VALLEY WIDE HEALTH SYSTEMS, INC. HEALTH REIMBURSEMENT ARRANGEMENT
|
2017
|
840706945
|
2018-06-05
|
VALLEY WIDE HEALTH SYSTEMS, INC.
|
231
|
|
File |
View Page
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
2008-08-01
|
Business code |
621111
|
Sponsor’s telephone number |
7195895161
|
Plan sponsor’s mailing address |
128 MARKET ST, ALAMOSA, CO, 811012290
|
Plan sponsor’s
address |
128 MARKET ST, ALAMOSA, CO, 811012290
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2018-06-05 |
Name of individual signing |
ALIFONSO BAROZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VALLEY WIDE HEALTH SYSTEMS, INC HEALTH REIMBURSEMENT ARRANGEMENT
|
2015
|
840706945
|
2016-06-06
|
VALLEY WIDE HEALTH SYSTEMS, INC
|
186
|
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
2008-08-01
|
Business code |
621111
|
Sponsor’s telephone number |
7195895161
|
Plan sponsor’s mailing address |
128 MARKET ST, ALAMOSA, CO, 811012290
|
Plan sponsor’s
address |
128 MARKET ST, ALAMOSA, CO, 811012290
|
Number of participants as of the end of the plan year
Active participants |
215 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2016-06-02 |
Name of individual signing |
BENJAMIN DUARTE |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-06-02 |
Name of individual signing |
BENJAMIN DUARTE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VALLEY WIDE HEALTH SYSTEMS, INC. FLEXIBLE BENEFIT PLAN
|
2014
|
840706945
|
2015-11-05
|
VALLEY WIDE HEALTH SYSTEMS, INC.
|
110
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2014-08-01
|
Business code |
621111
|
Sponsor’s telephone number |
7195895161
|
Plan sponsor’s mailing address |
128 MARKET STREET, ALAMOSA, CO, 81101
|
Plan sponsor’s
address |
128 MARKET STREET, ALAMOSA, CO, 81101
|
Number of participants as of the end of the plan year
Active participants |
98 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-11-03 |
Name of individual signing |
BENJAMIN DUARTE |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-11-03 |
Name of individual signing |
BENJAMIN DUARTE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VALLEY WIDE HEALTH SYSTEMS, INC HEALTH REIMBURSEMENT ARRANGEMENT
|
2014
|
840706945
|
2015-07-21
|
VALLEY WIDE HEALTH SYSTEMS, INC
|
154
|
|
File |
View Page
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
2010-08-01
|
Business code |
621111
|
Sponsor’s telephone number |
7195895161
|
Plan
sponsor’s DBA name |
VALLEY WIDE HEALTH SYSTEMS, INC
|
Plan sponsor’s mailing address |
128 MARKET STREET, ALAMOSA, CO, 81101
|
Plan sponsor’s
address |
128 MARKET STREET, ALAMOSA, CO, 81101
|
Number of participants as of the end of the plan year
Active participants |
296 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2015-07-20 |
Name of individual signing |
BENJAMIN DUARTE |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-07-20 |
Name of individual signing |
BENJAMIN DUARTE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VALLEY WIDE HEALTH SYSTEMS, INC HEALTH REIMBURSEMENT ARRANGEMENT
|
2014
|
840706945
|
2015-05-29
|
VALLEY WIDE HEALTH SYSTEMS, INC
|
154
|
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
2010-08-01
|
Business code |
621111
|
Sponsor’s telephone number |
7195895161
|
Plan
sponsor’s DBA name |
VALLEY WIDE HEALTH SYSTEMS, INC
|
Plan sponsor’s mailing address |
128 MARKET STREET, ALAMOSA, CO, 81101
|
Plan sponsor’s
address |
128 MARKET STREET, ALAMOSA, CO, 81101
|
Number of participants as of the end of the plan year
Active participants |
296 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Signature of
Role |
Employer/plan sponsor |
Date |
2015-05-29 |
Name of individual signing |
BENJAMIN DUARTE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VALLEY WIDE HEALTH SYSTEMS, INC HEALTH REIMBURSEMENT ARRANGEMENT
|
2013
|
840706945
|
2014-08-14
|
VALLEY WIDE HEALTH SYSTEMS, INC
|
198
|
|
File |
View Page
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
2010-08-01
|
Business code |
621111
|
Sponsor’s telephone number |
7195895161
|
Plan
sponsor’s DBA name |
VALLEY WIDE HEALTH SYSTEMS, INC
|
Plan sponsor’s mailing address |
128 MARKET STREET, ALAMOSA, CO, 81101
|
Plan sponsor’s
address |
128 MARKET STREET, ALAMOSA, CO, 81101
|
Number of participants as of the end of the plan year
Active participants |
246 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
227 |
Signature of
Role |
Plan administrator |
Date |
2014-08-14 |
Name of individual signing |
BENJAMIN DUARTE |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-08-14 |
Name of individual signing |
BENJAMIN DUARTE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VALLEY WIDE HEALTH SYSTEMS, INC. HEALTH REIMBURSEMENT ARRANGEMENT
|
2012
|
840706945
|
2013-06-26
|
VALLEY WIDE HEALTH SYSTEMS, INC.
|
193
|
|
File |
View Page
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
2010-08-01
|
Business code |
621111
|
Sponsor’s telephone number |
7195895161
|
Plan
sponsor’s DBA name |
VALLEY WIDE HEALTH SYSTEMS, INC.
|
Plan sponsor’s mailing address |
128 MARKET STREET, ALAMOSA, CO, 81101
|
Plan sponsor’s
address |
128 MARKET STREET, ALAMOSA, CO, 81101
|
Plan administrator’s name and address
Administrator’s EIN |
840706945 |
Plan administrator’s name |
BEN DUARTE |
Plan administrator’s
address |
128 MARKET STREET, ALAMOSA, CO, 81101 |
Administrator’s telephone number |
7195895161 |
Number of participants as of the end of the plan year
Active participants |
0 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
179 |
Signature of
Role |
Plan administrator |
Date |
2013-06-26 |
Name of individual signing |
BENJAMIN DUARTE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VALLEY WIDE HEALTH SYSTEMS, INC. HEALTH REIMBURSEMENT ARRANGEMENT
|
2011
|
840706945
|
2012-03-22
|
VALLEY WIDE HEALTH SYSTEMS, INC.
|
182
|
|
File |
View Page
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
2010-08-01
|
Business code |
621111
|
Sponsor’s telephone number |
7195895161
|
Plan
sponsor’s DBA name |
VALLEY WIDE HEALTH SYSTEMS, INC.
|
Plan sponsor’s mailing address |
128 MARKET STREET, ALAMOSA, CO, 81101
|
Plan sponsor’s
address |
128 MARKET STREET, ALAMOSA, CO, 81101
|
Plan administrator’s name and address
Administrator’s EIN |
840706945 |
Plan administrator’s name |
BEN DUARTE |
Plan administrator’s
address |
128 MARKET STREET, ALAMOSA, CO, 81101 |
Administrator’s telephone number |
7195895161 |
Number of participants as of the end of the plan year
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
178 |
Signature of
Role |
Plan administrator |
Date |
2012-03-22 |
Name of individual signing |
BENJAMIN DUARTE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VALLEY WIDE HEALTH SYSTEMS, INC. HEALTH REIMBURSEMENT ARRANGEMENT
|
2010
|
840706945
|
2011-07-27
|
VALLEY WIDE HEALTH SYSTEMS, INC.
|
188
|
|
File |
View Page
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
2010-08-01
|
Business code |
621111
|
Sponsor’s telephone number |
7195895161
|
Plan
sponsor’s DBA name |
VALLEY WIDE HEALTH SYSTEMS, INC.
|
Plan sponsor’s mailing address |
128 MARKET STREET, ALAMOSA, CO, 81101
|
Plan sponsor’s
address |
128 MARKET STREET, ALAMOSA, CO, 81101
|
Plan administrator’s name and address
Administrator’s EIN |
840706945 |
Plan administrator’s name |
BEN DUARTE |
Plan administrator’s
address |
128 MARKET STREET, ALAMOSA, CO, 81101 |
Administrator’s telephone number |
7195895161 |
Number of participants as of the end of the plan year
Active participants |
188 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Plan administrator |
Date |
2011-07-26 |
Name of individual signing |
BENJAMIN DUARTE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
VALLEY WIDE HEALTH SYSTEMS, INC. HEALTH REIMBURSEMENT ARRANGEMENT
|
2010
|
840706945
|
2011-07-18
|
VALLEY WIDE HEALTH SYSTEMS, INC.
|
188
|
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
2010-08-01
|
Business code |
621111
|
Sponsor’s telephone number |
7195895161
|
Plan
sponsor’s DBA name |
VALLEY WIDE HEALTH SYSTEMS, INC.
|
Plan sponsor’s mailing address |
128 MARKET STREET, ALAMOSA, CO, 81101
|
Plan sponsor’s
address |
128 MARKET STREET, ALAMOSA, CO, 81101
|
Plan administrator’s name and address
Administrator’s EIN |
840706945 |
Plan administrator’s name |
BEN DUARTE |
Plan administrator’s
address |
128 MARKET STREET, ALAMOSA, CO, 81101 |
Administrator’s telephone number |
7195895161 |
Number of participants as of the end of the plan year
Active participants |
188 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Deceased participants
whose
beneficiaries are receiving or are entitled to receive benefits |
0 |
Number of
participants
with
account balances as of the end of the plan year |
0 |
Number of participants that
terminated
employment during the plan year with accrued benefits that were less than 100%
vested |
0 |
Signature of
Role |
Employer/plan sponsor |
Date |
2011-07-12 |
Name of individual signing |
BENJAMIN DUARTE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|