HUMANA INSURANCE COMPANY
|
2014
|
362590353
|
2015-04-09
|
PROSPECT AIRPORT SERVICES INC.
|
47
|
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2014-12-01
|
Business code |
488100
|
Sponsor’s telephone number |
8472993636
|
Plan sponsor’s mailing address |
2130 S. WOLD ROAD, DESPLAINES, IL, 60018
|
Plan sponsor’s
address |
2130 S. WOLD ROAD, DESPLAINES, IL, 60018
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-04-09 |
Name of individual signing |
LORETTA MOORE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HUMANA INSURANCE COMPANY
|
2013
|
362590353
|
2015-03-10
|
PROSPECT AIRPORT SERVICES INC
|
129
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2012-12-01
|
Business code |
488100
|
Sponsor’s telephone number |
8472993636
|
Plan sponsor’s mailing address |
2130 S. WOLF ROAD, DESPLANES, IL, 60018
|
Plan sponsor’s
address |
2130 S. WOLF ROAD, DESPLANES, IL, 60018
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-03-10 |
Name of individual signing |
LORETTA MOORE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HUMANA INSURANCE COMPANY
|
2012
|
362590353
|
2015-06-18
|
PROSPECT AIRPORT SERVICES
|
129
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2011-12-01
|
Business code |
488100
|
Sponsor’s telephone number |
8472993636
|
Plan
sponsor’s DBA name |
SAME
|
Plan sponsor’s mailing address |
2130 S. WOLF ROAD, DES PLAINES, IL, 60018
|
Plan sponsor’s
address |
2130 S. WOLF ROAD, DES PLAINES, IL, 60018
|
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2015-06-18 |
Name of individual signing |
LORETTA MOORE |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-06-18 |
Name of individual signing |
LORETTA MOORE |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
HUMANA INSURANCE COMPANY
|
2011
|
362590353
|
2012-08-30
|
PROSPECT AIRPORT SERVICES, INC
|
127
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2010-12-01
|
Business code |
488100
|
Plan
sponsor’s DBA name |
SAME
|
Plan sponsor’s mailing address |
2130 S. WOLF ROAD, DESPLAINES, IL, 60018
|
Plan sponsor’s
address |
2130 S. WOLF ROAD, DESPLAINES, IL, 60018
|
Plan administrator’s name and address
Administrator’s EIN |
362590353 |
Plan administrator’s name |
PROSPECT AIRPORT SERVICES, INC |
Plan administrator’s
address |
2130 S. WOLF ROAD, DESPLAINES, IL, 60018 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2012-08-30 |
Name of individual signing |
RENATA CETERA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLUE CROSS BLUE SHIELD PPO BLUE PRINT AND BLUE CROSS BLUE SHIELD BLUE ADVANTAGE HMO
|
2010
|
362590353
|
2011-11-03
|
PROSPECT AIRPORT SERVICES INC
|
185
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2006-12-01
|
Business code |
488100
|
Sponsor’s telephone number |
8472993636
|
Plan sponsor’s mailing address |
2130 SOUTH WOLF ROAD, DES PLAINES, IL, 60018
|
Plan sponsor’s
address |
2130 SOUTH WOLF ROAD, DES PLAINES, IL, 60018
|
Plan administrator’s name and address
Administrator’s EIN |
362590353 |
Plan administrator’s name |
PROSPECT AIRPORT SERVICES INC |
Plan administrator’s
address |
2130 SOUTH WOLF ROAD, DES PLAINES, IL, 60018 |
Administrator’s telephone number |
8472993636 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2011-11-03 |
Name of individual signing |
RENATA CETERA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLUE CROSS BLUE SHIELD PPO BLUE PRINT AND BLUE CROSS BLUE SHIELD BLUE ADVANTAGE HMO
|
2010
|
362590353
|
2011-11-02
|
PROSPECT AIRPORT SERVICES
|
185
|
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2006-12-01
|
Business code |
488100
|
Sponsor’s telephone number |
8472993636
|
Plan sponsor’s mailing address |
2130 SOUTH WOLF ROAD, DES PLAINES, IL, 60018
|
Plan sponsor’s
address |
2130 SOUTH WOLF ROAD, DES PLAINES, IL, 60018
|
Plan administrator’s name and address
Administrator’s EIN |
362590353 |
Plan administrator’s name |
PROSPECT AIRPORT SERVICES |
Plan administrator’s
address |
2130 SOUTH WOLF ROAD, DES PLAINES, IL, 60018 |
Administrator’s telephone number |
8472993636 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2011-11-02 |
Name of individual signing |
RENATA CETERA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLUE CROSS BLUE SHIELD PPO BLUE PRINT AND BLUE CROSS BLUE SHIELD ADVANTAGE HMO
|
2010
|
362590353
|
2011-11-02
|
PROSPECT AIRPORT SERVICES
|
66
|
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2006-12-01
|
Business code |
488100
|
Sponsor’s telephone number |
8472993636
|
Plan sponsor’s mailing address |
2130 SOUTH WOLF ROAD, DES PLAINES, IL, 60018
|
Plan sponsor’s
address |
2130 SOUTH WOLF ROAD, DES PLAINES, IL, 60018
|
Plan administrator’s name and address
Administrator’s EIN |
362590353 |
Plan administrator’s name |
PROSPECT AIRPORT SERVICES |
Plan administrator’s
address |
2130 SOUTH WOLF ROAD, DES PLAINES, IL, 60018 |
Administrator’s telephone number |
8472993636 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2011-11-02 |
Name of individual signing |
RENATA CETERA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLUE CROSS BLUE SHIELD PPO BLUE PRINT AND BLUE CROSS BLUE SHIELD ADVANTAGE HMO
|
2010
|
362590353
|
2011-11-02
|
PROSPECT AIRPORT SERVICES
|
66
|
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2006-12-01
|
Business code |
488100
|
Sponsor’s telephone number |
8472993636
|
Plan sponsor’s mailing address |
2130 SOUTH WOLF ROAD, DES PLAINES, IL, 60018
|
Plan sponsor’s
address |
2130 SOUTH WOLF ROAD, DES PLAINES, IL, 60018
|
Plan administrator’s name and address
Administrator’s EIN |
362590353 |
Plan administrator’s name |
PROSPECT AIRPORT SERVICES |
Plan administrator’s
address |
2130 SOUTH WOLF ROAD, DES PLAINES, IL, 60018 |
Administrator’s telephone number |
8472993636 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2011-11-02 |
Name of individual signing |
RENATA CETERA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
BLUE CROSS BLUE SHIELD PPO BLUE PRINT AND BLUE CROSS BLUE SHIELD ADVANTAGE HMO
|
2010
|
362590353
|
2011-11-03
|
PROSPECT AIRPORT SERVICES INC
|
66
|
|
File |
View Page
|
Three-digit plan number (PN) |
501
|
Effective date of plan |
2006-12-01
|
Business code |
488100
|
Sponsor’s telephone number |
8472993636
|
Plan sponsor’s mailing address |
2130 SOUTH WOLF ROAD, DES PLAINES, IL, 60018
|
Plan sponsor’s
address |
2130 SOUTH WOLF ROAD, DES PLAINES, IL, 60018
|
Plan administrator’s name and address
Administrator’s EIN |
362590353 |
Plan administrator’s name |
PROSPECT AIRPORT SERVICES INC |
Plan administrator’s
address |
2130 SOUTH WOLF ROAD, DES PLAINES, IL, 60018 |
Administrator’s telephone number |
8472993636 |
Number of participants as of the end of the plan year
Signature of
Role |
Plan administrator |
Date |
2011-11-03 |
Name of individual signing |
RENATA CETERA |
Valid signature |
Filed with authorized/valid electronic signature |
|
|