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| Plan Name | PARK CENTER, INC. CONSOLIDATED WELFARE BENEFIT PLAN |
| Plan identification number | 511 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | PARK CENTER, INC. |
| Employer identification number (EIN): | 351135451 |
| NAIC Classification: | 621420 |
| NAIC Description: | Outpatient Mental Health and Substance Abuse Centers |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 511 | 2021-01-01 | ||||
| 511 | 2021-01-01 | CHARLES CLARK | |||
| 511 | 2020-01-01 | ||||
| 511 | 2019-01-01 | ||||
| 511 | 2018-01-01 | SUNITA WINCHESTER | |||
| 511 | 2017-01-01 | SCOTT MUSICK | |||
| 511 | 2016-01-01 | CLYDE NIX | CLYDE NIX | 2017-06-06 | |
| 511 | 2015-01-01 | BRAD ALTEVOGT | |||
| 511 | 2014-01-01 | BRAD ALTEVOGT | |||
| 511 | 2013-01-01 | BRAD ALTEVOGT | |||
| 511 | 2012-01-01 | BRAD ALTEVOGT | |||
| 511 | 2011-01-01 | BRAD ALTEVOGT | |||
| 511 | 2009-01-01 | BRAD ALTEVOGT |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) | |
| Policy contract number | 30036327 |
| Policy instance | 2 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |
| Policy contract number | G000AKA8 |
| Policy instance | 1 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |
| Policy contract number | G000AKA8 |
| Policy instance | 2 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) | |
| Policy contract number | 30036327 |
| Policy instance | 1 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |
| Policy contract number | G000AKA8 |
| Policy instance | 2 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) | |
| Policy contract number | 30036327 |
| Policy instance | 1 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |
| Policy contract number | G000AKA8 |
| Policy instance | 3 |
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) | |
| Policy contract number | V3742 |
| Policy instance | 2 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) | |
| Policy contract number | 30036327 |
| Policy instance | 1 |
| AMERICAN HERITAGE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60534 ) | |
| Policy contract number | V3742 |
| Policy instance | 3 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |
| Policy contract number | G000AKA8 |
| Policy instance | 2 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 ) | |
| Policy contract number | 30036327 |
| Policy instance | 1 |
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