| Plan Name | MIDTOWN COMMUNITY HEALTH CENTERS MEDICAL PLAN |
| Plan identification number | 505 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | MIDTOWN COMMUNITY HEALTH CENTER, INC. |
| Employer identification number (EIN): | 870540039 |
| NAIC Classification: | 621410 |
| NAIC Description: | Family Planning Centers |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 505 | 2020-01-01 | SONJA LEVESQUE | 2021-06-24 |
| 2020: MIDTOWN COMMUNITY HEALTH CENTERS MEDICAL PLAN 2020 form 5500 responses | ||
|---|---|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | First time form 5500 has been submitted | Yes |
| 2020-01-01 | This submission is the final filing | Yes |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |
| Policy contract number | 907122 |
| Policy instance | 1 |