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| Plan Name | MAMMOTH HOSPITAL DENTAL PLAN |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | MAMMOTH HOSPITAL |
| Employer identification number (EIN): | 953154530 |
| NAIC Classification: | 622000 |
| NAIC Description: | Hospitals |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2022-01-01 | SARAH VIGILANTE | 2023-09-05 | ||
| 502 | 2021-01-01 | ||||
| 502 | 2021-01-01 | SARAH VIGILANTE | |||
| 502 | 2020-01-01 | ||||
| 502 | 2019-01-01 | ||||
| 502 | 2018-01-01 | OLIVIA MOFFETT | OLIVIA MOFFETT | 2019-07-24 | |
| 502 | 2017-01-01 | SARAH VIGILANTE | |||
| 502 | 2016-01-01 | SARAH VIGILANTE | |||
| 502 | 2015-01-01 | SARAH VIGILANTE | |||
| 502 | 2014-01-01 | JEFFREY BYBERG | |||
| 502 | 2013-03-01 | JEFFREY BYBERG | |||
| 502 | 2012-03-01 | JEFFREY BYBERG | |||
| 502 | 2011-03-01 | JEFFREY BYBERG | |||
| 502 | 2010-03-01 | JEFFREY BYBERG | |||
| 502 | 2009-03-01 | JOE BOTTOM |
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 06674 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
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| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 06674 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 06674 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 06674 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 06674 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 06674 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 06674 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 06674 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 06674 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 06674 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 06674 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
| DELTA DENTAL OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 ) | |||||||||||||||||||
| Policy contract number | 6674 | ||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||
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