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| Plan Name | HUDSON HEADWATERS HEALTH NETWORK VOLUNTARY SHORT TERM DISABILITY |
| Plan identification number | 507 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | HUDSON HEADWATERS HEALTH NETWORK |
| Employer identification number (EIN): | 141628237 |
| NAIC Classification: | 621498 |
| NAIC Description: | All Other Outpatient Care Centers |
Additional information about HUDSON HEADWATERS HEALTH NETWORK
| Jurisdiction of Incorporation: | New York Department of State |
| Incorporation Date: | 1981-07-20 |
| Company Identification Number: | 712104 |
| Legal Registered Office Address: |
9 carey road Warren QUEENSBURY United States of America (USA) 12804 |
More information about HUDSON HEADWATERS HEALTH NETWORK
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 507 | 2016-09-01 | ||||
| 507 | 2015-09-01 | CHRISTOPHER TOURNIER |
| Measure | Date | Value |
|---|---|---|
| 2016: HUDSON HEADWATERS HEALTH NETWORK VOLUNTARY SHORT TERM DISABILITY 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-09-01 | 112 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-09-01 | 0 |
| Number of retired or separated participants receiving benefits | 2016-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-09-01 | 0 |
| Total of all active and inactive participants | 2016-09-01 | 0 |
| 2015: HUDSON HEADWATERS HEALTH NETWORK VOLUNTARY SHORT TERM DISABILITY 2015 401k membership | ||
| Total participants, beginning-of-year | 2015-09-01 | 112 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-09-01 | 112 |
| Number of retired or separated participants receiving benefits | 2015-09-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-09-01 | 0 |
| Total of all active and inactive participants | 2015-09-01 | 112 |
| 2016: HUDSON HEADWATERS HEALTH NETWORK VOLUNTARY SHORT TERM DISABILITY 2016 form 5500 responses | ||
|---|---|---|
| 2016-09-01 | Type of plan entity | Single employer plan |
| 2016-09-01 | Submission has been amended | No |
| 2016-09-01 | This submission is the final filing | Yes |
| 2016-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-09-01 | Plan is a collectively bargained plan | No |
| 2016-09-01 | Plan funding arrangement – Insurance | Yes |
| 2016-09-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: HUDSON HEADWATERS HEALTH NETWORK VOLUNTARY SHORT TERM DISABILITY 2015 form 5500 responses | ||
| 2015-09-01 | Type of plan entity | Single employer plan |
| 2015-09-01 | First time form 5500 has been submitted | Yes |
| 2015-09-01 | Submission has been amended | No |
| 2015-09-01 | This submission is the final filing | No |
| 2015-09-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-09-01 | Plan is a collectively bargained plan | No |
| 2015-09-01 | Plan funding arrangement – Insurance | Yes |
| 2015-09-01 | Plan benefit arrangement – Insurance | Yes |
| CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | VDY960079 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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