STOP LOSS-HEALTH
|
2012
|
590545223
|
2014-07-22
|
WITHLACOOCHEE RIVER ELECTRIC COOPERATIVE, INC.
|
455
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2010-01-01
|
Business code |
221100
|
Sponsor’s telephone number |
3525675133
|
Plan sponsor’s mailing address |
P.O. BOX 278, DADE CITY, FL, 33526
|
Plan sponsor’s
address |
14651 21ST STREET, DADE CITY, FL, 33523
|
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 |
Signature of
Role |
Plan administrator |
Date |
2014-07-22 |
Name of individual signing |
RONNIE DEESE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LTD,LIFE,AD&D
|
2012
|
590545223
|
2014-07-22
|
WITHLACOOCHEE RIVER ELECTRIC COOPERATIVE, INC.
|
459
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2011-01-01
|
Business code |
221100
|
Sponsor’s telephone number |
3525675133
|
Plan sponsor’s mailing address |
P.O. BOX 278, DADE CITY, FL, 33526
|
Plan sponsor’s
address |
14651 21ST STREET, DADE CITY, FL, 33523
|
Plan administrator’s name and address
Administrator’s EIN |
590545223 |
Plan administrator’s name |
WITHLACOOCHEE RIVER ELECTRIC COOPERATIVE, INC. |
Plan administrator’s
address |
P.O. BOX 278, DADE CITY, FL, 33526 |
Administrator’s telephone number |
3525675133 |
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 |
Signature of
Role |
Plan administrator |
Date |
2014-07-22 |
Name of individual signing |
RONNIE DEESE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL
|
2012
|
590545223
|
2014-07-22
|
WITHLACOOCHEE RIVER ELECTRIC COOPERATIVE, INC.
|
459
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1998-01-01
|
Business code |
221100
|
Sponsor’s telephone number |
3525675133
|
Plan sponsor’s mailing address |
P.O. BOX 278, DADE CITY, FL, 33526
|
Plan sponsor’s
address |
14651 21ST STREET, DADE CITY, FL, 33523
|
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 |
Signature of
Role |
Plan administrator |
Date |
2014-07-22 |
Name of individual signing |
RONNIE DEESE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
LTD, LIFE, AD&D
|
2012
|
590545223
|
2013-07-17
|
WITHLACOOCHEE RIVER ELECTRIC COOPERATIVE, INC.
|
459
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2011-01-01
|
Business code |
221100
|
Sponsor’s telephone number |
3525675133
|
Plan sponsor’s mailing address |
P.O. BOX 278, DADE CITY, FL, 33526
|
Plan sponsor’s
address |
14651 21ST STREET, DADE CITY, FL, 33523
|
Number of participants as of the end of the plan year
Active participants |
437 |
Retired or separated participants receiving
benefits |
16 |
Signature of
Role |
Plan administrator |
Date |
2013-07-17 |
Name of individual signing |
RONNIE DEESE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
STOP LOSS - HEALTH
|
2012
|
590545223
|
2013-07-17
|
WITHLACOOCHEE RIVER ELECTRIC COOPERATIVE, INC.
|
455
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2010-01-01
|
Business code |
221100
|
Sponsor’s telephone number |
3525675133
|
Plan sponsor’s mailing address |
P.O. BOX 278, DADE CITY, FL, 33526
|
Plan sponsor’s
address |
14651 21ST STREET, DADE CITY, FL, 33523
|
Number of participants as of the end of the plan year
Active participants |
427 |
Retired or separated participants receiving
benefits |
27 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2013-07-17 |
Name of individual signing |
RONNIE DEESE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HEALTH
|
2012
|
590545223
|
2013-07-17
|
WITHLACOOCHEE RIVER ELECTRIC COOPERATIVE, INC
|
456
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1992-07-01
|
Business code |
221100
|
Sponsor’s telephone number |
3525675133
|
Plan sponsor’s mailing address |
P.O. BOX 278, DADE CITY, FL, 33526
|
Plan sponsor’s
address |
14651 21ST STREET, DADE CITY, FL, 33523
|
Number of participants as of the end of the plan year
Active participants |
427 |
Retired or separated participants receiving
benefits |
27 |
Signature of
Role |
Plan administrator |
Date |
2013-07-17 |
Name of individual signing |
RONNIE DEESE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DENTAL
|
2012
|
590545223
|
2013-07-17
|
WITHLACOOCHEE RIVER ELECTRIC COOPERATIVE, INC.
|
459
|
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1998-01-01
|
Business code |
221100
|
Sponsor’s telephone number |
3525675133
|
Plan sponsor’s mailing address |
P.O. BOX 278, DADE CITY, FL, 33526
|
Plan sponsor’s
address |
14651 21ST STREET, DADE CITY, FL, 33523
|
Number of participants as of the end of the plan year
Active participants |
433 |
Retired or separated participants receiving
benefits |
25 |
Signature of
Role |
Plan administrator |
Date |
2013-07-17 |
Name of individual signing |
RONNIE DEESE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
STOP LOSS - HEALTH
|
2011
|
590545223
|
2012-07-25
|
WITHLACOOCHEE RIVER ELECTRIC COOPERATIVE, INC.
|
448
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2010-01-01
|
Business code |
221100
|
Sponsor’s telephone number |
3525675133
|
Plan sponsor’s mailing address |
P.O. BOX 278, DADE CITY, FL, 33526
|
Plan sponsor’s
address |
14651 21ST STREET, DADE CITY, FL, 33523
|
Plan administrator’s name and address
Administrator’s EIN |
590545223 |
Plan administrator’s name |
WITHLACOOCHEE RIVER ELECTRIC COOPERATIVE, INC. |
Plan administrator’s
address |
P.O. BOX 278, DADE CITY, FL, 33526 |
Administrator’s telephone number |
3525675133 |
Number of participants as of the end of the plan year
Active participants |
429 |
Retired or separated participants receiving
benefits |
25 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2012-07-23 |
Name of individual signing |
RONNIE DEESE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP DISABILITY INSURANCE - DENTAL
|
2011
|
590545223
|
2012-07-25
|
WITHLACOOCHEE RIVER ELECTRIC COOPERATIVE, INC.
|
454
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1998-01-01
|
Business code |
221100
|
Sponsor’s telephone number |
3525675133
|
Plan sponsor’s mailing address |
P.O. BOX 278, DADE CITY, FL, 33526
|
Plan sponsor’s
address |
14651 21ST STREET, DADE CITY, FL, 33523
|
Plan administrator’s name and address
Administrator’s EIN |
590545223 |
Plan administrator’s name |
WITHLACOOCHEE RIVER ELECTRIC COOPERATIVE, INC. |
Plan administrator’s
address |
P.O. BOX 278, DADE CITY, FL, 33526 |
Administrator’s telephone number |
3525675133 |
Number of participants as of the end of the plan year
Active participants |
442 |
Retired or separated participants receiving
benefits |
17 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2012-07-23 |
Name of individual signing |
RONNIE DEESE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP DISABILITY INSURANCE - LTD, LIFE, & AD&D
|
2011
|
590545223
|
2012-07-25
|
WITHLACOOCHEE RIVER ELECTRIC COOPERATIVE, INC.
|
459
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2011-01-01
|
Business code |
221100
|
Sponsor’s telephone number |
3525675133
|
Plan sponsor’s mailing address |
P.O. BOX 278, DADE CITY, FL, 33526
|
Plan sponsor’s
address |
14651 21ST STREET, DADE CITY, FL, 33523
|
Plan administrator’s name and address
Administrator’s EIN |
590545223 |
Plan administrator’s name |
WITHLACOOCHEE RIVER ELECTRIC COOPERATIVE, INC. |
Plan administrator’s
address |
P.O. BOX 278, DADE CITY, FL, 33526 |
Administrator’s telephone number |
3525675133 |
Number of participants as of the end of the plan year
Active participants |
447 |
Retired or separated participants receiving
benefits |
17 |
Signature of
Role |
Plan administrator |
Date |
2012-07-23 |
Name of individual signing |
RONNIE DEESE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|