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  5. GIBSON AREA HOSPITAL & HEALTH SERVICES

GIBSON AREA HOSPITAL & HEALTH SERVICES

Company Details

Entity Name: GIBSON AREA HOSPITAL & HEALTH SERVICES
Jurisdiction: Illinois
Entity Type: Corporation - Not-for-Profit
Status: Goodstanding
Date Formed: 30 Nov 1946
Company Number: CORP_29370524
File Number: 29370524
Place of Formation: ILLINOIS

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
FM64J25K4GE7 2025-01-31 1120 N MELVIN ST, GIBSON CITY, IL, 60936, 1477, USA 1120 N. MELVIN, P.O. BOX 420, GIBSON CITY, IL, 60936, 1477, USA

Business Information
Congressional District 02
State/Country of Incorporation IL, USA
Activation Date 2024-02-05
Initial Registration Date 2008-01-14
Entity Start Date 1952-10-21
Fiscal Year End Close Date Sep 30

Points of Contacts
Electronic Business
Title PRIMARY POC
Name ROBERT SCHMITT
Role CEO
Address 1120 N. MELVIN, BOX 429, GIBSON CITY, IL, 60936, 1477, USA
Title ALTERNATE POC
Name MATTEW ERTEL
Role CFO
Address 1120 N. MELVIN, BOX 429, GIBSON CITY, IL, 60936, 1477, USA
Government Business
Title PRIMARY POC
Name ROBERT SCHMITT
Role CEO
Address 1120 N. MELVIN, BOX 429, GIBSON CITY, IL, 60936, 1477, USA
Title ALTERNATE POC
Name MATTHEW ERTEL
Role CFO
Address 1120 N. MELVIN, BOX 429, GIBSON CITY, IL, 60936, 1477, USA
Past Performance Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
GIBSON ARE HOSPITAL & HEALTH SERVICES EMPLOYEES' TAX DEFERRED ANNUITY PLAN 2023 370647938 2024-09-11 GIBSON AREA HOSPITAL & HEALTH SERVICES 37
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 622000
Sponsor’s telephone number 2177844251
Plan sponsor’s address 1120 N. MELVIN ST. PO BOX 429, GIBSON CITY, IL, 60936

Signature of
Role Plan administrator
Date 2024-09-11
Name of individual signing TY ROYAL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-09-11
Name of individual signing TY ROYAL
Valid signature Filed with authorized/valid electronic signature
GIBSON AREA HOSPITAL & HEALTH SERVICES EMPLOYEES' 401K PLAN 2022 370647938 2023-11-17 GIBSON AREA HOSPITAL & HEALTH SERVICES 879
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2005-03-01
Business code 622000
Sponsor’s telephone number 2177842614
Plan sponsor’s mailing address PO BOX 429, GIBSON CITY, IL, 60936
Plan sponsor’s address 1120 N MELVIN STREET, GIBSON CITY, IL, 60936

Number of participants as of the end of the plan year
Active participants 825
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 104
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 673
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2023-11-17
Name of individual signing TY ROYAL
Valid signature Filed with authorized/valid electronic signature
GIBSON AREA HOSPITAL & HEALTH SERVICES EMPLOYEES' 401K PLAN 2022 370647938 2023-10-16 GIBSON AREA HOSPITAL & HEALTH SERVICES 879
Three-digit plan number (PN) 003
Effective date of plan 2005-03-01
Business code 622000
Sponsor’s telephone number 2177842614
Plan sponsor’s mailing address PO BOX 429, GIBSON CITY, IL, 60936
Plan sponsor’s address 1120 N MELVIN STREET, GIBSON CITY, IL, 60936

Number of participants as of the end of the plan year
Active participants 825
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 104
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 673
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2023-10-16
Name of individual signing TY ROYAL
Valid signature Filed with authorized/valid electronic signature
GIBSON AREA HOSPITAL AND HEALTH SERVICES EMPLOYEES' TAX DEFERRED ANNUITY PLAN 2022 370647938 2023-10-04 GIBSON AREA HOSPITAL & HEALTH SERVICES 42
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 622000
Sponsor’s telephone number 2177842614
Plan sponsor’s address PO BOX 429, GIBSON CITY, IL, 60936

Signature of
Role Plan administrator
Date 2023-10-04
Name of individual signing TY ROYAL
Valid signature Filed with authorized/valid electronic signature
GIBSON AREA HOSPITAL & HEALTH SERVICES EMPLOYEES' 401K PLAN 2021 370647938 2022-10-17 GIBSON AREA HOSPITAL & HEALTH SERVICES 879
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2005-03-01
Business code 622000
Sponsor’s telephone number 2177842614
Plan sponsor’s mailing address PO BOX 429, GIBSON CITY, IL, 60936
Plan sponsor’s address 1120 N MELVIN STREET, GIBSON CITY, IL, 60936

Number of participants as of the end of the plan year
Active participants 825
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 104
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 673
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2022-10-17
Name of individual signing TY ROYAL
Valid signature Filed with authorized/valid electronic signature
GIBSON AREA HOSPITAL AND HEALTH SERVICES EMPLOYEES' TAX DEFERRED ANNUITY PLAN 2021 370647938 2022-09-20 GIBSON AREA HOSPITAL & HEALTH SERVICES 43
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 622000
Sponsor’s telephone number 2177842614
Plan sponsor’s address PO BOX 429, GIBSON CITY, IL, 60936

Signature of
Role Plan administrator
Date 2022-09-20
Name of individual signing TY ROYAL
Valid signature Filed with authorized/valid electronic signature
GIBSON AREA HOSPITAL & HEALTH SERVICES EMPLOYEES' 401K PLAN 2020 370647938 2021-10-14 GIBSON AREA HOSPITAL & HEALTH SERVICES 893
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2005-03-01
Business code 622000
Sponsor’s telephone number 2177842614
Plan sponsor’s mailing address PO BOX 429, GIBSON CITY, IL, 60936
Plan sponsor’s address 1120 N MELVIN STREET, GIBSON CITY, IL, 60936

Number of participants as of the end of the plan year
Active participants 771
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 104
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 1
Number of participants with account balances as of the end of the plan year 677
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2021-10-14
Name of individual signing TY ROYAL
Valid signature Filed with authorized/valid electronic signature
GIBSON AREA HOSPITAL AND HEALTH SERVICES EMPLOYEES' TAX DEFERRED ANNUITY PLAN 2020 370647938 2021-09-02 GIBSON AREA HOSPITAL & HEALTH SERVICES 45
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 622000
Sponsor’s telephone number 2177842614
Plan sponsor’s address PO BOX 429, GIBSON CITY, IL, 60936

Signature of
Role Plan administrator
Date 2021-09-02
Name of individual signing TY ROYAL
Valid signature Filed with authorized/valid electronic signature
GIBSON AREA HOSPITAL & HEALTH SERVICES EMPLOYEES' 401K PLAN 2019 370647938 2020-10-12 GIBSON AREA HOSPITAL & HEALTH SERVICES 900
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2005-03-01
Business code 622000
Sponsor’s telephone number 2177842614
Plan sponsor’s mailing address PO BOX 429, GIBSON CITY, IL, 60936
Plan sponsor’s address 1120 N MELVIN STREET, GIBSON CITY, IL, 60936

Number of participants as of the end of the plan year
Active participants 809
Retired or separated participants receiving benefits 1
Other retired or separated participants entitled to future benefits 81
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 698
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2020-10-12
Name of individual signing TY ROYAL
Valid signature Filed with authorized/valid electronic signature
GIBSON AREA HOSPITAL AND HEALTH SERVICES EMPLOYEES' TAX DEFERRED ANNUITY PLAN 2019 370647938 2020-08-13 GIBSON AREA HOSPITAL & HEALTH SERVICES 55
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 622000
Sponsor’s telephone number 2177842614
Plan sponsor’s address PO BOX 429, GIBSON CITY, IL, 60936

Signature of
Role Plan administrator
Date 2020-08-13
Name of individual signing TY ROYAL
Valid signature Filed with authorized/valid electronic signature

Agent

Name and Address Role Appointment Date
MARTIN NUSS, 1120 N MELVIN ST, GIBSON CITY, 60936, FORD Agent 2018-04-02

Assumed Names

Name Type Effective Date Cancellation Date Cancellation Type Last Renewal Date
GIBSON FAMILY PHARMACY, A MEMBER OF THE MEDICINE SHOPPE FAMILY NFP Assume Name 2020-06-19 No data No data No data

Historical Names

Name Change Date
GIBSON COMMUNITY HOSPITAL ASSOCIATION 1998-05-26

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 23 Dec 2024

Sources: Illinois Office of the Secretary of State

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