| Plan Name | NIAGARA LUTHERAN DEVELOPMENT, INC. HEALTH PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | NIAGARA LUTHERAN DEVELOPMENT, INC. |
| Employer identification number (EIN): | 161502150 |
| NAIC Classification: | 623000 |
| NAIC Description: | Nursing and Residential Care Facilities |
Additional information about NIAGARA LUTHERAN DEVELOPMENT, INC.
| Jurisdiction of Incorporation: | New York Department of State |
| Incorporation Date: | 1996-01-02 |
| Company Identification Number: | 1986259 |
| Legal Registered Office Address: |
64 HAGER STREET Erie BUFFALO United States of America (USA) 14208 |
More information about NIAGARA LUTHERAN DEVELOPMENT, INC.
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2022-04-01 | ||||
| 501 | 2022-04-01 | STEVEN CHIZUK | |||
| 501 | 2021-04-01 | ||||
| 501 | 2021-04-01 | STEVEN CHIZUK | |||
| 501 | 2020-04-01 | ||||
| 501 | 2019-04-01 | ||||
| 501 | 2018-04-01 | ||||
| 501 | 2017-02-01 | LAURIE JANKOWSKI | |||
| 501 | 2017-01-01 | LAURIE JANKOWSKI | |||
| 501 | 2016-01-01 | LAURIE JANKOWSKI | |||
| 501 | 2015-01-01 | LAURIE JANKOWSKI | |||
| 501 | 2014-01-01 | LAURIE JANKOWSKI | |||
| 501 | 2013-01-01 | LAURIE JANKOWSKI | |||
| 501 | 2012-01-01 | LAURIE JANKOWSKI | |||
| 501 | 2011-01-01 | LAURIE JANKOWSKI | |||
| 501 | 2010-01-01 | LAURIE JANKOWSKI | |||
| 501 | 2009-01-01 | LAURIE JANKOWSKI |
| 2022: NIAGARA LUTHERAN DEVELOPMENT, INC. HEALTH PLAN 2022 form 5500 responses | ||
|---|---|---|
| 2022-04-01 | Type of plan entity | Single employer plan |
| 2022-04-01 | Submission has been amended | No |
| 2022-04-01 | This submission is the final filing | No |
| 2022-04-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2022-04-01 | Plan is a collectively bargained plan | No |
| 2022-04-01 | Plan funding arrangement – Insurance | Yes |
| 2022-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: NIAGARA LUTHERAN DEVELOPMENT, INC. HEALTH PLAN 2021 form 5500 responses | ||
| 2021-04-01 | Type of plan entity | Single employer plan |
| 2021-04-01 | Submission has been amended | No |
| 2021-04-01 | This submission is the final filing | No |
| 2021-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-04-01 | Plan is a collectively bargained plan | No |
| 2021-04-01 | Plan funding arrangement – Insurance | Yes |
| 2021-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: NIAGARA LUTHERAN DEVELOPMENT, INC. HEALTH PLAN 2020 form 5500 responses | ||
| 2020-04-01 | Type of plan entity | Single employer plan |
| 2020-04-01 | Submission has been amended | No |
| 2020-04-01 | This submission is the final filing | No |
| 2020-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-04-01 | Plan is a collectively bargained plan | No |
| 2020-04-01 | Plan funding arrangement – Insurance | Yes |
| 2020-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: NIAGARA LUTHERAN DEVELOPMENT, INC. HEALTH PLAN 2019 form 5500 responses | ||
| 2019-04-01 | Type of plan entity | Single employer plan |
| 2019-04-01 | Submission has been amended | No |
| 2019-04-01 | This submission is the final filing | No |
| 2019-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-04-01 | Plan is a collectively bargained plan | No |
| 2019-04-01 | Plan funding arrangement – Insurance | Yes |
| 2019-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: NIAGARA LUTHERAN DEVELOPMENT, INC. HEALTH PLAN 2018 form 5500 responses | ||
| 2018-04-01 | Type of plan entity | Single employer plan |
| 2018-04-01 | Submission has been amended | No |
| 2018-04-01 | This submission is the final filing | No |
| 2018-04-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-04-01 | Plan is a collectively bargained plan | No |
| 2018-04-01 | Plan funding arrangement – Insurance | Yes |
| 2018-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: NIAGARA LUTHERAN DEVELOPMENT, INC. HEALTH PLAN 2017 form 5500 responses | ||
| 2017-02-01 | Type of plan entity | Single employer plan |
| 2017-02-01 | Submission has been amended | No |
| 2017-02-01 | This submission is the final filing | No |
| 2017-02-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2017-02-01 | Plan is a collectively bargained plan | No |
| 2017-02-01 | Plan funding arrangement – Insurance | Yes |
| 2017-02-01 | Plan benefit arrangement – Insurance | Yes |
| 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: NIAGARA LUTHERAN DEVELOPMENT, INC. HEALTH 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 benefit arrangement – Insurance | Yes |
| 2015: NIAGARA LUTHERAN DEVELOPMENT, INC. HEALTH 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 benefit arrangement – Insurance | Yes |
| 2014: NIAGARA LUTHERAN DEVELOPMENT, INC. HEALTH 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: NIAGARA LUTHERAN DEVELOPMENT, INC. HEALTH 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: NIAGARA LUTHERAN DEVELOPMENT, INC. HEALTH 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: NIAGARA LUTHERAN DEVELOPMENT, INC. HEALTH 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 |
| 2010: NIAGARA LUTHERAN DEVELOPMENT, INC. HEALTH PLAN 2010 form 5500 responses | ||
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | Submission has been amended | No |
| 2010-01-01 | This submission is the final filing | No |
| 2010-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2010-01-01 | Plan is a collectively bargained plan | No |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: NIAGARA LUTHERAN DEVELOPMENT, INC. HEALTH 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 |
| INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 32099 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||
| |||||||||||||||||||||||||||||||||||||||||||||||||
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 398152 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||
| INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 32099 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 398152 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||
| INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 32099 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||
| INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 32099 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 398152 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||
| INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 32099 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 398152 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 398152 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||
| INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 32099 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||
| INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 32099 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 398152 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||
| INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 32099 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 398152 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||
| FIRST UNUM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 64297 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 398152 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||||||||||||||||||||||||
| CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | FLY960019 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||
| INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | B6092 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||
| INDEPENDENT HEALTH (National Association of Insurance Commissioners NAIC id number: 47034 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | B6092 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||
| CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | FLY960019 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||||||||||||||||||||||||
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 15187 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||
| PRESIDENTIAL LIFE (National Association of Insurance Commissioners NAIC id number: 68039 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 1114 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 4 | ||||||||||||||||||||||||||||||||||||||||||||||||
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 1114 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 5 | ||||||||||||||||||||||||||||||||||||||||||||||||
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47029 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 1114 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 4 | ||||||||||||||||||||||||||||||||||||||||||||||||
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 15187 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||
| CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | FLY960019 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||
| PRESIDENTIAL LIFE (National Association of Insurance Commissioners NAIC id number: 68039 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 1114 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||||||||||||||||||||||||
| CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | FLY960019 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||
| PRESIDENTIAL LIFE (National Association of Insurance Commissioners NAIC id number: 68039 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 1114 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||||||||||||||||||||||||
| EXCELLUS BLUE CROSS/BLUE SHIELD PLAN (National Association of Insurance Commissioners NAIC id number: 55107 ) | |||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 700947 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||