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| Plan Name | KIRKHAVEN SHORT TERM DISABILITY INSURANCE PLAN |
| Plan identification number | 505 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | KIRKHAVEN |
| Employer identification number (EIN): | 222291346 |
| NAIC Classification: | 623000 |
| NAIC Description: | Nursing and Residential Care Facilities |
Additional information about KIRKHAVEN
| Jurisdiction of Incorporation: | New York Department of State |
| Incorporation Date: | 1980-01-23 |
| Company Identification Number: | 603826 |
| Legal Registered Office Address: |
254 ALEXANDER STREET Monroe ROCHESTER United States of America (USA) 146072591 |
More information about KIRKHAVEN
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 505 | 2016-01-01 | ALEXANDRA REICH | ALEXANDRA REICH | 2017-07-31 | |
| 505 | 2015-01-01 | JAMES DEVOE | JAMES DEVOE | 2016-07-25 |
| 2016: KIRKHAVEN SHORT TERM DISABILITY INSURANCE PLAN 2016 form 5500 responses | ||
|---|---|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | First time form 5500 has been submitted | Yes |
| 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: KIRKHAVEN SHORT TERM DISABILITY INSURANCE PLAN 2015 form 5500 responses | ||
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | First time form 5500 has been submitted | Yes |
| 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 |
| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |
| Policy contract number | TS05358028 |
| Policy instance | 1 |
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