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  5. COUNTRY HEALTH, INC.

COUNTRY HEALTH, INC.

Company Details

Entity Name: COUNTRY HEALTH, INC.
Jurisdiction: Illinois
Entity Type: Corporation - Not-for-Profit
Status: Goodstanding
Date Formed: 28 Feb 1967
Company Number: CORP_47413087
File Number: 47413087
Place of Formation: ILLINOIS

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
EQD2KKGHLUX4 2025-01-10 2304 COUNTY ROAD 3000 N, GIFFORD, IL, 61847, 9756, USA 2304 COUNTY ROAD 3000 N, GIFFORD, IL, 61847, 9756, USA

Business Information
Congressional District 02
State/Country of Incorporation IL, USA
Activation Date 2024-01-25
Initial Registration Date 2021-03-15
Entity Start Date 1967-02-28
Fiscal Year End Close Date Dec 31

Service Classifications
NAICS Codes 623110

Points of Contacts
Electronic Business
Title PRIMARY POC
Name BENJAMIN HART
Role PRESIDENT & CEO
Address 115 W JEFFERSON ST STE 401, BLOOMINGTON, IL, 61701, USA
Government Business
Title PRIMARY POC
Name STEVEN HART
Role COO
Address 115 W JEFFERSON ST STE 401, BLOOMINGTON, IL, 61701, USA
Past Performance Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
COUNTRY HEALTH RETIREMENT SAVINGS PLAN 2023 376064916 2024-04-11 COUNTRY HEALTH, INC. 80
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 623000
Sponsor’s telephone number 3098284361
Plan sponsor’s address 2304 COUNTY ROAD 3000 N, GIFFORD, IL, 618479756

Signature of
Role Plan administrator
Date 2024-04-11
Name of individual signing KATE HERZEL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-04-11
Name of individual signing KATE HERZEL
Valid signature Filed with authorized/valid electronic signature
COUNTRY HEALTH RETIREMENT SAVINGS PLAN 2022 376064916 2023-09-24 COUNTRY HEALTH, INC. 82
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 623000
Sponsor’s telephone number 3098284361
Plan sponsor’s address 2304 COUNTY ROAD 3000 N, GIFFORD, IL, 618479756

Signature of
Role Plan administrator
Date 2023-09-24
Name of individual signing KATE HERZEL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-09-24
Name of individual signing KATE HERZEL
Valid signature Filed with authorized/valid electronic signature
COUNTRY HEALTH RETIREMENT SAVINGS PLAN 2021 376064916 2022-10-05 COUNTRY HEALTH, INC. 84
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 623000
Sponsor’s telephone number 3098237159
Plan sponsor’s address 2304 COUNTY ROAD 3000 N, GIFFORD, IL, 618479756

Signature of
Role Plan administrator
Date 2022-10-05
Name of individual signing KATIE MARTIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-10-05
Name of individual signing KATIE MARTIN
Valid signature Filed with authorized/valid electronic signature
COUNTRY HEALTH RETIREMENT SAVINGS PLAN 2020 376064916 2021-04-16 COUNTRY HEALTH, INC. 93
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 623000
Sponsor’s telephone number 3098237159
Plan sponsor’s address 2304 COUNTY ROAD 3000 N, GIFFORD, IL, 618479756

Signature of
Role Plan administrator
Date 2021-04-16
Name of individual signing LINDSEY BARBER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-04-16
Name of individual signing LINDSEY BARBER
Valid signature Filed with authorized/valid electronic signature
COUNTRY HEALTH RETIREMENT SAVINGS PLAN 2019 376064916 2020-05-19 COUNTRY HEALTH, INC. 90
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 623000
Sponsor’s telephone number 3098237159
Plan sponsor’s address 2304 COUNTY ROAD 3000 N, GIFFORD, IL, 618479756

Signature of
Role Plan administrator
Date 2020-05-19
Name of individual signing LINDSEY BARBER
Valid signature Filed with authorized/valid electronic signature
COUNTRY HEALTH RETIREMENT SAVINGS PLAN 2018 376064916 2019-07-10 COUNTRY HEALTH, INC. 88
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 623000
Sponsor’s telephone number 3098237159
Plan sponsor’s address 2304 COUNTY ROAD 3000 N, GIFFORD, IL, 618479756

Signature of
Role Plan administrator
Date 2019-07-10
Name of individual signing JENNA ZBINDEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-07-10
Name of individual signing JENNA ZBINDEN
Valid signature Filed with authorized/valid electronic signature
COUNTRY HEALTH RETIREMENT SAVINGS PLAN 2017 376064916 2018-05-02 COUNTRY HEALTH, INC. 85
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 623000
Sponsor’s telephone number 3098237159
Plan sponsor’s address 2304 COUNTY ROAD 3000 N, GIFFORD, IL, 618479756

Signature of
Role Plan administrator
Date 2018-05-02
Name of individual signing CONNIE HOSELTON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-05-02
Name of individual signing CONNIE HOSELTON
Valid signature Filed with authorized/valid electronic signature
COUNTRY HEALTH RETIREMENT SAVINGS PLAN 2016 376064916 2017-06-26 COUNTRY HEALTH, INC. 79
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 623000
Sponsor’s telephone number 3098237159
Plan sponsor’s address 2304 COUNTY ROAD 3000 N, GIFFORD, IL, 618479756

Signature of
Role Plan administrator
Date 2017-06-26
Name of individual signing CONNIE HOSELTON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-06-26
Name of individual signing CONNIE HOSELTON
Valid signature Filed with authorized/valid electronic signature
COUNTRY HEALTH RETIREMENT SAVINGS PLAN 2015 376064916 2016-06-13 COUNTRY HEALTH, INC. 80
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 623000
Sponsor’s telephone number 3098237159
Plan sponsor’s address 2304 COUNTY ROAD 3000 N, GIFFORD, IL, 618479756

Signature of
Role Plan administrator
Date 2016-06-13
Name of individual signing CONNIE HOSELTON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-06-13
Name of individual signing CONNIE HOSELTON
Valid signature Filed with authorized/valid electronic signature
COUNTRY HEALTH RETIREMENT SAVINGS PLAN 2014 376064916 2015-07-20 COUNTRY HEALTH, INC. 76
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621610
Sponsor’s telephone number 3098237159
Plan sponsor’s address 2304 COUNTY ROAD 3000 N, GIFFORD, IL, 618479756

Signature of
Role Plan administrator
Date 2015-07-20
Name of individual signing CONNIE HOSELTON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-20
Name of individual signing CONNIE HOSELTON
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
BENJAMIN HART, 115 W JEFFERSON ST STE 401, BLOOMINGTON, 61701, MC LEAN Agent 2014-01-30

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 13 Jan 2025

Sources: Illinois Office of the Secretary of State

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