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  5. EVERLONG GROUP MEDICAL CAPTIVE SERVICES, LLC

EVERLONG GROUP MEDICAL CAPTIVE SERVICES, LLC

Headquarter

Company Details

Entity Name: EVERLONG GROUP MEDICAL CAPTIVE SERVICES, LLC
Jurisdiction: Illinois
Entity Type: Limited Liability Company
Status: Goodstanding
Date Formed: 17 Oct 2012
Company Number: LLC_04077288
File Number: 04077288
Type of Management: Manager Managed
Date Status Change: 24 Aug 2024
Address 1901 BUTTERFIELD RD, STE 120, DOWNERS GROVE, 60515, IL
Place of Formation: ILLINOIS

Links between entities

Type Company Name Company Number State
Headquarter of EVERLONG GROUP MEDICAL CAPTIVE SERVICES, LLC, FLORIDA M20000000620 FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EVERLONG GROUP MEDICAL CAPTIVE SERVICES 401(K) PLAN 2022 461279719 2023-08-30 EVERLONG GROUP MEDICAL CAPTIVE SERVICES 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-05-01
Business code 524210
Sponsor’s telephone number 6308695356
Plan sponsor’s address 1901 BUTTERFIELD ROAD, SUITE 920, DOWNERS GROVE, IL, 60515

Signature of
Role Plan administrator
Date 2023-08-30
Name of individual signing SHERRY GASKILL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-08-30
Name of individual signing SHERRY GASKILL
Valid signature Filed with authorized/valid electronic signature
EVERLONG GROUP MEDICAL CAPTIVE SERVICES 401(K) PLAN 2021 461279719 2022-09-19 EVERLONG GROUP MEDICAL CAPTIVE SERVICES 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-05-01
Business code 524210
Sponsor’s telephone number 6308695356
Plan sponsor’s address 1901 BUTTERFIELD ROAD, SUITE 920, DOWNERS GROVE, IL, 60515

Signature of
Role Plan administrator
Date 2022-09-19
Name of individual signing SHERRY GASKILL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-09-19
Name of individual signing SHERRY GASKILL
Valid signature Filed with authorized/valid electronic signature
EVERLONG GROUP MEDICAL CAPTIVE SERVICES 401(K) PLAN 2020 461279719 2021-08-31 EVERLONG GROUP MEDICAL CAPTIVE SERVICES, LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-05-01
Business code 524210
Sponsor’s telephone number 6306011504
Plan sponsor’s address 1900 BUTTERFIELD ROAD, SUITE 120, DOWNERS GROVE, IL, 60515

Signature of
Role Plan administrator
Date 2021-08-31
Name of individual signing SHERRY GASKILL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-08-31
Name of individual signing SHERRY GASKILL
Valid signature Filed with authorized/valid electronic signature
EVERLONG GROUP MEDICAL CAPTIVE SERVICES 401(K) PLAN 2019 461279719 2020-08-31 EVERLONG GROUP MEDICAL CAPTIVE SERVICES, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-05-01
Business code 524210
Sponsor’s telephone number 6306011504
Plan sponsor’s address 1900 BUTTERFIELD ROAD, SUITE 120, DOWNERS GROVE, IL, 60515

Signature of
Role Plan administrator
Date 2020-08-31
Name of individual signing SHERRY GASKILL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-08-31
Name of individual signing SHERRY GASKILL
Valid signature Filed with authorized/valid electronic signature
EVERLONG GROUP MEDICAL CAPTIVE SERVICES 401(K) PLAN 2018 461279719 2019-09-25 EVERLONG GROUP MEDICAL CAPTIVE SERVICES, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-05-01
Business code 524210
Sponsor’s telephone number 6306011504
Plan sponsor’s address 1900 BUTTERFIELD ROAD, STE 120, DOWNERS GROVE, IL, 60515

Signature of
Role Plan administrator
Date 2019-09-25
Name of individual signing SHERRY GASKILL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-09-25
Name of individual signing SHERRY GASKILL
Valid signature Filed with authorized/valid electronic signature
DUPAGE VALLEY ANESTHESIOLOGISTS,LTD EMPLOYEES SAVINGS PLAN 2011 363928515 2012-07-27 DUPAGE VALLEY ANESTHESIOLOGISTS,LTD 41
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-11-07
Business code 621111
Sponsor’s telephone number 6308682200
Plan sponsor’s address 40 SHUMAN BLVD SUITE 275, NAPERVILLE, IL, 60563

Plan administrator’s name and address
Administrator’s EIN 363928515
Plan administrator’s name DUPAGE VALLEY ANESTHESIOLOGISTS,LTD
Plan administrator’s address 40 SHUMAN BLVD SUITE 275, NAPERVILLE, IL, 60563
Administrator’s telephone number 6308682200

Signature of
Role Plan administrator
Date 2012-07-26
Name of individual signing KALAVATHI SHENOY
Valid signature Filed with authorized/valid electronic signature
DUPAGE VALLEY ANESTHESIOLOGISTSLTD EMPLOYEES SAVINGS PLAN 2010 363928515 2011-07-22 DUPAGE VALLEY ANESTHESIOLOGISTS,LTD 40
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1994-11-07
Business code 621111
Sponsor’s telephone number 6308682200
Plan sponsor’s address 40 SHUMAN BLVD SUITE 275, NAPERVILLE, IL, 60563

Plan administrator’s name and address
Administrator’s EIN 363928515
Plan administrator’s name DUPAGE VALLEY ANESTHESIOLOGISTS LTD
Plan administrator’s address 40 SHUMAN BLVD SUITE 275, NAPERVILLE, IL, 60563
Administrator’s telephone number 6308682200

Signature of
Role Plan administrator
Date 2011-07-22
Name of individual signing JAMES CANNON
Valid signature Filed with authorized/valid electronic signature
DUPAGE VALLEY ANESTHESIOLOGISTSLTD EMPLOYEES SAVINGS PLAN 2009 363928515 2010-09-16 DUPAGE VALLEY ANESTHESIOLOGISTS,LTD 41
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1994-11-07
Business code 621111
Sponsor’s telephone number 6308682200
Plan sponsor’s address 40 SHUMAN BLVD SUITE 275, NAPERVILLE, IL, 60563

Plan administrator’s name and address
Administrator’s EIN 363928515
Plan administrator’s name DUPAGE VALLEY ANESTHESIOLOGISTS LTD
Plan administrator’s address 40 SHUMAN BLVD SUITE 275, NAPERVILLE, IL, 60563
Administrator’s telephone number 6308682200

Signature of
Role Plan administrator
Date 2010-09-16
Name of individual signing VICTOR DUDZIK
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
DOUGLAS L TRUAX, 1901 BUTTERFIELD RD., STE 920, DOWNERS GROVE, 60515 Agent 2020-09-23

Manager

Name and Address Role Appointment Date
DOUGLAS TRUAX, 106 REGENTS PLACE, PONTE VEDRA BEACH, FL, 32082 Manager 2024-08-24

Related by officers

No related officers

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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