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| Plan Name | HEPBURN HEALTH SYSTEM WELFARE BENEFIT PLAN |
| Plan identification number | 504 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | CLAXTON-HEPBURN MEDICAL CENTER |
| Employer identification number (EIN): | 150559686 |
| NAIC Classification: | 622000 |
| NAIC Description: | Hospitals |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 504 | 2011-01-01 | LOU ANN MCNALLY | 2013-06-20 | ||
| 504 | 2010-01-01 | LOUANN MCNALLY | 2011-07-18 |
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