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| Plan Name | OHIO EASTERN STAR HOME HEALTH AND WELFARE BENEFIT PLAN |
| Plan identification number | 503 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | THE OHIO EASTERN STAR HOME |
| Employer identification number (EIN): | 314405826 |
| NAIC Classification: | 623000 |
| NAIC Description: | Nursing and Residential Care Facilities |
Additional information about THE OHIO EASTERN STAR HOME
| Jurisdiction of Incorporation: | Ohio Secretary of State Business Services Division |
| Incorporation Date: | 1951-10-01 |
| Company Identification Number: | 224851 |
| Legal Registered Office Address: |
10 S GAY STREET PO BOX 469 MOUNT VERNON United States of America (USA) 43050 |
More information about THE OHIO EASTERN STAR HOME
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 503 | 2021-07-01 | MICHELE ENGELBACH | 2022-11-01 | ||
| 503 | 2020-07-01 | MICHELLE GARCIA | 2021-12-29 |
| 2021: OHIO EASTERN STAR HOME HEALTH AND WELFARE BENEFIT PLAN 2021 form 5500 responses | ||
|---|---|---|
| 2021-07-01 | Type of plan entity | Single employer plan |
| 2021-07-01 | Plan funding arrangement – Insurance | Yes |
| 2021-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: OHIO EASTERN STAR HOME HEALTH AND WELFARE BENEFIT PLAN 2020 form 5500 responses | ||
| 2020-07-01 | Type of plan entity | Single employer plan |
| 2020-07-01 | First time form 5500 has been submitted | Yes |
| 2020-07-01 | Plan funding arrangement – Insurance | Yes |
| 2020-07-01 | Plan benefit arrangement – Insurance | Yes |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 575389 |
| Policy instance | 6 |
| TELEMEDICINE MANAGEMENT, INC. DBA SWIFTMD (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 1026 |
| Policy instance | 5 |
| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) | |
| Policy contract number | G00616772 |
| Policy instance | 4 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) | |
| Policy contract number | 10158771001 |
| Policy instance | 3 |
| DELTA DENTAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 54402 ) | |
| Policy contract number | 981 |
| Policy instance | 2 |
| COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 ) | |
| Policy contract number | W50110 |
| Policy instance | 1 |
| TELEMEDICINE MANAGEMENT, INC. DBA SWIFTMD (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 1026 |
| Policy instance | 5 |
| AMERICAN UNITED LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60895 ) | |
| Policy contract number | G00616772 |
| Policy instance | 4 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) | |
| Policy contract number | 10158771001 |
| Policy instance | 3 |
| DELTA DENTAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 54402 ) | |
| Policy contract number | 981 |
| Policy instance | 2 |
| COMMUNITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 10345 ) | |
| Policy contract number | W50110 |
| Policy instance | 1 |
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