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| Plan Name | DELTA DENTAL INSURANCE |
| Plan identification number | 503 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | CUBRC INC |
| Employer identification number (EIN): | 222505934 |
| NAIC Classification: | 541700 |
Additional information about CUBRC INC
| Jurisdiction of Incorporation: | New York Department of State |
| Incorporation Date: | 1983-12-07 |
| Company Identification Number: | 862775 |
| Legal Registered Office Address: |
4455 GENESEE STREET SUITE 106 BUFFALO United States of America (USA) 14225 |
More information about CUBRC INC
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 503 | 2017-01-01 | TRACY GERTZ | TRACY GERTZ | 2018-07-19 | |
| 503 | 2016-01-01 | TRACY GERTZ | |||
| 503 | 2015-01-01 | TRACY GERTZ | |||
| 503 | 2014-01-01 | TRACY GERTZ | |||
| 503 | 2013-01-01 | TRACY GERTZ | TRACY GERTZ | 2014-10-03 | |
| 503 | 2012-01-01 | TRACY GERTZ | |||
| 503 | 2011-01-01 | TRACY GERTZ |
| Measure | Date | Value |
|---|---|---|
| 2017: DELTA DENTAL INSURANCE 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-01-01 | 99 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 97 |
| Total of all active and inactive participants | 2017-01-01 | 97 |
| Total participants | 2017-01-01 | 97 |
| 2016: DELTA DENTAL INSURANCE 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-01-01 | 89 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 99 |
| Total of all active and inactive participants | 2016-01-01 | 99 |
| Total participants | 2016-01-01 | 99 |
| 2015: DELTA DENTAL INSURANCE 2015 401k membership | ||
| Total participants, beginning-of-year | 2015-01-01 | 86 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 89 |
| Total of all active and inactive participants | 2015-01-01 | 89 |
| Total participants | 2015-01-01 | 89 |
| 2014: DELTA DENTAL INSURANCE 2014 401k membership | ||
| Total participants, beginning-of-year | 2014-01-01 | 118 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 86 |
| Number of retired or separated participants receiving benefits | 2014-01-01 | 1 |
| Total of all active and inactive participants | 2014-01-01 | 87 |
| Total participants | 2014-01-01 | 87 |
| 2013: DELTA DENTAL INSURANCE 2013 401k membership | ||
| Total participants, beginning-of-year | 2013-01-01 | 109 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 119 |
| Number of retired or separated participants receiving benefits | 2013-01-01 | 1 |
| Total of all active and inactive participants | 2013-01-01 | 120 |
| Total participants | 2013-01-01 | 120 |
| 2012: DELTA DENTAL INSURANCE 2012 401k membership | ||
| Total participants, beginning-of-year | 2012-01-01 | 110 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 107 |
| Number of retired or separated participants receiving benefits | 2012-01-01 | 2 |
| Total of all active and inactive participants | 2012-01-01 | 109 |
| Total participants | 2012-01-01 | 109 |
| 2011: DELTA DENTAL INSURANCE 2011 401k membership | ||
| Total participants, beginning-of-year | 2011-01-01 | 117 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 107 |
| Number of retired or separated participants receiving benefits | 2011-01-01 | 4 |
| Total of all active and inactive participants | 2011-01-01 | 111 |
| Total participants | 2011-01-01 | 111 |
| 2017: DELTA DENTAL INSURANCE 2017 form 5500 responses | ||
|---|---|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | First time form 5500 has been submitted | Yes |
| 2017-01-01 | Submission has been amended | No |
| 2017-01-01 | This submission is the final filing | No |
| 2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-01-01 | Plan is a collectively bargained plan | No |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: DELTA DENTAL INSURANCE 2016 form 5500 responses | ||
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | First time form 5500 has been submitted | Yes |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: DELTA DENTAL INSURANCE 2015 form 5500 responses | ||
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | First time form 5500 has been submitted | Yes |
| 2015-01-01 | Submission has been amended | No |
| 2015-01-01 | This submission is the final filing | No |
| 2015-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-01-01 | Plan is a collectively bargained plan | No |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: DELTA DENTAL INSURANCE 2014 form 5500 responses | ||
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | First time form 5500 has been submitted | Yes |
| 2014-01-01 | Submission has been amended | No |
| 2014-01-01 | This submission is the final filing | No |
| 2014-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-01-01 | Plan is a collectively bargained plan | No |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: DELTA DENTAL INSURANCE 2013 form 5500 responses | ||
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Submission has been amended | No |
| 2013-01-01 | This submission is the final filing | No |
| 2013-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-01-01 | Plan is a collectively bargained plan | No |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: DELTA DENTAL INSURANCE 2012 form 5500 responses | ||
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Submission has been amended | No |
| 2012-01-01 | This submission is the final filing | No |
| 2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-01-01 | Plan is a collectively bargained plan | No |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: DELTA DENTAL INSURANCE 2011 form 5500 responses | ||
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | First time form 5500 has been submitted | Yes |
| 2011-01-01 | Submission has been amended | No |
| 2011-01-01 | This submission is the final filing | No |
| 2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-01-01 | Plan is a collectively bargained plan | No |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 ) | |
| Policy contract number | 05219 |
| Policy instance | 1 |
| DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 ) | |
| Policy contract number | 05219 |
| Policy instance | 1 |
| DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 ) | |
| Policy contract number | 05219 |
| Policy instance | 1 |
| DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 ) | |
| Policy contract number | 05219 |
| Policy instance | 1 |
| DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 ) | |
| Policy contract number | 05219 |
| Policy instance | 1 |
| DELTA DENTAL OF NEW YORK (National Association of Insurance Commissioners NAIC id number: 55263 ) | |
| Policy contract number | 05219 |
| Policy instance | 1 |