|
PSI RESOURCES LLC EMPLOYEE GROUP HEALTH PLAN
|
2018
|
275469808
|
2019-06-21
|
PSI RESOURCES LLC
|
2
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
501
|
| Effective date of plan |
2018-12-31
|
| Business code |
541990
|
| Sponsor’s telephone number |
6309680061
|
| Plan sponsor’s
address |
2001 BUTTERFIELD RD STE 165, DOWNERS GROVE, IL, 605151088
|
Signature of
| Role |
Plan administrator |
| Date |
2019-06-21 |
| Name of individual signing |
TINA THOMAS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PSI RESOURCES LLC EMPLOYEE GROUP HEALTH PLAN
|
2017
|
275469808
|
2018-09-13
|
PSI RESOURCES LLC
|
1
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
501
|
| Effective date of plan |
2017-01-01
|
| Business code |
561300
|
| Plan sponsor’s
address |
2001 BUTTERFIELD RD STE 165, DOWNERS GROVE, IL, 605151088
|
Signature of
| Role |
Plan administrator |
| Date |
2018-09-13 |
| Name of individual signing |
TINA THOMAS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
PSI RESOURCES LLC EMPLOYEE GROUP HEALTH PLAN
|
2016
|
275469808
|
2017-07-12
|
PSI RESOURCES LLC
|
2
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
501
|
| Effective date of plan |
2016-12-31
|
| Business code |
541990
|
| Sponsor’s telephone number |
6309680061
|
| Plan sponsor’s
address |
2001 BUTTERFIELD RD STE 165, DOWNERS GROVE, IL, 605151088
|
Signature of
| Role |
Plan administrator |
| Date |
2017-07-12 |
| Name of individual signing |
TINA THOMAS |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
