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| Plan Name | FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. GROUP MEDICAL PLAN |
| Plan identification number | 505 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | FAYETTE MEMORIAL HOSPITAL ASSOCIATION, INC. |
| Employer identification number (EIN): | 350900741 |
| NAIC Classification: | 622000 |
| NAIC Description: | Hospitals |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 505 | 2017-01-01 | ||||
| 505 | 2016-01-01 | HAYLEE CAVINS | |||
| 505 | 2015-01-01 | RHONDA MCPHERSON | |||
| 505 | 2014-01-01 | RHONDA MCPHERSON | |||
| 505 | 2013-01-01 | RHONDA MCPHERSON | |||
| 505 | 2012-01-01 | RHONDA MCPHERSON | RHONDA MCPHERSON | 2013-05-10 | |
| 505 | 2011-01-01 | RHONDA MCPHERSON | RHONDA MCPHERSON | 2012-07-19 | |
| 505 | 2010-01-01 | RHONDA MCPHERSON | RHONDA MCPHERSON | 2011-07-13 | |
| 505 | 2009-01-01 | RHONDA MCPHERSON |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |
| Policy contract number | 1000711 |
| Policy instance | 1 |
| COLONIAL LIFE & ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60049 ) | |
| Policy contract number | E4710000 |
| Policy instance | 2 |
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