THE STEADMAN CLINIC, PROFESSIONAL LLC GROUP HEALTH PLAN
|
2018
|
841415470
|
2019-07-16
|
THE STEADMAN CLINIC, PROFESSIONAL LLC
|
141
|
|
File |
View Page
|
Three-digit plan number (PN) |
511
|
Effective date of plan |
2014-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9704761100
|
Plan sponsor’s mailing address |
181 W MEADOW DR STE 400, VAIL, CO, 816575058
|
Plan sponsor’s
address |
181 W MEADOW DR STE 400, VAIL, CO, 816575058
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-07-16 |
Name of individual signing |
LORI GAY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE STEADMAN CLINIC, PLLC HEALTH REIMBURSEMENT ARRANGEMENT
|
2018
|
841415470
|
2019-07-16
|
THE STEADMAN CLINIC, PROFESSIONAL LLC
|
141
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2014-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9704761100
|
Plan sponsor’s mailing address |
181 W MEADOW DR STE 400, VAIL, CO, 816575058
|
Plan sponsor’s
address |
181 W MEADOW DR STE 400, VAIL, CO, 816575058
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-07-16 |
Name of individual signing |
LORI GAY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE STEADMAN CLINIC PLAN
|
2018
|
841415470
|
2019-07-16
|
THE STEADMAN CLINIC, PROFESSIONAL LLC
|
149
|
|
File |
View Page
|
Three-digit plan number (PN) |
510
|
Effective date of plan |
2014-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9704761100
|
Plan sponsor’s mailing address |
181 W MEADOW DR STE 400, VAIL, CO, 816575058
|
Plan sponsor’s
address |
181 W MEADOW DR STE 400, VAIL, CO, 816575058
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-07-16 |
Name of individual signing |
LORI GAY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
STEADMAN CLINIC
|
2018
|
841415470
|
2019-07-16
|
THE STEADMAN CLINIC, PROFESSIONAL LLC
|
140
|
|
File |
View Page
|
Three-digit plan number (PN) |
512
|
Effective date of plan |
2014-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9704761100
|
Plan sponsor’s mailing address |
181 W MEADOW DR STE 400, VAIL, CO, 816575058
|
Plan sponsor’s
address |
181 W MEADOW DR STE 400, VAIL, CO, 816575058
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-07-16 |
Name of individual signing |
LORI GAY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE STEADMAN CLINIC, PROFESSIONAL LLC GROUP HEALTH PLAN
|
2017
|
841415470
|
2018-07-26
|
THE STEADMAN CLINIC, PROFESSIONAL LLC
|
102
|
|
File |
View Page
|
Three-digit plan number (PN) |
511
|
Effective date of plan |
2014-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9704761100
|
Plan sponsor’s mailing address |
181 W MEADOW DR STE 400, VAIL, CO, 816575058
|
Plan sponsor’s
address |
181 W MEADOW DR STE 400, VAIL, CO, 816575058
|
Number of participants as of the end of the plan year
Active participants |
133 |
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 |
2018-07-26 |
Name of individual signing |
LORI GAY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE STEADMAN CLINIC PLAN
|
2017
|
841415470
|
2018-07-26
|
THE STEADMAN CLINIC, PROFESSIONAL LLC
|
101
|
|
File |
View Page
|
Three-digit plan number (PN) |
510
|
Effective date of plan |
2014-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9704761100
|
Plan sponsor’s mailing address |
181 W MEADOW DR STE 400, VAIL, CO, 816575058
|
Plan sponsor’s
address |
181 W MEADOW DR STE 400, VAIL, CO, 816575058
|
Number of participants as of the end of the plan year
Active participants |
149 |
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 |
2018-07-26 |
Name of individual signing |
LORI GAY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
STEADMAN CLINIC
|
2017
|
841415470
|
2018-07-26
|
THE STEADMAN CLINIC, PROFESSIONAL LLC
|
102
|
|
File |
View Page
|
Three-digit plan number (PN) |
512
|
Effective date of plan |
2014-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9704761100
|
Plan sponsor’s mailing address |
181 W MEADOW DR STE 400, VAIL, CO, 816575058
|
Plan sponsor’s
address |
181 W MEADOW DR STE 400, VAIL, CO, 816575058
|
Number of participants as of the end of the plan year
Active participants |
140 |
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 |
2018-07-26 |
Name of individual signing |
LORI GAY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE STEADMAN CLINIC, PLLC HEALTH REIMBURSEMENT ARRANGEMENT
|
2017
|
841415470
|
2018-07-26
|
THE STEADMAN CLINIC, PROFESSIONAL LLC
|
102
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2014-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9704761100
|
Plan sponsor’s mailing address |
181 W MEADOW DR STE 400, VAIL, CO, 816575058
|
Plan sponsor’s
address |
181 W MEADOW DR STE 400, VAIL, CO, 816575058
|
Number of participants as of the end of the plan year
Active participants |
133 |
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 |
2018-07-26 |
Name of individual signing |
LORI GAY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE STEADMAN CLINIC, PLLC HEALTH REIMBURSEMENT ARRANGEMENT
|
2016
|
841415470
|
2017-10-05
|
THE STEADMAN CLINIC, PROFESSIONAL LLC
|
105
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2014-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9704761100
|
Plan sponsor’s mailing address |
181 W MEADOW DR STE 400, VAIL, CO, 816575058
|
Plan sponsor’s
address |
181 W MEADOW DR STE 400, VAIL, CO, 816575058
|
Number of participants as of the end of the plan year
Active participants |
99 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2017-10-04 |
Name of individual signing |
LORI GAY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
THE STEADMAN CLINIC, PROFESSIONAL LLC GROUP HEALTH PLAN
|
2016
|
841415470
|
2017-10-05
|
THE STEADMAN CLINIC, PROFESSIONAL LLC
|
105
|
|
File |
View Page
|
Three-digit plan number (PN) |
511
|
Effective date of plan |
2014-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9704761100
|
Plan sponsor’s mailing address |
181 W MEADOW DR STE 400, VAIL, CO, 816575058
|
Plan sponsor’s
address |
181 W MEADOW DR STE 400, VAIL, CO, 816575058
|
Number of participants as of the end of the plan year
Active participants |
99 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2017-10-04 |
Name of individual signing |
LORI GAY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|