PROHEALTH GROUP, INC.
|
2017
|
475658024
|
2019-06-21
|
PROHEALTH GROUP, INC.
|
541
|
|
File |
View Page
|
Three-digit plan number (PN) |
999
|
Effective date of plan |
2016-12-01
|
Business code |
551112
|
Sponsor’s telephone number |
2058207000
|
Plan sponsor’s mailing address |
717 37TH ST S, BIRMINGHAM, AL, 352223244
|
Plan sponsor’s
address |
717 37TH ST S, BIRMINGHAM, AL, 352223244
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-06-20 |
Name of individual signing |
DAVID LESTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-06-20 |
Name of individual signing |
DAVID LESTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PROHEALTH GROUP, INC - DENTAL
|
2017
|
475658024
|
2019-06-21
|
PROHEALTH GROUP, INC
|
533
|
|
File |
View Page
|
Three-digit plan number (PN) |
999
|
Effective date of plan |
2016-12-01
|
Business code |
551112
|
Sponsor’s telephone number |
2058207000
|
Plan sponsor’s mailing address |
717 37TH ST S, BIRMINGHAM, AL, 352223244
|
Plan sponsor’s
address |
717 37TH ST S, BIRMINGHAM, AL, 352223244
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-06-20 |
Name of individual signing |
DAVID LESTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-06-20 |
Name of individual signing |
DAVID LESTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PROHEALTH GROUP, INC.
|
2017
|
475658024
|
2019-06-20
|
PROHEALTH GROUP, INC.
|
541
|
|
Three-digit plan number (PN) |
999
|
Effective date of plan |
2016-12-01
|
Business code |
551112
|
Sponsor’s telephone number |
2058207000
|
Plan sponsor’s mailing address |
717 37TH ST S, BIRMINGHAM, AL, 352223244
|
Plan sponsor’s
address |
717 37TH ST S, BIRMINGHAM, AL, 352223244
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-06-17 |
Name of individual signing |
DAVID LESTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-06-17 |
Name of individual signing |
DAVID LESTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PROHEALTH GROUP, INC - DENTAL
|
2017
|
475658024
|
2019-06-20
|
PROHEALTH GROUP, INC
|
533
|
|
Three-digit plan number (PN) |
999
|
Effective date of plan |
2016-12-01
|
Business code |
551112
|
Sponsor’s telephone number |
2058207000
|
Plan sponsor’s mailing address |
717 37TH ST S, BIRMINGHAM, AL, 352223244
|
Plan sponsor’s
address |
717 37TH ST S, BIRMINGHAM, AL, 352223244
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2019-06-20 |
Name of individual signing |
DAVID LESTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-06-20 |
Name of individual signing |
DAVID LESTER |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PROHEALTH GROUP INC
|
2016
|
475658024
|
2018-07-16
|
PROHEALTH GROUP INC
|
0
|
|
File |
View Page
|
Three-digit plan number (PN) |
999
|
Effective date of plan |
2016-12-01
|
Business code |
551112
|
Sponsor’s telephone number |
2058200604
|
Plan sponsor’s mailing address |
717 37TH ST S, BIRMINGHAM, AL, 352223244
|
Plan sponsor’s
address |
717 37TH ST S, BIRMINGHAM, AL, 352223244
|
Plan administrator’s name and address
Administrator’s EIN |
630103830 |
Plan administrator’s name |
BLUE CROSS AND BLUE SHIELD OF ALABAMA |
Plan administrator’s
address |
450 RIVERCHASE PKWY E, HOOVER, AL, 352442858 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2018-07-16 |
Name of individual signing |
MARY MANGINA |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-07-16 |
Name of individual signing |
MARY MANGINA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PROHEALTH GROUP INC - DENTAL
|
2016
|
475658024
|
2018-07-16
|
PROHEALTH GROUP INC
|
0
|
|
File |
View Page
|
Three-digit plan number (PN) |
999
|
Effective date of plan |
2016-12-01
|
Business code |
551112
|
Sponsor’s telephone number |
2058200604
|
Plan sponsor’s mailing address |
717 37TH ST S, BIRMINGHAM, AL, 352223244
|
Plan sponsor’s
address |
717 37TH ST S, BIRMINGHAM, AL, 352223244
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2018-07-16 |
Name of individual signing |
MARY MANGINA |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-07-16 |
Name of individual signing |
MARY MANGINA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|