EMPLOYEE HEALTH AND SAFETY PROGRAM BENEFIT PLAN
|
2017
|
061153720
|
2018-06-28
|
ALMOST FAMILY, INC.
|
155
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2016-12-31
|
Business code |
623000
|
Sponsor’s telephone number |
5028911000
|
Plan sponsor’s mailing address |
9510 ORMSBY STATION RD STE 300, LOUISVILLE, KY, 402235016
|
Plan sponsor’s
address |
9510 ORMSBY STATION RD STE 300, LOUISVILLE, KY, 402235016
|
Plan administrator’s name and address
Administrator’s EIN |
061153720 |
Plan administrator’s name |
ALMOST FAMILY, INC. |
Plan administrator’s
address |
9510 ORMSBY STATION RD STE 300, LOUISVILLE, KY, 402235016 |
Administrator’s telephone number |
5028911000 |
Number of participants as of the end of the plan year
Active participants |
139 |
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 |
2018-06-28 |
Name of individual signing |
VICKY DICLEMENTE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ALMOST FAMILY, INC. EMPLOYEE HEALTH PLAN
|
2010
|
061153720
|
2011-10-17
|
ALMOST FAMILY, INC.
|
5832
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1999-05-01
|
Business code |
621610
|
Sponsor’s telephone number |
5028911000
|
Plan sponsor’s mailing address |
9510 ORMSBY STATION RD., #300, LOUISVILLE, KY, 40223
|
Plan sponsor’s
address |
9510 ORMSBY STATION RD., #300, LOUISVILLE, KY, 40223
|
Plan administrator’s name and address
Administrator’s EIN |
061153720 |
Plan administrator’s name |
ALMOST FAMILY, INC. |
Plan administrator’s
address |
9510 ORMSBY STATION RD., #300, LOUISVILLE, KY, 40223 |
Administrator’s telephone number |
5028911000 |
Number of participants as of the end of the plan year
Active participants |
6003 |
Retired or separated participants receiving
benefits |
69 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2011-10-14 |
Name of individual signing |
MARK SUTTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-10-17 |
Name of individual signing |
PATRICK LYLES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ALMOST FAMILY, INC. FLEXIBLE BENEFIT PLAN
|
2010
|
061153720
|
2011-07-28
|
ALMOST FAMILY, INC.
|
2411
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1991-01-01
|
Business code |
621610
|
Sponsor’s telephone number |
5028911000
|
Plan sponsor’s mailing address |
9510 ORMSBY STATION RD., #300, LOUISVILLE, KY, 40223
|
Plan sponsor’s
address |
9510 ORMSBY STATION RD., #300, LOUISVILLE, KY, 40223
|
Plan administrator’s name and address
Administrator’s EIN |
061153720 |
Plan administrator’s name |
ALMOST FAMILY, INC. |
Plan administrator’s
address |
9510 ORMSBY STATION RD., #300, LOUISVILLE, KY, 40223 |
Administrator’s telephone number |
5028911000 |
Number of participants as of the end of the plan year
Active participants |
2626 |
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 |
2011-07-28 |
Name of individual signing |
MARK SUTTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-07-28 |
Name of individual signing |
PATRICK LYLES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ALMOST FAMILY, INC. EMPLOYEE VISION PLAN
|
2010
|
061153720
|
2011-07-28
|
ALMOST FAMILY, INC.
|
1123
|
|
File |
View Page
|
Three-digit plan number (PN) |
508
|
Effective date of plan |
2006-01-01
|
Business code |
621610
|
Sponsor’s telephone number |
5028911000
|
Plan sponsor’s mailing address |
9510 ORMSBY STATION RD., #300, LOUISVILLE, KY, 40223
|
Plan sponsor’s
address |
9510 ORMSBY STATION RD., #300, LOUISVILLE, KY, 40223
|
Plan administrator’s name and address
Administrator’s EIN |
061153720 |
Plan administrator’s name |
ALMOST FAMILY, INC. |
Plan administrator’s
address |
9510 ORMSBY STATION RD., #300, LOUISVILLE, KY, 40223 |
Administrator’s telephone number |
5028911000 |
Number of participants as of the end of the plan year
Active participants |
1142 |
Retired or separated participants receiving
benefits |
27 |
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 |
2011-07-28 |
Name of individual signing |
MARK SUTTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-07-28 |
Name of individual signing |
PATRICK LYLES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP LIFE INSURANCE FOR EMPLOYEES OF ALMOST FAMILY, INC.
|
2010
|
061153720
|
2011-07-28
|
ALMOST FAMILY, INC.
|
2153
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
1998-01-01
|
Business code |
621610
|
Sponsor’s telephone number |
5028911000
|
Plan sponsor’s mailing address |
9510 ORMSBY STATION RD., #300, LOUISVILLE, KY, 40223
|
Plan sponsor’s
address |
9510 ORMSBY STATION RD., #300, LOUISVILLE, KY, 40223
|
Plan administrator’s name and address
Administrator’s EIN |
061153720 |
Plan administrator’s name |
ALMOST FAMILY, INC. |
Plan administrator’s
address |
9510 ORMSBY STATION RD., #300, LOUISVILLE, KY, 40223 |
Administrator’s telephone number |
5028911000 |
Number of participants as of the end of the plan year
Active participants |
2357 |
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 |
2011-07-19 |
Name of individual signing |
MARK SUTTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-07-28 |
Name of individual signing |
PATRICK LYLES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ALMOST FAMILY INC. EMPLOYEE VISION PLAN
|
2009
|
061153720
|
2010-07-30
|
ALMOST FAMILY, INC.
|
962
|
|
File |
View Page
|
Three-digit plan number (PN) |
508
|
Effective date of plan |
2006-01-01
|
Business code |
621610
|
Sponsor’s telephone number |
5028911000
|
Plan sponsor’s mailing address |
9510 ORMSBY STATION RD., SUITE 300, LOUISVILLE, KY, 40223
|
Plan sponsor’s
address |
9510 ORMSBY STATION RD., SUITE 300, LOUISVILLE, KY, 40223
|
Plan administrator’s name and address
Administrator’s EIN |
061153720 |
Plan administrator’s name |
ALMOST FAMILY, INC. |
Plan administrator’s
address |
9510 ORMSBY STATION RD., SUITE 300, LOUISVILLE, KY, 40223 |
Administrator’s telephone number |
5028911000 |
Number of participants as of the end of the plan year
Active participants |
1045 |
Retired or separated participants receiving
benefits |
28 |
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 |
2010-07-30 |
Name of individual signing |
MARK SUTTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-07-30 |
Name of individual signing |
PATRICK LYLES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ALMOST FAMILY, INC. EMPLOYEE HEALTH PLAN
|
2009
|
061153720
|
2010-07-30
|
ALMOST FAMILY, INC.
|
5131
|
|
File |
View Page
|
Three-digit plan number (PN) |
502
|
Effective date of plan |
1999-05-01
|
Business code |
621610
|
Sponsor’s telephone number |
5028911000
|
Plan sponsor’s mailing address |
9510 ORMSBY STATION RD., #300, LOUISVILLE, KY, 40223
|
Plan sponsor’s
address |
9510 ORMSBY STATION RD., #300, LOUISVILLE, KY, 40223
|
Plan administrator’s name and address
Administrator’s EIN |
061153720 |
Plan administrator’s name |
ALMOST FAMILY, INC. |
Plan administrator’s
address |
9510 ORMSBY STATION RD., #300, LOUISVILLE, KY, 40223 |
Administrator’s telephone number |
5028911000 |
Number of participants as of the end of the plan year
Active participants |
5767 |
Retired or separated participants receiving
benefits |
65 |
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 |
2010-07-30 |
Name of individual signing |
MARK SUTTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-07-30 |
Name of individual signing |
PATRICK LYLES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
ALMOST FAMILY FLEXIBLE BENEFIT PLAN
|
2009
|
061153720
|
2010-07-30
|
ALMOST FAMILY, INC.
|
1988
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
1991-01-01
|
Business code |
621610
|
Sponsor’s telephone number |
5028911000
|
Plan sponsor’s mailing address |
9510 ORMSBY STATION RD., #300, LOUISVILLE, KY, 40223
|
Plan sponsor’s
address |
9510 ORMSBY STATION RD., #300, LOUISVILLE, KY, 40223
|
Plan administrator’s name and address
Administrator’s EIN |
061153720 |
Plan administrator’s name |
ALMOST FAMILY, INC. |
Plan administrator’s
address |
9510 ORMSBY STATION RD., #300, LOUISVILLE, KY, 40223 |
Administrator’s telephone number |
5028911000 |
Number of participants as of the end of the plan year
Active participants |
2264 |
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 |
2010-07-30 |
Name of individual signing |
MARK SUTTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-07-30 |
Name of individual signing |
PATRICK LYLES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
GROUP LIFE INSURANCE FOR EMPLOYEES OF ALMOST FAMILY, INC.
|
2009
|
061153720
|
2010-07-30
|
ALMOST FAMILY, INC.
|
1749
|
|
File |
View Page
|
Three-digit plan number (PN) |
504
|
Effective date of plan |
1998-01-01
|
Business code |
621610
|
Sponsor’s telephone number |
5028911000
|
Plan sponsor’s mailing address |
9510 ORMSBY STATION RD., SUITE 300, LOUISVILLE, KY, 40223
|
Plan sponsor’s
address |
9510 ORMSBY STATION RD., SUITE 300, LOUISVILLE, KY, 40223
|
Plan administrator’s name and address
Administrator’s EIN |
061153720 |
Plan administrator’s name |
ALMOST FAMILY, INC. |
Plan administrator’s
address |
9510 ORMSBY STATION RD., SUITE 300, LOUISVILLE, KY, 40223 |
Administrator’s telephone number |
5028911000 |
Number of participants as of the end of the plan year
Active participants |
2130 |
Retired or separated participants receiving
benefits |
0 |
Other
retired or separated participants entitled to future benefits |
0 |
Signature of
Role |
Plan administrator |
Date |
2010-07-29 |
Name of individual signing |
MARK SUTTON |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2010-07-30 |
Name of individual signing |
PATRICK LYLES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|