SUCCESS HEALTHCARE VISION PLAN
|
2013
|
263245401
|
2014-12-30
|
SUCCESS HEALTHCARE, LLC
|
701
|
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
2011-01-01
|
Business code |
622000
|
Sponsor’s telephone number |
5618693100
|
Plan sponsor’s mailing address |
999 YAMATO ROAD, SUITE 300, BOCA RATON, FL, 33431
|
Plan sponsor’s
address |
999 YAMATO ROAD, SUITE 300, BOCA RATON, FL, 33431
|
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 |
2014-12-30 |
Name of individual signing |
DAVID ARMSTRONG |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ST. ALEXIUS HOSPITAL CORP. MEDICAL PLAN
|
2013
|
263245401
|
2014-12-30
|
SUCCESS HEALTHCARE, LLC
|
361
|
|
File |
View Page
|
Three-digit plan number (PN) |
508
|
Effective date of plan |
2011-01-01
|
Business code |
622000
|
Sponsor’s telephone number |
5618693100
|
Plan sponsor’s mailing address |
999 YAMATO ROAD, SUITE 300, BOCA RATON, FL, 33431
|
Plan sponsor’s
address |
999 YAMATO ROAD, SUITE 300, BOCA RATON, FL, 33431
|
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 |
2014-12-30 |
Name of individual signing |
DAVID ARMSTRONG |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ST. ALEXIUS HOSPITAL CORP. MEDICAL PLAN
|
2012
|
263245401
|
2014-03-11
|
SUCCESS HEALTHCARE, LLC
|
246
|
|
File |
View Page
|
Three-digit plan number (PN) |
508
|
Effective date of plan |
2011-01-01
|
Business code |
622000
|
Sponsor’s telephone number |
5618693100
|
Plan sponsor’s mailing address |
999 YAMATO ROAD, SUITE 300, BOCA RATON, FL, 33431
|
Plan sponsor’s
address |
999 YAMATO ROAD, SUITE 300, BOCA RATON, FL, 33431
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-03-10 |
Name of individual signing |
DAVID J. ARMSTRONG, ESQ. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUCCESS HEALTHCARE VISION PLAN
|
2012
|
263245401
|
2014-03-11
|
SUCCESS HEALTHCARE, LLC
|
732
|
|
File |
View Page
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
2011-01-01
|
Business code |
622000
|
Sponsor’s telephone number |
5618693100
|
Plan sponsor’s mailing address |
999 YAMATO ROAD, SUITE 300, BOCA RATON, FL, 33431
|
Plan sponsor’s
address |
999 YAMATO ROAD, SUITE 300, BOCA RATON, FL, 33431
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-03-10 |
Name of individual signing |
DAVID J. ARMSTRONG, ESQ. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ST. ALEXIUS HOSPITAL CORP. MEDICAL PLAN
|
2012
|
263245401
|
2013-03-13
|
SUCCESS HEALTHCARE, LLC
|
257
|
|
Three-digit plan number (PN) |
508
|
Effective date of plan |
2011-01-01
|
Business code |
622000
|
Sponsor’s telephone number |
5618693100
|
Plan sponsor’s mailing address |
999 YAMATO ROAD, SUITE 300, BOCA RATON, FL, 33431
|
Plan sponsor’s
address |
999 YAMATO ROAD, SUITE 300, BOCA RATON, FL, 33431
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-03-12 |
Name of individual signing |
DAVID J. ARMSTRONG, ESQ. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUCCESS HEALTHCARE VISION PLAN
|
2012
|
263245401
|
2013-03-13
|
SUCCESS HEALTHCARE, LLC
|
728
|
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
2011-01-01
|
Business code |
622000
|
Sponsor’s telephone number |
5618693100
|
Plan sponsor’s mailing address |
999 YAMATO ROAD, SUITE 300, BOCA RATON, FL, 33431
|
Plan sponsor’s
address |
999 YAMATO ROAD, SUITE 300, BOCA RATON, FL, 33431
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-03-12 |
Name of individual signing |
DAVID J. ARMSTRONG, ESQ. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUCCESS HEALTHCARE DENTAL INSURANCE PLAN
|
2011
|
263245401
|
2013-03-13
|
SUCCESS HEALTHCARE, LLC
|
894
|
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2008-04-01
|
Business code |
622000
|
Sponsor’s telephone number |
5618693100
|
Plan sponsor’s mailing address |
999 YAMATO ROAD, 3RD FL, BOCA RATON, FL, 33431
|
Plan sponsor’s
address |
999 YAMATO ROAD, 3RD FL, BOCA RATON, FL, 33431
|
Plan administrator’s name and address
Administrator’s EIN |
263245401 |
Plan administrator’s name |
SUCCESS HEALTHCARE, LLC |
Plan administrator’s
address |
999 YAMATO ROAD, 3RD FL, BOCA RATON, FL, 33431 |
Administrator’s telephone number |
5618693100 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2013-03-12 |
Name of individual signing |
DAVID J. ARMSTRONG, ESQ. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SUCCESS HEALTHCARE VISION PLAN
|
2011
|
263245401
|
2012-10-22
|
SUCCESS HEALTHCARE, LLC
|
0
|
|
File |
View Page
|
Three-digit plan number (PN) |
505
|
Effective date of plan |
2011-01-01
|
Business code |
622000
|
Sponsor’s telephone number |
5618693100
|
Plan sponsor’s mailing address |
999 YAMATO ROAD, SUITE 300, BOCA RATON, FL, 33431
|
Plan sponsor’s
address |
999 YAMATO ROAD, SUITE 300, BOCA RATON, FL, 33431
|
Plan administrator’s name and address
Administrator’s EIN |
263245401 |
Plan administrator’s name |
SUCCESS HEALTHCARE, LLC |
Plan administrator’s
address |
999 YAMATO ROAD, SUITE 300, BOCA RATON, FL, 33431 |
Administrator’s telephone number |
5618693100 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-10-19 |
Name of individual signing |
DAVID J. ARMSTRONG, ESQ. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ST. ALEXIUS HOSPITAL CORP. MEDICAL PLAN
|
2011
|
263245401
|
2012-10-15
|
SUCCESS HEALTHCARE, LLC
|
0
|
|
File |
View Page
|
Three-digit plan number (PN) |
508
|
Effective date of plan |
2011-01-01
|
Business code |
622000
|
Sponsor’s telephone number |
5618693100
|
Plan sponsor’s mailing address |
999 YAMATO ROAD, SUITE 300, BOCA RATON, FL, 33431
|
Plan sponsor’s
address |
999 YAMATO ROAD, SUITE 300, BOCA RATON, FL, 33431
|
Plan administrator’s name and address
Administrator’s EIN |
263245401 |
Plan administrator’s name |
SUCCESS HEALTHCARE, LLC |
Plan administrator’s
address |
999 YAMATO ROAD, SUITE 300, BOCA RATON, FL, 33431 |
Administrator’s telephone number |
5618693100 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-10-15 |
Name of individual signing |
DAVID J. ARMSTRONG, ESQ. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|