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  5. DELNOR-COMMUNITY HEALTH SYSTEM

DELNOR-COMMUNITY HEALTH SYSTEM

Headquarter

Company Details

Entity Name: DELNOR-COMMUNITY HEALTH SYSTEM
Jurisdiction: Illinois
Entity Type: Corporation - Not-for-Profit
Status: Merged/Consolidated
Date Formed: 03 Apr 1985
Company Number: CORP_53799124
File Number: 53799124
Type of Business: Not for Profit
Date Status Change: 31 Mar 2011
Place of Formation: ILLINOIS

Links between entities

Type Company Name Company Number State
Headquarter of DELNOR-COMMUNITY HEALTH SYSTEM, NEW YORK 1497329 NEW YORK

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
VISION SERVICE PLAN FOR EMPLOYEES OF DELNOR COMMUNITY HOSPITAL 2011 363379958 2012-10-12 DELNOR COMMUNITY HEALTH SYSTEM 718
File View Page
Three-digit plan number (PN) 510
Effective date of plan 2003-01-01
Business code 622000
Sponsor’s telephone number 6302083000
Plan sponsor’s mailing address 300 RANDALL ROAD, GENEVA, IL, 60134
Plan sponsor’s address 300 RANDALL ROAD, GENEVA, IL, 60134

Plan administrator’s name and address
Administrator’s EIN 363379958
Plan administrator’s name DELNOR COMMUNITY HEALTH SYSTEM
Plan administrator’s address 300 RANDALL ROAD, GENEVA, IL, 60134
Administrator’s telephone number 6302083000

Number of participants as of the end of the plan year
Active participants 0
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 2012-10-12
Name of individual signing SHAWN FITZGERALD
Valid signature Filed with authorized/valid electronic signature
WEEKLY DISABILITY INCOME INSURANCE PLAN FOR EMPLOYEES OF DELNOR COMMUNITY HEALTH SYSTEM 2011 363379958 2012-10-12 DELNOR COMMUNITY HEALTH SYSTEM 1039
File View Page
Three-digit plan number (PN) 509
Effective date of plan 2001-07-01
Business code 622000
Sponsor’s telephone number 6302083000
Plan sponsor’s mailing address 300 RANDALL ROAD, GENEVA, IL, 60134
Plan sponsor’s address 300 RANDALL ROAD, GENEVA, IL, 60134

Plan administrator’s name and address
Administrator’s EIN 363379958
Plan administrator’s name DELNOR COMMUNITY HEALTH SYSTEM
Plan administrator’s address 300 RANDALL ROAD, GENEVA, IL, 60134
Administrator’s telephone number 6302083000

Number of participants as of the end of the plan year
Active participants 0
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 2012-10-12
Name of individual signing SHAWN FITZGERALD
Valid signature Filed with authorized/valid electronic signature
DELNOR COMMUNITY HEALTH SYSTEM EMPLOYEES GROUP LIFE INSURANCE PLAN 2011 363379958 2012-10-12 DELNOR COMMUNITY HEALTH SYSTEM 1383
File View Page
Three-digit plan number (PN) 508
Effective date of plan 1997-09-01
Business code 622000
Sponsor’s telephone number 6302083000
Plan sponsor’s mailing address 300 RANDALL ROAD, GENEVA, IL, 60134
Plan sponsor’s address 300 RANDALL ROAD, GENEVA, IL, 60134

Plan administrator’s name and address
Administrator’s EIN 363379958
Plan administrator’s name DELNOR COMMUNITY HEALTH SYSTEM
Plan administrator’s address 300 RANDALL ROAD, GENEVA, IL, 60134
Administrator’s telephone number 6302083000

Number of participants as of the end of the plan year
Active participants 0
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 2012-10-12
Name of individual signing SHAWN FITZGERALD
Valid signature Filed with authorized/valid electronic signature
DELNOR COMMUNITY HEALTH SYSTEM EMPLOYEE BENEFIT HEALTH PLAN 2011 363379958 2012-10-12 DELNOR COMMUNITY HEALTH SYSTEM 1018
File View Page
Three-digit plan number (PN) 505
Effective date of plan 1981-09-01
Business code 622000
Sponsor’s telephone number 6302083000
Plan sponsor’s mailing address 300 RANDALL ROAD, GENEVA, IL, 60134
Plan sponsor’s address 300 RANDALL ROAD, GENEVA, IL, 60134

Plan administrator’s name and address
Administrator’s EIN 363379958
Plan administrator’s name DELNOR COMMUNITY HEALTH SYSTEM
Plan administrator’s address 300 RANDALL ROAD, GENEVA, IL, 60134
Administrator’s telephone number 6302083000

Number of participants as of the end of the plan year
Active participants 0
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 2012-10-12
Name of individual signing SHAWN FITZGERALD
Valid signature Filed with authorized/valid electronic signature
GROUP LONG TERM DISABILITY INSURANCE FOR EMPLOYEES OF DELNOR COMMUNITY HEALTH SYSTEM 2011 363379958 2012-10-12 DELNOR COMMUNITY HEALTH SYSTEM 690
File View Page
Three-digit plan number (PN) 502
Effective date of plan 2001-07-01
Business code 622000
Sponsor’s telephone number 6302083000
Plan sponsor’s mailing address 300 RANDALL ROAD, GENEVA, IL, 60134
Plan sponsor’s address 300 RANDALL ROAD, GENEVA, IL, 60134

Plan administrator’s name and address
Administrator’s EIN 363379958
Plan administrator’s name DELNOR COMMUNITY HEALTH SYSTEM
Plan administrator’s address 300 RANDALL ROAD, GENEVA, IL, 60134
Administrator’s telephone number 6302083000

Number of participants as of the end of the plan year
Active participants 0
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 2012-10-12
Name of individual signing SHAWN FITZGERALD
Valid signature Filed with authorized/valid electronic signature
DELNOR COMMUNITY HEALTH SYSTEM EMPLOYEES GROUP LIFE INSURANCE 2010 363379958 2012-10-12 DELNOR COMMUNITY HEALTH SYSTEM 1702
File View Page
Three-digit plan number (PN) 508
Effective date of plan 1997-09-01
Business code 622000
Sponsor’s telephone number 6302083000
Plan sponsor’s mailing address 300 RANDAL ROAD, GENEVA, IL, 60134
Plan sponsor’s address 300 RANDAL ROAD, GENEVA, IL, 60134

Plan administrator’s name and address
Administrator’s EIN 363379958
Plan administrator’s name DELNOR COMMUNITY HEALTH SYSTEM
Plan administrator’s address 300 RANDAL ROAD, GENEVA, IL, 60134
Administrator’s telephone number 6302083000

Number of participants as of the end of the plan year
Active participants 1383
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 2012-10-12
Name of individual signing SHAWN FITZGERALD
Valid signature Filed with authorized/valid electronic signature
DELNOR COMMUNITY HEALTH SYSTEM EMPLOYE BENEFIT HEALTH PLAN 2010 363379958 2012-10-12 DELNOR COMMUNITY HEALTH SYSTEM 1089
File View Page
Three-digit plan number (PN) 505
Effective date of plan 1981-09-01
Business code 622000
Sponsor’s telephone number 6302083000
Plan sponsor’s mailing address 300 RANDAL ROAD, GENEVA, IL, 60134
Plan sponsor’s address 300 RANDAL ROAD, GENEVA, IL, 60134

Plan administrator’s name and address
Administrator’s EIN 363379958
Plan administrator’s name DELNOR COMMUNITY HEALTH SYSTEM
Plan administrator’s address 300 RANDAL ROAD, GENEVA, IL, 60134
Administrator’s telephone number 6302083000

Number of participants as of the end of the plan year
Active participants 1018
Retired or separated participants receiving benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0

Signature of
Role Plan administrator
Date 2012-10-12
Name of individual signing SHAWN FITZGERALD
Valid signature Filed with authorized/valid electronic signature
GROUP LONG TERM DISABILITY INSURANCE FOR EMPLOYEES OF DELNOR COMMUNITY HEALTH SYSTEM 2010 363379958 2012-10-12 DELNOR COMMUNITY HEALTH SYSTEM 791
File View Page
Three-digit plan number (PN) 502
Effective date of plan 2001-07-01
Business code 622000
Sponsor’s telephone number 6302083000
Plan sponsor’s mailing address 300 RANDAL ROAD, GENEVA, IL, 60134
Plan sponsor’s address 300 RANDAL ROAD, GENEVA, IL, 60134

Plan administrator’s name and address
Administrator’s EIN 363379958
Plan administrator’s name DELNOR COMMUNITY HEALTH SYSTEM
Plan administrator’s address 300 RANDAL ROAD, GENEVA, IL, 60134
Administrator’s telephone number 6302083000

Number of participants as of the end of the plan year
Active participants 690
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 2012-10-12
Name of individual signing SHAWN FITZGERALD
Valid signature Filed with authorized/valid electronic signature
WEEKLY DISABILITY INCOME INSURANCE PLAN FOR EMPLOYEES OF DLENOR COMMUNITY HEALTH SYSTEM 2010 363379958 2012-10-12 DELNOR COMMUNITY HEALTH SYSTEM 1232
File View Page
Three-digit plan number (PN) 509
Effective date of plan 2001-07-01
Business code 622000
Sponsor’s telephone number 6302083000
Plan sponsor’s mailing address 300 RANDALL ROAD, GENEVA, IL, 60134
Plan sponsor’s address 300 RANDALL ROAD, GENEVA, IL, 60134

Plan administrator’s name and address
Administrator’s EIN 363379958
Plan administrator’s name DELNOR COMMUNITY HEALTH SYSTEM
Plan administrator’s address 300 RANDALL ROAD, GENEVA, IL, 60134
Administrator’s telephone number 6302083000

Number of participants as of the end of the plan year
Active participants 1039
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 2012-10-12
Name of individual signing SHAWN FITZGERALD
Valid signature Filed with authorized/valid electronic signature
VISION SERVICE PLAN FOR EMPLOYEES OF DELNOR COMMUNITY HOSPITAL 2010 363379958 2011-04-01 DELNOR COMMUNITY HEALTH SYSTEM 843
File View Page
Three-digit plan number (PN) 510
Effective date of plan 2003-01-01
Business code 622000
Sponsor’s telephone number 6302083000
Plan sponsor’s DBA name DELNOR HOSPITAL
Plan sponsor’s mailing address 300 RANDALL ROAD, GENEVA, IL, 60134
Plan sponsor’s address 300 RANDALL ROAD, GENEVA, IL, 60134

Plan administrator’s name and address
Administrator’s EIN 363379958
Plan administrator’s name DELNOR COMMUNITY HEALTH SYSTEM
Plan administrator’s address 300 RANDALL ROAD, GENEVA, IL, 60134
Administrator’s telephone number 6302083000

Number of participants as of the end of the plan year
Active participants 781

Signature of
Role Plan administrator
Date 2011-04-01
Name of individual signing MICHAEL KITTOE
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
THOMAS L WRIGHT, 300 RANDALL ROAD, GENEVA, 60134, KANE Agent 1993-12-13

Historical Names

Name Change Date
DELNOR COMMUNITY HEALTH SYSTEM 1996-05-01

Related by officers

THOMAS L WRIGHT, 300 RANDALL ROAD, GENEVA, 60134, KANE

DELNOR PHYSICIAN GROUP

Related by address

No related companies by address

Date of last update: 16 Jan 2025

Sources: Illinois Office of the Secretary of State

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