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| Plan Name | VISITING NURSE SERVICE OF SCHENECTADY & SARATOGA COUNTIES HEALTH & WELFARE EMPLOYEE BENEFITS PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | VISITING NURSE SERVICE OF NORTHEASTERN NEW YORK |
| Employer identification number (EIN): | 141338478 |
| NAIC Classification: | 621610 |
| NAIC Description: | Home Health Care Services |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2017-01-01 | JENNIFER LEALE | |||
| 501 | 2016-01-01 | BRIAN FRASIER |
| Measure | Date | Value |
|---|---|---|
| 2017: VISITING NURSE SERVICE OF SCHENECTADY & SARATOGA COUNTIES HEALTH & WELFARE EMPLOYEE BENEFITS PLAN 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-01-01 | 107 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 83 |
| Number of retired or separated participants receiving benefits | 2017-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-01-01 | 0 |
| Total of all active and inactive participants | 2017-01-01 | 83 |
| 2016: VISITING NURSE SERVICE OF SCHENECTADY & SARATOGA COUNTIES HEALTH & WELFARE EMPLOYEE BENEFITS PLAN 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-01-01 | 105 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 107 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-01-01 | 0 |
| Total of all active and inactive participants | 2016-01-01 | 107 |
| 2017: VISITING NURSE SERVICE OF SCHENECTADY & SARATOGA COUNTIES HEALTH & WELFARE EMPLOYEE BENEFITS 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: VISITING NURSE SERVICE OF SCHENECTADY & SARATOGA COUNTIES HEALTH & WELFARE EMPLOYEE BENEFITS 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 |
| CAPITAL DISTRICT PHYSICIANS HEALTH PLAN INC (National Association of Insurance Commissioners NAIC id number: 95491 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 10008775 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| WELLCHOICE HMO OF NEW JERSEY (National Association of Insurance Commissioners NAIC id number: 95433 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 386040 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| MVP HEALTH CARE (National Association of Insurance Commissioners NAIC id number: 95521 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 210821 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 10661 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 4 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| FIDELITY SECURITY LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 67288 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 9877481 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 5 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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