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| Plan Name | COBALT REHABILITATION HOSPITALS LONG TERM DISABILITY PLAN |
| Plan identification number | 503 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | COBALT REHABILITATION HOSPITALS LLC |
| Employer identification number (EIN): | 465350523 |
| NAIC Classification: | 622000 |
| NAIC Description: | Hospitals |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 503 | 2017-08-01 | STEVE PUTERBAUGH | 2019-04-04 |
| 2017: COBALT REHABILITATION HOSPITALS LONG TERM DISABILITY PLAN 2017 form 5500 responses | ||
|---|---|---|
| 2017-08-01 | Type of plan entity | Single employer plan |
| 2017-08-01 | First time form 5500 has been submitted | Yes |
| 2017-08-01 | Plan funding arrangement – Insurance | Yes |
| 2017-08-01 | Plan benefit arrangement – Insurance | Yes |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |
| Policy contract number | GLTD0B7D4 |
| Policy instance | 1 |
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