EIN): | 134245687 |
| NAIC Classification: | 621111 |
| NAIC Description: | Offices of Physicians (except Mental Health Specialists) |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2018-05-01 | MATT APPENZELLER | 2019-10-24 | ||
| 501 | 2017-12-01 | MATT APPENZELLER | 2019-01-17 |