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| Plan Name | KAISER FOUNDATION HEALTH PLAN |
| Plan identification number | 012 |
| Company Name: | CASTEEN DENTAL CORP. DBA CAPITAL DENTAL GROUP |
| Employer identification number (EIN): | 205137326 |
| NAIC Classification: | 621210 |
| NAIC Description: | Offices of Dentists |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 012 | 2020-12-01 |
| Measure | Date | Value |
|---|---|---|
| 2020: KAISER FOUNDATION HEALTH PLAN 2020 401k membership | ||
| Total participants, beginning-of-year | 2020-12-01 | 53 |
| Total of all active and inactive participants | 2020-12-01 | 0 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2020-12-01 | 0 |
| Total participants | 2020-12-01 | 0 |
| Number of participants with account balances | 2020-12-01 | 0 |
| Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2020-12-01 | 0 |
| 2020: KAISER FOUNDATION HEALTH PLAN 2020 form 5500 responses | ||
|---|---|---|
| 2020-12-01 | Type of plan entity | Single employer plan |
| 2020-12-01 | First time form 5500 has been submitted | Yes |
| 2020-12-01 | Submission has been amended | No |
| 2020-12-01 | This submission is the final filing | No |
| 2020-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-12-01 | Plan is a collectively bargained plan | No |
| 2020-12-01 | Plan funding arrangement – Insurance | Yes |
| 2020-12-01 | Plan benefit arrangement – Insurance | Yes |
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