PROMISE HEALTHCARE, INC. MEDICAL PLAN
|
2013
|
141887953
|
2014-12-30
|
PROMISE HEALTHCARE, INC.
|
1320
|
|
Three-digit plan number (PN) |
512
|
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 |
|
|
PROMISE HEALTHCARE VISION PLAN
|
2013
|
141887953
|
2014-12-30
|
PROMISE HEALTHCARE, INC.
|
1203
|
|
Three-digit plan number (PN) |
511
|
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 |
|
|
PROMISE HEALTHCARE, INC. LIFE, CRITICAL INJURY AND SHORT-TERM DISAB PLAN
|
2013
|
141887953
|
2014-06-18
|
PROMISE HEALTHCARE, INC.
|
1100
|
|
File |
View Page
|
Three-digit plan number (PN) |
509
|
Effective date of plan |
2007-01-01
|
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 |
2014-06-16 |
Name of individual signing |
DAVID J. ARMSTRONG, ESQ. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PROMISE HEALTHCARE, INC. MEDICAL PLAN
|
2012
|
141887953
|
2014-03-11
|
PROMISE HEALTHCARE, INC.
|
773
|
|
File |
View Page
|
Three-digit plan number (PN) |
512
|
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 |
|
|
PROMISE HEALTHCARE VISION PLAN
|
2012
|
141887953
|
2014-03-11
|
PROMISE HEALTHCARE, INC.
|
1254
|
|
File |
View Page
|
Three-digit plan number (PN) |
511
|
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 |
|
|
PROMISE HEALTHCARE, INC. LIFE, CRITICAL INJURY AND SHORT-TERM DISAB PLAN
|
2012
|
141887953
|
2013-10-11
|
PROMISE HEALTHCARE, INC.
|
1898
|
|
File |
View Page
|
Three-digit plan number (PN) |
509
|
Effective date of plan |
2007-01-01
|
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 |
2013-10-10 |
Name of individual signing |
DAVID J. ARMSTRONG, ESQ. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PROMISE HEALTHCARE, INC. MEDICAL PLAN
|
2012
|
141887953
|
2013-03-13
|
PROMISE HEALTHCARE, INC.
|
859
|
|
Three-digit plan number (PN) |
512
|
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 |
|
|
PROMISE HEALTHCARE VISION PLAN
|
2012
|
141887953
|
2013-03-13
|
PROMISE HEALTHCARE, INC.
|
1288
|
|
Three-digit plan number (PN) |
511
|
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 |
|
|
PROMISE HEALTHCARE, INC. MEDICAL PLAN
|
2011
|
141887953
|
2013-03-15
|
PROMISE HEALTHCARE, INC.
|
1009
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2004-06-01
|
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 |
141887953 |
Plan administrator’s name |
PROMISE HEALTHCARE, INC. |
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 |
2013-03-15 |
Name of individual signing |
DAVID J. ARMSTRONG, ESQ. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PROMISE HEALTHCARE VISION PLAN
|
2011
|
141887953
|
2012-10-22
|
PROMISE HEALTHCARE, INC.
|
0
|
|
File |
View Page
|
Three-digit plan number (PN) |
511
|
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 |
141887953 |
Plan administrator’s name |
PROMISE HEALTHCARE, INC. |
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 |
|
|