DISMAS CHARITIES LONG TERM DISABILITY INSURANCE
|
2023
|
610663854
|
2024-07-26
|
DISMAS CHARITIES
|
272
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2023-06-01
|
Business code |
623000
|
Sponsor’s telephone number |
5026362033
|
Plan sponsor’s mailing address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078
|
Plan sponsor’s
address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2024-07-26 |
Name of individual signing |
MICHELLE KERSTING |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES GROUP DENTAL INSURANCE PLAN
|
2023
|
610663854
|
2024-07-26
|
DISMAS CHARITIES
|
233
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2023-06-01
|
Business code |
623000
|
Sponsor’s telephone number |
5026362033
|
Plan sponsor’s mailing address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078
|
Plan sponsor’s
address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2024-07-26 |
Name of individual signing |
MICHELLE KERSTING |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES GROUP HEALTH PLAN
|
2023
|
610663854
|
2024-07-26
|
DISMAS CHARITIES
|
85
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2023-03-01
|
Business code |
623000
|
Sponsor’s telephone number |
5026362033
|
Plan sponsor’s mailing address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078
|
Plan sponsor’s
address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2024-07-26 |
Name of individual signing |
MICHELLE KERSTING |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES EMPLOYEE GROUP LIFE INSURANCE
|
2023
|
610663854
|
2024-08-01
|
DISMAS CHARITIES
|
465
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2023-06-01
|
Business code |
623000
|
Sponsor’s telephone number |
5026362033
|
Plan sponsor’s mailing address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078
|
Plan sponsor’s
address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2024-08-01 |
Name of individual signing |
MICHELLE KERSTING |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES GROUP DENTAL INSURANCE PLAN
|
2022
|
610663854
|
2023-09-21
|
DISMAS CHARITIES
|
180
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2022-06-01
|
Business code |
623000
|
Sponsor’s telephone number |
5026362033
|
Plan sponsor’s mailing address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078
|
Plan sponsor’s
address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-09-21 |
Name of individual signing |
MICHELLE KERSTING |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-09-21 |
Name of individual signing |
MICHELLE KERSTING |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES GROUP HEALTH PLAN
|
2022
|
610663854
|
2023-09-21
|
DISMAS CHARITIES
|
86
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
2022-03-01
|
Business code |
623000
|
Sponsor’s telephone number |
5026362033
|
Plan sponsor’s mailing address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078
|
Plan sponsor’s
address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-09-21 |
Name of individual signing |
MICHELLE KERSTING |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-09-21 |
Name of individual signing |
MICHELLE KERSTING |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES LONG TERM DISABILITY INSURANCE
|
2022
|
610663854
|
2023-09-21
|
DISMAS CHARITIES
|
258
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2022-06-01
|
Business code |
623000
|
Sponsor’s telephone number |
5026362033
|
Plan sponsor’s mailing address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078
|
Plan sponsor’s
address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-09-21 |
Name of individual signing |
MICHELLE KERSTING |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-09-21 |
Name of individual signing |
MICHELLE KERSTING |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES EMPLOYEE GROUP LIFE INSURANCE
|
2022
|
610663854
|
2023-09-21
|
DISMAS CHARITIES
|
396
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2022-06-01
|
Business code |
623000
|
Sponsor’s telephone number |
5026362033
|
Plan sponsor’s mailing address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078
|
Plan sponsor’s
address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-09-21 |
Name of individual signing |
MICHELLE KERSTING |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-09-21 |
Name of individual signing |
MICHELLE KERSTING |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES EMPLOYEE GROUP LIFE INSURANCE
|
2021
|
610663854
|
2023-09-11
|
DISMAS CHARITIES
|
438
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
2021-06-01
|
Business code |
623000
|
Sponsor’s telephone number |
5026362033
|
Plan sponsor’s mailing address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078
|
Plan sponsor’s
address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-09-11 |
Name of individual signing |
MICHELLE KERSTING |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-09-11 |
Name of individual signing |
MICHELLE KERSTING |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES GROUP DENTAL INSURANCE PLAN
|
2021
|
610663854
|
2023-09-11
|
DISMAS CHARITIES
|
176
|
|
File |
View Page
|
Three-digit plan number (PN) |
503
|
Effective date of plan |
2021-06-01
|
Business code |
623000
|
Sponsor’s telephone number |
5026362033
|
Plan sponsor’s mailing address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078
|
Plan sponsor’s
address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-09-11 |
Name of individual signing |
MICHELLE KERSTING |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-09-11 |
Name of individual signing |
MICHELLE KERSTING |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES GROUP HEALTH PLAN
|
2021
|
610663854
|
2023-09-11
|
DISMAS CHARITIES
|
78
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2023/09/11/20230911102434NAL0041713730001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
2021-03-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Plan sponsor’s
address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-09-11 |
Name of individual signing |
MICHELLE KERSTING |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-09-11 |
Name of individual signing |
MICHELLE KERSTING |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES LONG TERM DISABILITY INSURANCE
|
2021
|
610663854
|
2023-09-11
|
DISMAS CHARITIES
|
321
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2023/09/11/20230911110236NAL0026540688001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
2021-06-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Plan sponsor’s
address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-09-11 |
Name of individual signing |
MICHELLE KERSTING |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-09-11 |
Name of individual signing |
MICHELLE KERSTING |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES LONG TERM DISABILITY INSURANCE
|
2020
|
610663854
|
2023-09-11
|
DISMAS CHARITIES, INC.
|
346
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2023/09/11/20230911095725NAL0041660882001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
2020-06-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Plan sponsor’s
address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-09-11 |
Name of individual signing |
MICHELLE KERSTING |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-09-11 |
Name of individual signing |
MICHELLE KERSTING |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES GROUP HEALTH INSURANCE PLAN
|
2020
|
610663854
|
2023-09-11
|
DISMAS CHARITIES, INC.
|
82
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2023/09/11/20230911085828NAL0026427584001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
2020-03-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Plan sponsor’s
address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-09-11 |
Name of individual signing |
MICHELLE KERSTING |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-09-11 |
Name of individual signing |
MICHELLE KERSTING |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES EMPLOYEE GROUP LIFE INSURANCE
|
2020
|
610663854
|
2023-09-11
|
DISMAS CHARITIES, INC.
|
383
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2023/09/11/20230911094416NAL0019448081001.pdf |
Three-digit plan number (PN) |
502 |
Effective date of plan |
2020-06-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Plan sponsor’s
address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-09-11 |
Name of individual signing |
MICHELLE KERSTING |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-09-11 |
Name of individual signing |
MICHELLE KERSTING |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES GROUP DENTAL INSURANCE PLAN
|
2020
|
610663854
|
2023-09-11
|
DISMAS CHARITIES, INC.
|
161
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2023/09/11/20230911091150NAL0026442864001.pdf |
Three-digit plan number (PN) |
503 |
Effective date of plan |
2020-06-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Plan sponsor’s
address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2023-09-11 |
Name of individual signing |
MICHELLE KERSTING |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-09-11 |
Name of individual signing |
MICHELLE KERSTING |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES GROUP LONG TERM DISABILITY INSURANCE
|
2020
|
610663854
|
2021-12-07
|
DISMAS CHARITIES INC
|
333
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2021/12/07/20211207163346NAL0021705264001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
2000-12-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan
sponsor’s DBA name |
DISMAS CHARITIES INC. |
Plan sponsor’s mailing address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Plan sponsor’s
address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-12-07 |
Name of individual signing |
ADAM CONLIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-12-07 |
Name of individual signing |
ADAM CONLIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES GROUP DENTAL INSURANCE PLAN
|
2020
|
610663854
|
2022-01-05
|
DISMAS CHARITIES INC
|
177
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2022/01/05/20220105132120NAL0003557857001.pdf |
Three-digit plan number (PN) |
503 |
Effective date of plan |
2003-05-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Plan sponsor’s
address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2022-01-05 |
Name of individual signing |
ADAM CONLIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES INC GROUP DENTAL INSURANCE PLAN
|
2020
|
610663854
|
2022-01-05
|
DISMAS CHARITIES INC
|
112
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2022/01/05/20220105131215NAL0004718496001.pdf |
Three-digit plan number (PN) |
503 |
Effective date of plan |
2003-05-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan
sponsor’s DBA name |
DISMAS CHARITIES INC. |
Plan sponsor’s mailing address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Plan sponsor’s
address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2022-01-05 |
Name of individual signing |
ADAM CONLIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES INC GROUP DENTAL INSURANCE
|
2020
|
610663854
|
2022-01-05
|
DISMAS CHARITIES INC.
|
90
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2022/01/05/20220105124727NAL0005569728001.pdf |
Three-digit plan number (PN) |
503 |
Effective date of plan |
2003-05-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan
sponsor’s DBA name |
DISMAS CHARITIES INC. |
Plan sponsor’s mailing address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Plan sponsor’s
address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2022-01-05 |
Name of individual signing |
ADAM CONLIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES GROUP HEALTH INSURANCE PLAN
|
2020
|
610663854
|
2021-12-08
|
DISMAS CHARITIES INC
|
62
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2021/12/08/20211208110405NAL0016502225001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
2000-04-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan
sponsor’s DBA name |
DISMAS CHARITIES INC. |
Plan sponsor’s mailing address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Plan sponsor’s
address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-12-08 |
Name of individual signing |
ADAM CONLIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-12-08 |
Name of individual signing |
ADAM CONLIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES LONG TERM DISABILITY INSURANCE
|
2020
|
610663854
|
2021-12-08
|
DISMAS CHARITIES INC
|
274
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2021/12/08/20211208102523NAL0041856498001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
2000-12-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan
sponsor’s DBA name |
DISMAS CHARITIES INC. |
Plan sponsor’s mailing address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Plan sponsor’s
address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-12-08 |
Name of individual signing |
ADAM CONLIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-12-08 |
Name of individual signing |
ADAM CONLIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES GROUP HEALTH INSURANCE PLAN
|
2020
|
610663854
|
2021-12-10
|
DISMAS CHARITIES INC
|
83
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2021/12/10/20211210125827NAL0014839681001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
2000-04-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan
sponsor’s DBA name |
DISMAS CHARITIES INC. |
Plan sponsor’s mailing address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Plan sponsor’s
address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-12-10 |
Name of individual signing |
ADAM CONLIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-12-10 |
Name of individual signing |
ADAM CONLIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES GROUP HEALTH INSURANCE PLAN
|
2020
|
610663854
|
2021-12-10
|
DISMAS CHARITIES , INC
|
76
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2021/12/10/20211210124539NAL0019965728001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
2000-04-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan
sponsor’s DBA name |
DISMAS CHARITIES INC. |
Plan sponsor’s mailing address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Plan sponsor’s
address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-12-10 |
Name of individual signing |
ADAM CONLIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-12-10 |
Name of individual signing |
ADAM CONLIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES GROUP DENTAL INSURANCE PLAN
|
2019
|
610663854
|
2022-01-05
|
DISMAS CHARITIES INC
|
158
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2022/01/05/20220105132929NAL0010414930001.pdf |
Three-digit plan number (PN) |
503 |
Effective date of plan |
2003-05-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan
sponsor’s DBA name |
DISMAS CHARITIES INC. |
Plan sponsor’s mailing address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Plan sponsor’s
address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2022-01-05 |
Name of individual signing |
ADAM CONLIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES LONG TERM DISABILITY INSURANCE
|
2019
|
610663854
|
2021-12-08
|
DISMAS CHARITIES INC
|
330
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2021/12/08/20211208104440NAL0022527904001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
2000-12-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan
sponsor’s DBA name |
DISMAS CHARITIES INC. |
Plan sponsor’s mailing address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Plan sponsor’s
address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-12-08 |
Name of individual signing |
ADAM CONLIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-12-08 |
Name of individual signing |
ADAM CONLIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES GROUP HEALTH INSURANCE PLAN
|
2019
|
610663854
|
2021-12-10
|
DISMAS CHARITIES INC
|
82
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2021/12/10/20211210132512NAL0020023280001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
2000-04-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan
sponsor’s DBA name |
DISMAS CHARITIES INC. |
Plan sponsor’s mailing address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Plan sponsor’s
address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2021-12-10 |
Name of individual signing |
ADAM CONLIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-12-10 |
Name of individual signing |
ADAM CONLIN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES GROUP LONG TERM DISABILITY INSURANCE
|
2015
|
610663854
|
2017-10-16
|
DISMAS CHARITIES INC
|
234
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2017/10/16/20171016150548P040232734033001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
2000-12-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Plan sponsor’s
address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-10-16 |
Name of individual signing |
RAYMOND WEIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES INC. GROUP DENTAL INSURANCE
|
2015
|
610663854
|
2017-10-16
|
DISMAS CHARITIES INC.
|
90
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2017/10/16/20171016150513P040209888103001.pdf |
Three-digit plan number (PN) |
503 |
Effective date of plan |
2003-05-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Plan sponsor’s
address |
2500 7TH STREET RD, LOUISVILLE, KY, 402081078 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2017-10-16 |
Name of individual signing |
RAYMOND WEIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES INC. GROUP HEALTH INSURANCE PLAN
|
2014
|
610663854
|
2016-10-11
|
DISMAS CHARITIES INC.
|
65
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2016/10/11/20161011162538P040021802673001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
2000-04-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan sponsor’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-10-07 |
Name of individual signing |
RAYMOND WEIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES INC. GROUP DENTAL INSURANCE
|
2014
|
610663854
|
2016-10-11
|
DISMAS CHARITIES INC.
|
251
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2016/10/11/20161011162518P040021801889001.pdf |
Three-digit plan number (PN) |
503 |
Effective date of plan |
2003-05-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan sponsor’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-10-07 |
Name of individual signing |
RAYMOND WEIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES INC. EMPLOYEE GROUP LIFE INSURANCE
|
2014
|
610663854
|
2016-10-11
|
DISMAS CHARITIES INC.
|
293
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2016/10/11/20161011162501P030019241127001.pdf |
Three-digit plan number (PN) |
502 |
Effective date of plan |
2000-12-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan sponsor’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-10-07 |
Name of individual signing |
RAYMOND WEIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES GROUP LONG TERM DISABILITY INSURANCE
|
2014
|
610663854
|
2016-10-11
|
DISMAS CHARITIES INC.
|
262
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2016/10/11/20161011162441P030019240439001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
2000-12-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan sponsor’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2016-10-07 |
Name of individual signing |
RAYMOND WEIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES GROUP LONG TERM DISABILITY
|
2013
|
610663854
|
2015-09-15
|
DISMAS CHARITIES, INC.
|
57
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2015/09/15/20150915144638P030003076183001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
2000-04-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan sponsor’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-09-15 |
Name of individual signing |
RAYMOND WEIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES GROUP DENTAL INSURANCE
|
2013
|
610663854
|
2015-09-15
|
DISMAS CHARITIES, INC.
|
251
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2015/09/15/20150915144620P040003349265001.pdf |
Three-digit plan number (PN) |
503 |
Effective date of plan |
2003-05-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan sponsor’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-09-15 |
Name of individual signing |
RAYMOND WEIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES GROUP LONG TERM DISABILITY
|
2013
|
610663854
|
2015-09-15
|
DISMAS CHARITIES, INC.
|
251
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2015/09/15/20150915144601P040003348737001.pdf |
Three-digit plan number (PN) |
502 |
Effective date of plan |
2000-12-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan sponsor’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-09-15 |
Name of individual signing |
RAYMOND WEIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES GROUP LONG TERM DISABILITY
|
2013
|
610663854
|
2015-09-15
|
DISMAS CHARITIES, INC.
|
261
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2015/09/15/20150915144542P030003074679001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
2000-12-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan sponsor’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-09-15 |
Name of individual signing |
RAYMOND WEIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES INC. GROUP HEALTH INSURANCE
|
2012
|
610663854
|
2014-08-07
|
DISMAS CHARITIES INC.
|
66
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2014/08/07/20140807161633P040031403245001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
2000-04-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan sponsor’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-08-07 |
Name of individual signing |
RAYMOND WEIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES INC. GROUP DENTAL INSURANCE
|
2012
|
610663854
|
2014-08-07
|
DISMAS CHARITIES INC.
|
118
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2014/08/07/20140807161615P040031403117001.pdf |
Three-digit plan number (PN) |
503 |
Effective date of plan |
2003-05-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan sponsor’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-08-07 |
Name of individual signing |
RAYMOND WEIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES INC. EMPLOYEE GROUP LIFE INSURANCE
|
2012
|
610663854
|
2014-08-07
|
DISMAS CHARITIES INC.
|
291
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2014/08/07/20140807161556P030075349255001.pdf |
Three-digit plan number (PN) |
502 |
Effective date of plan |
2000-12-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan sponsor’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-08-07 |
Name of individual signing |
RAYMOND WEIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES GROUP LONG TERM DISABILITY INSURANCE
|
2012
|
610663854
|
2014-08-07
|
DISMAS CHARITIES INC.
|
283
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2014/08/07/20140807161536P040031402941001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
2000-12-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan sponsor’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2014-08-07 |
Name of individual signing |
RAYMOND WEIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES INC GROUP HEALTH INSURANCE PLAN
|
2011
|
610663854
|
2013-09-13
|
DISMAS CHARITIES INC
|
65
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/09/13/20130913125209P030051774535001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
2000-04-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan sponsor’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan administrator’s name and address
Administrator’s EIN |
610663854 |
Plan administrator’s name |
DISMAS CHARITIES INC |
Plan administrator’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Administrator’s telephone number |
5026362033 |
Number of participants as of the end of the plan year
Signature of
Role |
Employer/plan sponsor |
Date |
2013-09-13 |
Name of individual signing |
RAYMOND WEIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES INC GROUP DENTAL INSURANCE
|
2011
|
610663854
|
2013-09-13
|
DISMAS CHARITIES INC
|
123
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/09/13/20130913125145P030051774519001.pdf |
Three-digit plan number (PN) |
503 |
Effective date of plan |
2003-05-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan sponsor’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan administrator’s name and address
Administrator’s EIN |
610663854 |
Plan administrator’s name |
DISMAS CHARITIES INC |
Plan administrator’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Administrator’s telephone number |
5026362033 |
Number of participants as of the end of the plan year
Signature of
Role |
Employer/plan sponsor |
Date |
2013-09-13 |
Name of individual signing |
RAYMOND WEIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES INC EMPLOYEE GROUP LIFE INS.
|
2011
|
610663854
|
2013-09-13
|
DISMAS CHARITIES INC
|
303
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/09/13/20130913125123P030051774471001.pdf |
Three-digit plan number (PN) |
502 |
Effective date of plan |
2000-12-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan sponsor’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan administrator’s name and address
Administrator’s EIN |
610663854 |
Plan administrator’s name |
DISMAS CHARITIES INC |
Plan administrator’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Administrator’s telephone number |
5026362033 |
Number of participants as of the end of the plan year
Signature of
Role |
Employer/plan sponsor |
Date |
2013-09-13 |
Name of individual signing |
RAYMOND WEIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES GROUP LONG TERM DISABILITY INSURANCE
|
2011
|
610663854
|
2013-09-13
|
DISMAS CHARITIES INC.
|
263
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/09/13/20130913125039P030051774343001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
2000-12-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan sponsor’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan administrator’s name and address
Administrator’s EIN |
610663854 |
Plan administrator’s name |
DISMAS CHARITIES INC. |
Plan administrator’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Administrator’s telephone number |
5026362033 |
Number of participants as of the end of the plan year
Signature of
Role |
Employer/plan sponsor |
Date |
2013-09-13 |
Name of individual signing |
RAYMOND WEIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES INC. GROUP HEALTH INSURANCE PLAN
|
2010
|
610663854
|
2012-09-14
|
DISMAS CHARITIES, INC.
|
71
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/09/14/20120914151552P040002415493001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
2000-04-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan sponsor’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan administrator’s name and address
Administrator’s EIN |
610663854 |
Plan administrator’s name |
DISMAS CHARITIES, INC. |
Plan administrator’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Administrator’s telephone number |
5026362033 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-09-14 |
Name of individual signing |
RAYMOND WEIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES INC EMPLOYEE GROUP LIFE INSURANCE
|
2010
|
610663854
|
2012-09-14
|
DISMAS CHARITIES INC
|
265
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/09/14/20120914151515P040004138388001.pdf |
Three-digit plan number (PN) |
502 |
Effective date of plan |
2000-12-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan sponsor’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan administrator’s name and address
Administrator’s EIN |
610663854 |
Plan administrator’s name |
DISMAS CHARITIES INC |
Plan administrator’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Administrator’s telephone number |
5026362033 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-09-14 |
Name of individual signing |
RAYMOND WEIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES INC GROUP DENTAL INSURANCE
|
2010
|
610663854
|
2012-09-14
|
DISMAS CHARITIES INC.
|
119
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/09/14/20120914151415P040004138340001.pdf |
Three-digit plan number (PN) |
503 |
Effective date of plan |
2003-05-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan sponsor’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan administrator’s name and address
Administrator’s EIN |
610663854 |
Plan administrator’s name |
DISMAS CHARITIES INC. |
Plan administrator’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Administrator’s telephone number |
5026362033 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-09-14 |
Name of individual signing |
RAYMOND WEIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES GROUP LONG TERM DIABILITY INSURANCE
|
2010
|
610663854
|
2012-06-13
|
DISMAS CHARITIES, INC.
|
249
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2012/06/13/20120613145607P030003147286001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
2000-12-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 SEVENTH STRRET ROAD, LOUISVILLE, KY, 40208 |
Plan sponsor’s
address |
2500 SEVENTH STRRET ROAD, LOUISVILLE, KY, 40208 |
Plan administrator’s name and address
Administrator’s EIN |
610663854 |
Plan administrator’s name |
DISMAS CHARITIES, INC. |
Plan administrator’s
address |
2500 SEVENTH STRRET ROAD, LOUISVILLE, KY, 40208 |
Administrator’s telephone number |
5026362033 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-06-13 |
Name of individual signing |
RAYMOND WEIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES INC. GROUP HEALTH INSURANCE PLAN
|
2009
|
610663854
|
2011-09-14
|
DISMAS CHARITIES INC
|
78
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/09/14/20110914124105P030130069409001.pdf |
Three-digit plan number (PN) |
504 |
Effective date of plan |
2000-04-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan sponsor’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan administrator’s name and address
Administrator’s EIN |
610663854 |
Plan administrator’s name |
DISMAS CHARITIES INC |
Plan administrator’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Administrator’s telephone number |
5026362033 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2011-09-10 |
Name of individual signing |
RAYMOND WEIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES INC GROUP DENTAL INSURANCE
|
2009
|
610663854
|
2011-09-14
|
DISMAS CHARITIES INC
|
122
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/09/14/20110914124042P030042070087001.pdf |
Three-digit plan number (PN) |
503 |
Effective date of plan |
2003-05-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan sponsor’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan administrator’s name and address
Administrator’s EIN |
610663854 |
Plan administrator’s name |
DISMAS CHARITIES INC |
Plan administrator’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Administrator’s telephone number |
5026362033 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2011-09-10 |
Name of individual signing |
RAYMOND WEIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES INC EMPLOYEE GROUP LIFE INSURANCE
|
2009
|
610663854
|
2011-09-14
|
DISMAS CHARITIES INC
|
244
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/09/14/20110914124134P030606451168001.pdf |
Three-digit plan number (PN) |
502 |
Effective date of plan |
2000-12-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan sponsor’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan administrator’s name and address
Administrator’s EIN |
610663854 |
Plan administrator’s name |
DISMAS CHARITIES INC |
Plan administrator’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Administrator’s telephone number |
5026362033 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2011-09-10 |
Name of individual signing |
RAYMOND WEIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
DISMAS CHARITIES GROUP LONG TERM DISABILITY INSURANCE
|
2009
|
610663854
|
2011-06-28
|
DISMAS CHARITIES, INC
|
220
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2011/06/28/20110628083105P030012171762001.pdf |
Three-digit plan number (PN) |
501 |
Effective date of plan |
2000-12-01 |
Business code |
623000 |
Sponsor’s telephone number |
5026362033 |
Plan sponsor’s mailing address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan sponsor’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Plan administrator’s name and address
Administrator’s EIN |
610663854 |
Plan administrator’s name |
DISMAS CHARITIES, INC |
Plan administrator’s
address |
2500 SEVENTH STREET ROAD, LOUISVILLE, KY, 40208 |
Administrator’s telephone number |
5026362033 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2011-06-27 |
Name of individual signing |
RAYMOND WEIS |
Valid signature |
Filed with authorized/valid electronic signature |
|
|