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| Plan Name | SOUTHERN COMMUNITY HOSPICE MEDOVA LIFESTYLE HEALTH PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | SOUTHERN COMMUNITY HOSPICE INC. |
| Employer identification number (EIN): | 582483048 |
| 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 | 2021-12-01 | ROBERT MOORE | 2024-08-28 | ||
| 501 | 2020-12-01 | ROBERT MOORE | 2022-08-30 |
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