401k Plan data: FINGER LAKES HEALTH WELFARE BENEFITS PLAN plan

FINGER LAKES HEALTH WELFARE BENEFITS PLAN 401k Plan overview

Plan Name	FINGER LAKES HEALTH WELFARE BENEFITS PLAN
Plan identification number	520

FINGER LAKES HEALTH WELFARE BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

FINGER LAKES REGIONAL HEALTH SYSTEM, INC. has sponsored the creation of one or more 401k plans.

Company Name: FINGER LAKES REGIONAL HEALTH SYSTEM, INC.

Employer identification number (EIN): 160743032

NAIC Classification: 622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FINGER LAKES HEALTH WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
520 2020-01-01 CHAD HOFFMAN-FRAGALE 2021-10-18
520 2020-01-01 CHAD HOFFMAN-FRAGALE 2021-10-12
520 2019-01-01
520 2018-01-01 PATRICK BOYLE
520 2017-01-01 PATRICK BOYLE
520 2016-01-01 PATRICK BOYLE
520 2015-01-01 PATRICK BOYLE
520 2014-01-01 PATRICK BOYLE
520 2013-01-01 PATRICK BOYLE
520 2012-01-01 PATRICK BOYLE
520 2011-01-01 PATRICK BOYLE
520 2009-01-01 PATRICK BOYLE
520 2009-01-01 PATRICK BOYLE

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
520	2020-01-01	CHAD HOFFMAN-FRAGALE	2021-10-18
520	2020-01-01	CHAD HOFFMAN-FRAGALE	2021-10-12
520	2019-01-01
520	2018-01-01	PATRICK BOYLE
520	2017-01-01	PATRICK BOYLE
520	2016-01-01	PATRICK BOYLE
520	2015-01-01	PATRICK BOYLE
520	2014-01-01	PATRICK BOYLE
520	2013-01-01	PATRICK BOYLE
520	2012-01-01	PATRICK BOYLE
520	2011-01-01	PATRICK BOYLE
520	2009-01-01	PATRICK BOYLE
520	2009-01-01	PATRICK BOYLE

Plan Statistics for FINGER LAKES HEALTH WELFARE BENEFITS PLAN

401k plan membership statisitcs for FINGER LAKES HEALTH WELFARE BENEFITS PLAN

Measure Date Value
2020: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 1,324
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 1,347
Number of retired or separated participants receiving benefits 2020-01-01 6
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 1,353
2019: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 342
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 325
Total of all active and inactive participants 2019-01-01 325
2018: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 382
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 342
Total of all active and inactive participants 2018-01-01 342
2017: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 382
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 382
Total of all active and inactive participants 2017-01-01 382
2016: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 347
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 382
Total of all active and inactive participants 2016-01-01 382
2015: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 445
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 347
Total of all active and inactive participants 2015-01-01 347
2014: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 459
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 445
Total of all active and inactive participants 2014-01-01 445
2013: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 494
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 459
Total of all active and inactive participants 2013-01-01 459
2012: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 517
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 494
Total of all active and inactive participants 2012-01-01 494
2011: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 530
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 517
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 517
2009: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 1,439
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 1,438
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 1,438

Measure	Date	Value
2020: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	1,324
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	1,347
Number of retired or separated participants receiving benefits	2020-01-01	6
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	1,353
2019: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	342
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	325
Total of all active and inactive participants	2019-01-01	325
2018: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	382
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	342
Total of all active and inactive participants	2018-01-01	342
2017: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	382
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	382
Total of all active and inactive participants	2017-01-01	382
2016: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	347
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	382
Total of all active and inactive participants	2016-01-01	382
2015: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	445
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	347
Total of all active and inactive participants	2015-01-01	347
2014: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	459
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	445
Total of all active and inactive participants	2014-01-01	445
2013: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	494
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	459
Total of all active and inactive participants	2013-01-01	459
2012: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	517
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	494
Total of all active and inactive participants	2012-01-01	494
2011: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	530
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	517
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	517
2009: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	1,439
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	1,438
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	1,438

Form 5500 Responses for FINGER LAKES HEALTH WELFARE BENEFITS PLAN

2020: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	Yes
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2018: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: FINGER LAKES HEALTH WELFARE 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 funding arrangement – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
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 funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2015: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2014: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: FINGER LAKES HEALTH WELFARE BENEFITS PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number	70289
Policy instance	2
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number	7275 & 45250
Policy instance	1
FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )
Policy contract number	LTD 683681
Policy instance	3
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract number	GTU-5091823-08
Policy instance	1
ANTHEM LIFE & DISABILITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 13573 )
Policy contract number	AL00006388
Policy instance	2
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number	100390
Policy instance	4
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number	000400122676
Policy instance	5
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number	000010109220
Policy instance	6
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number	0400122676
Policy instance	5
FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )
Policy contract number	LTD 683681
Policy instance	3
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number	100390
Policy instance	4
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number	010109220
Policy instance	6
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract number	GTU-5091823-08
Policy instance	1
ANTHEM LIFE & DISABILITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 13573 )
Policy contract number	AL00006388
Policy instance	2
RELIASTAR LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 51360 )
Policy contract number	68296-9
Policy instance	2
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number	010109220
Policy instance	6
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number	0400122676
Policy instance	5
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number	100390
Policy instance	4
FIRST RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71005 )
Policy contract number	LTD 683681
Policy instance	3
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract number	GTU-5091823
Policy instance	1
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number	010109220
Policy instance	5
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number	0400122676
Policy instance	4
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number	100390/45250
Policy instance	3
RELIASTAR LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 51360 )
Policy contract number	68296-9
Policy instance	2
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract number	GTU-5091823
Policy instance	1
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract number	GTU-5091823
Policy instance	3
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number	0400122676
Policy instance	2
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number	010109220
Policy instance	1
RELIASTAR LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 51360 )
Policy contract number	68296-9
Policy instance	4
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number	00501843
Policy instance	3
RELIASTAR LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 51360 )
Policy contract number	63470-0
Policy instance	5
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract number	GTU-5091823
Policy instance	4
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number	0400122676
Policy instance	2
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number	010109220
Policy instance	1
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number	7070
Policy instance	3
RELIASTAR LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 51360 )
Policy contract number	63470-0
Policy instance	5
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract number	GTU-5091823
Policy instance	4
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number	0400122676
Policy instance	2
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number	010109220
Policy instance	1
ZURICH AMERICAN INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 16535 )
Policy contract number	GTU-5091823
Policy instance	1
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number	0400122676
Policy instance	5
RELIASTAR LIFE INSURANCE COMPANY OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 51360 )
Policy contract number	63470-0
Policy instance	3
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number	010109220
Policy instance	6
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number	7070
Policy instance	4
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number	5016
Policy instance	2
NATIONAL UNION FIRE INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 60607 )
Policy contract number	GTP 8007606
Policy instance	1
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number	7070
Policy instance	3
RELIASTAR LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67105 )
Policy contract number	31524-9
Policy instance	6
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number	010109220
Policy instance	5
LINCOLN LIFE AND ANNUITY CO OF NY (National Association of Insurance Commissioners NAIC id number: 62057 )
Policy contract number	0400122676
Policy instance	4
EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 )
Policy contract number	5016
Policy instance	2

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Company Name:	FINGER LAKES REGIONAL HEALTH SYSTEM, INC.
Employer identification number (EIN):	160743032
NAIC Classification:	622000
NAIC Description:	Hospitals