| Plan Name | HEALTH INSURANCE PLAN OF NORTHERN RIVERS FAMILY SE |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | NORTHERN RIVERS FAMILY SERVICES, INC. |
| Employer identification number (EIN): | 460759782 |
| NAIC Classification: | 624100 |
| NAIC Description: | Individual and Family Services |
Additional information about NORTHERN RIVERS FAMILY SERVICES, INC.
| Jurisdiction of Incorporation: | New York Department of State |
| Incorporation Date: | 2012-07-23 |
| Company Identification Number: | 4274195 |
| Legal Registered Office Address: |
60 ACADEMY ROAD ATTENTION: PRESIDENT ALBANY United States of America (USA) 12208 |
More information about NORTHERN RIVERS FAMILY SERVICES, INC.
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2017-01-01 | ||||
| 501 | 2016-01-01 | ||||
| 501 | 2015-01-01 | ||||
| 501 | 2014-01-01 |
| 2017: HEALTH INSURANCE PLAN OF NORTHERN RIVERS FAMILY SE 2017 form 5500 responses | ||
|---|---|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: HEALTH INSURANCE PLAN OF NORTHERN RIVERS FAMILY SE 2016 form 5500 responses | ||
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: HEALTH INSURANCE PLAN OF NORTHERN RIVERS FAMILY SE 2015 form 5500 responses | ||
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: HEALTH INSURANCE PLAN OF NORTHERN RIVERS FAMILY SE 2014 form 5500 responses | ||
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | First time form 5500 has been submitted | Yes |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 ) | |
| Policy contract number | 16428 |
| Policy instance | 1 |
| CAPITAL DISTRICT PHYSICIANS HEALTH PLAN INC (National Association of Insurance Commissioners NAIC id number: 95491 ) | |
| Policy contract number | 20029982 |
| Policy instance | 2 |
| DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 ) | |
| Policy contract number | 16428 |
| Policy instance | 1 |
| CAPITAL DISTRICT PHYSICIANS HEALTH PLAN INC (National Association of Insurance Commissioners NAIC id number: 95491 ) | |
| Policy contract number | 20029982 |
| Policy instance | 2 |
| DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 ) | |
| Policy contract number | 16428 |
| Policy instance | 1 |
| EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) | |
| Policy contract number | 720865 |
| Policy instance | 2 |