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| Plan Name | ST LUKES MINERS MEMORIAL HOSPITAL FLEXIBLE BENEFITS PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | ST. LUKE'S MINERS MEMORIAL HOSPITAL |
| Employer identification number (EIN): | 251550350 |
| NAIC Classification: | 622000 |
| NAIC Description: | Hospitals |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2016-01-01 | THOMAS LICHTENWALNER | |||
| 501 | 2015-01-01 | THOMAS LICHTENWALNER | |||
| 501 | 2014-01-01 | THOMAS LICHTENWALNER | |||
| 501 | 2013-01-01 | THOMAS P. LICHTENWALNER | |||
| 501 | 2012-01-01 | THOMAS P. LICHTENWALNER | THOMAS P LICHTENWALNER | 2013-09-25 | |
| 501 | 2011-01-01 | THOMAS P. LICHTENWALNER | THOMAS P LICHTENWALNER | 2012-10-09 | |
| 501 | 2010-01-01 | THOMAS P. LICHTENWALNER | |||
| 501 | 2009-01-01 | THOMAS P. LICHTENWALNER | THOMAS P LICHTENWALNER | 2010-10-15 |
| AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) | |
| Policy contract number | 44498 |
| Policy instance | 1 |
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) | |
| Policy contract number | 47365 |
| Policy instance | 2 |
| AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) | |
| Policy contract number | 44498 |
| Policy instance | 1 |
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) | |
| Policy contract number | 47365 |
| Policy instance | 2 |
| AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) | |
| Policy contract number | 44498 |
| Policy instance | 1 |
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) | |
| Policy contract number | 47365 |
| Policy instance | 2 |
| AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) | |
| Policy contract number | 44498 |
| Policy instance | 1 |
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) | |
| Policy contract number | 47365 |
| Policy instance | 2 |
| AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) | |
| Policy contract number | 44498 |
| Policy instance | 1 |
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) | |
| Policy contract number | 47365 |
| Policy instance | 2 |
| AMERICAN FIDELITY ASSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60410 ) | |
| Policy contract number | 13777-44498 |
| Policy instance | 1 |
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) | |
| Policy contract number | 47365 |
| Policy instance | 2 |
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