Plan Name | DENTAL INSURANCE PLAN |
Plan identification number | 504 |
401k Plan Type | Welfare Benefit |
Plan Features/Benefits |
|
Company Name: | CHAMPLAIN VALLEY PHYSICIANS HOSPITAL |
Employer identification number (EIN): | 141338471 |
NAIC Classification: | 622000 |
NAIC Description: | Hospitals |
Additional information about CHAMPLAIN VALLEY PHYSICIANS HOSPITAL
Jurisdiction of Incorporation: | New York Department of State |
Incorporation Date: | 1910-10-13 |
Company Identification Number: | 29737 |
Legal Registered Office Address: |
75 BEEKMAN STREET Clinton PLATTSBURGH United States of America (USA) 12901 |
More information about CHAMPLAIN VALLEY PHYSICIANS HOSPITAL
Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
---|---|---|---|---|---|
504 | 2021-01-01 | JUDY PETERSON | 2022-10-14 | MICHELLE LEBEAU | 2022-10-14 |
504 | 2021-01-01 | JUDY PETERSON | 2023-07-06 | MICHELLE LEBEAU | 2023-07-06 |
504 | 2020-01-01 | ||||
504 | 2019-01-01 | ||||
504 | 2018-01-01 | ||||
504 | 2017-01-01 | MICHELLE LEBEAU | |||
504 | 2016-01-01 | STEPHENS MUNDY | |||
504 | 2015-01-01 | STEPHENS MUNDY | |||
504 | 2014-01-01 | STEPHENS MUNDY | |||
504 | 2013-01-01 | STEPHENS MUNDY | |||
504 | 2012-01-01 | STEPHENS MUNDY |
2021: DENTAL INSURANCE PLAN 2021 form 5500 responses | ||
---|---|---|
2021-01-01 | Type of plan entity | Single employer plan |
2021-01-01 | Submission has been amended | Yes |
2021-01-01 | This submission is the final filing | Yes |
2021-01-01 | Plan funding arrangement – Insurance | Yes |
2021-01-01 | Plan benefit arrangement – Insurance | Yes |
2020: DENTAL INSURANCE PLAN 2020 form 5500 responses | ||
2020-01-01 | Type of plan entity | Single employer plan |
2020-01-01 | Submission has been amended | No |
2020-01-01 | This submission is the final filing | No |
2020-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2020-01-01 | Plan is a collectively bargained plan | No |
2020-01-01 | Plan funding arrangement – Insurance | Yes |
2020-01-01 | Plan benefit arrangement – Insurance | Yes |
2019: DENTAL INSURANCE PLAN 2019 form 5500 responses | ||
2019-01-01 | Type of plan entity | Single employer plan |
2019-01-01 | Submission has been amended | No |
2019-01-01 | This submission is the final filing | No |
2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2019-01-01 | Plan is a collectively bargained plan | No |
2019-01-01 | Plan funding arrangement – Insurance | Yes |
2019-01-01 | Plan benefit arrangement – Insurance | Yes |
2018: DENTAL INSURANCE PLAN 2018 form 5500 responses | ||
2018-01-01 | Type of plan entity | Single employer plan |
2018-01-01 | Submission has been amended | No |
2018-01-01 | This submission is the final filing | No |
2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2018-01-01 | Plan is a collectively bargained plan | No |
2018-01-01 | Plan funding arrangement – Insurance | Yes |
2018-01-01 | Plan benefit arrangement – Insurance | Yes |
2017: DENTAL INSURANCE PLAN 2017 form 5500 responses | ||
2017-01-01 | Type of plan entity | Single employer plan |
2017-01-01 | Submission has been amended | No |
2017-01-01 | This submission is the final filing | No |
2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2017-01-01 | Plan is a collectively bargained plan | No |
2017-01-01 | Plan funding arrangement – Insurance | Yes |
2017-01-01 | Plan benefit arrangement – Insurance | Yes |
2016: DENTAL INSURANCE PLAN 2016 form 5500 responses | ||
2016-01-01 | Type of plan entity | Single employer plan |
2016-01-01 | Submission has been amended | No |
2016-01-01 | This submission is the final filing | No |
2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-01-01 | Plan is a collectively bargained plan | No |
2016-01-01 | Plan funding arrangement – Insurance | Yes |
2016-01-01 | Plan benefit arrangement – Insurance | Yes |
2015: DENTAL INSURANCE PLAN 2015 form 5500 responses | ||
2015-01-01 | Type of plan entity | Single employer plan |
2015-01-01 | Submission has been amended | No |
2015-01-01 | This submission is the final filing | No |
2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-01-01 | Plan is a collectively bargained plan | No |
2015-01-01 | Plan funding arrangement – Insurance | Yes |
2015-01-01 | Plan benefit arrangement – Insurance | Yes |
2014: DENTAL INSURANCE PLAN 2014 form 5500 responses | ||
2014-01-01 | Type of plan entity | Single employer plan |
2014-01-01 | Submission has been amended | No |
2014-01-01 | This submission is the final filing | No |
2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-01-01 | Plan is a collectively bargained plan | No |
2014-01-01 | Plan funding arrangement – Insurance | Yes |
2014-01-01 | Plan benefit arrangement – Insurance | Yes |
2013: DENTAL INSURANCE PLAN 2013 form 5500 responses | ||
2013-01-01 | Type of plan entity | Single employer plan |
2013-01-01 | First time form 5500 has been submitted | Yes |
2013-01-01 | Submission has been amended | No |
2013-01-01 | This submission is the final filing | No |
2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-01-01 | Plan is a collectively bargained plan | No |
2013-01-01 | Plan funding arrangement – Insurance | Yes |
2013-01-01 | Plan benefit arrangement – Insurance | Yes |
2012: DENTAL INSURANCE PLAN 2012 form 5500 responses | ||
2012-01-01 | Type of plan entity | Single employer plan |
2012-01-01 | First time form 5500 has been submitted | Yes |
2012-01-01 | Submission has been amended | No |
2012-01-01 | This submission is the final filing | No |
2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-01-01 | Plan is a collectively bargained plan | No |
2012-01-01 | Plan funding arrangement – Insurance | Yes |
2012-01-01 | Plan benefit arrangement – Insurance | Yes |
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) | |
Policy contract number | 720762 |
Policy instance | 1 |
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) | |
Policy contract number | 238418 |
Policy instance | 1 |
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) | |
Policy contract number | 238418 |
Policy instance | 1 |
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) | |
Policy contract number | 238418 |
Policy instance | 1 |
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) | |
Policy contract number | 238418 |
Policy instance | 1 |
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) | |
Policy contract number | 238418 |
Policy instance | 1 |
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) | |
Policy contract number | 238418 |
Policy instance | 1 |
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) | |
Policy contract number | 238418 |
Policy instance | 1 |
EMPIRE HEALTHCHOICE ASSURANCE, INC. (National Association of Insurance Commissioners NAIC id number: 55093 ) | |
Policy contract number | 238418 |
Policy instance | 1 |