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GROUP DENTAL - PLAN I AND IV EMPLOYEES 401k Plan overview

Plan NameGROUP DENTAL - PLAN I AND IV EMPLOYEES
Plan identification number 503

GROUP DENTAL - PLAN I AND IV EMPLOYEES Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Dental

401k Sponsoring company profile

J.C. BLAIR MEMORIAL HOSPITAL has sponsored the creation of one or more 401k plans.

Company Name:J.C. BLAIR MEMORIAL HOSPITAL
Employer identification number (EIN):231352159
NAIC Classification:622000
NAIC Description: Hospitals

Additional information about J.C. BLAIR MEMORIAL HOSPITAL

Jurisdiction of Incorporation: COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF STATE
Incorporation Date:
Company Identification Number: 38355

More information about J.C. BLAIR MEMORIAL HOSPITAL

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP DENTAL - PLAN I AND IV EMPLOYEES

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032020-07-01
5032019-07-01
5032018-07-01
5032017-07-01JEFF TRAPP JEFF TRAPP2019-03-08
5032016-07-01JEFF TRAPP JEFF TRAPP2018-02-16
5032015-07-01DEBORAH SHUGHART DEBORAH SHUGHART2017-03-13
5032014-07-01DEBORAH SHUGHART DEBORAH SHUGHART2016-03-14
5032013-07-01DEBORAH SHUGHART DEBORAH SHUGHART2015-03-12
5032012-07-01EDWARD M. QUINN EDWARD M. QUINN2014-03-10
5032011-07-01EDWARD M. QUINN EDWARD M. QUINN2013-03-12
5032010-07-01MICHAEL H. WIDENER MICHAEL H. WIDENER2012-03-13
5032009-07-01NANCY GLIDDEN NANCY GLIDDEN2011-03-14

Plan Statistics for GROUP DENTAL - PLAN I AND IV EMPLOYEES

401k plan membership statisitcs for GROUP DENTAL - PLAN I AND IV EMPLOYEES

Measure Date Value
2020: GROUP DENTAL - PLAN I AND IV EMPLOYEES 2020 401k membership
Total participants, beginning-of-year2020-07-01140
Total number of active participants reported on line 7a of the Form 55002020-07-01127
Total of all active and inactive participants2020-07-01127
2019: GROUP DENTAL - PLAN I AND IV EMPLOYEES 2019 401k membership
Total participants, beginning-of-year2019-07-01204
Total number of active participants reported on line 7a of the Form 55002019-07-01140
Total of all active and inactive participants2019-07-01140
2018: GROUP DENTAL - PLAN I AND IV EMPLOYEES 2018 401k membership
Total participants, beginning-of-year2018-07-01201
Total number of active participants reported on line 7a of the Form 55002018-07-01204
Total of all active and inactive participants2018-07-01204
2017: GROUP DENTAL - PLAN I AND IV EMPLOYEES 2017 401k membership
Total participants, beginning-of-year2017-07-01223
Total number of active participants reported on line 7a of the Form 55002017-07-01201
Total of all active and inactive participants2017-07-01201
2016: GROUP DENTAL - PLAN I AND IV EMPLOYEES 2016 401k membership
Total participants, beginning-of-year2016-07-01293
Total number of active participants reported on line 7a of the Form 55002016-07-01223
Total of all active and inactive participants2016-07-01223
2015: GROUP DENTAL - PLAN I AND IV EMPLOYEES 2015 401k membership
Total participants, beginning-of-year2015-07-01250
Total number of active participants reported on line 7a of the Form 55002015-07-01293
Total of all active and inactive participants2015-07-01293
2014: GROUP DENTAL - PLAN I AND IV EMPLOYEES 2014 401k membership
Total participants, beginning-of-year2014-07-01224
Total number of active participants reported on line 7a of the Form 55002014-07-01250
Total of all active and inactive participants2014-07-01250
2013: GROUP DENTAL - PLAN I AND IV EMPLOYEES 2013 401k membership
Total participants, beginning-of-year2013-07-01221
Total number of active participants reported on line 7a of the Form 55002013-07-01224
Total of all active and inactive participants2013-07-01224
2012: GROUP DENTAL - PLAN I AND IV EMPLOYEES 2012 401k membership
Total participants, beginning-of-year2012-07-01200
Total number of active participants reported on line 7a of the Form 55002012-07-01221
Total of all active and inactive participants2012-07-01221
2011: GROUP DENTAL - PLAN I AND IV EMPLOYEES 2011 401k membership
Total participants, beginning-of-year2011-07-01208
Total number of active participants reported on line 7a of the Form 55002011-07-01200
Total of all active and inactive participants2011-07-01200
2010: GROUP DENTAL - PLAN I AND IV EMPLOYEES 2010 401k membership
Total participants, beginning-of-year2010-07-01198
Total number of active participants reported on line 7a of the Form 55002010-07-01208
Total of all active and inactive participants2010-07-01208
2009: GROUP DENTAL - PLAN I AND IV EMPLOYEES 2009 401k membership
Total participants, beginning-of-year2009-07-01458
Total number of active participants reported on line 7a of the Form 55002009-07-01198
Total of all active and inactive participants2009-07-01198

Form 5500 Responses for GROUP DENTAL - PLAN I AND IV EMPLOYEES

2020: GROUP DENTAL - PLAN I AND IV EMPLOYEES 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – InsuranceYes
2019: GROUP DENTAL - PLAN I AND IV EMPLOYEES 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – InsuranceYes
2018: GROUP DENTAL - PLAN I AND IV EMPLOYEES 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – InsuranceYes
2017: GROUP DENTAL - PLAN I AND IV EMPLOYEES 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – InsuranceYes
2016: GROUP DENTAL - PLAN I AND IV EMPLOYEES 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan benefit arrangement – InsuranceYes
2015: GROUP DENTAL - PLAN I AND IV EMPLOYEES 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – InsuranceYes
2014: GROUP DENTAL - PLAN I AND IV EMPLOYEES 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Plan funding arrangement – InsuranceYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013: GROUP DENTAL - PLAN I AND IV EMPLOYEES 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Plan funding arrangement – InsuranceYes
2013-07-01Plan benefit arrangement – InsuranceYes
2012: GROUP DENTAL - PLAN I AND IV EMPLOYEES 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Plan funding arrangement – InsuranceYes
2012-07-01Plan benefit arrangement – InsuranceYes
2011: GROUP DENTAL - PLAN I AND IV EMPLOYEES 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – InsuranceYes
2010: GROUP DENTAL - PLAN I AND IV EMPLOYEES 2010 form 5500 responses
2010-07-01Type of plan entitySingle employer plan
2010-07-01Plan funding arrangement – InsuranceYes
2010-07-01Plan benefit arrangement – InsuranceYes
2009: GROUP DENTAL - PLAN I AND IV EMPLOYEES 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01This submission is the final filingNo
2009-07-01Plan funding arrangement – InsuranceYes
2009-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number11377
Policy instance 1
Insurance contract or identification number11377
Number of Individuals Covered127
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $842
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $842
Insurance broker organization code?3
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number11377
Policy instance 1
Insurance contract or identification number11377
Number of Individuals Covered140
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $1,090
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,090
Insurance broker organization code?3
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number11377
Policy instance 1
Insurance contract or identification number11377
Number of Individuals Covered204
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $1,338
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,338
Insurance broker organization code?3
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number11377
Policy instance 1
Insurance contract or identification number11377
Number of Individuals Covered201
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $1,362
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number11377
Policy instance 1
Insurance contract or identification number11377
Number of Individuals Covered293
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $1,626
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,626
Insurance broker organization code?3
Insurance broker nameAIA BENEFITS RESOURCE GROUP INC
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number11377
Policy instance 1
Insurance contract or identification number11377
Number of Individuals Covered250
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $1,426
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,426
Insurance broker organization code?3
Insurance broker nameAIA BENEFITS RESOURCE GROUP INC
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number11377
Policy instance 1
Insurance contract or identification number11377
Number of Individuals Covered224
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $1,375
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,375
Insurance broker organization code?3
Insurance broker nameAIA BENEFITS RESOURCE GROUP INC
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number11377
Policy instance 1
Insurance contract or identification number11377
Number of Individuals Covered221
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $1,365
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,365
Insurance broker organization code?3
Insurance broker nameAIA BENEFITS RESOURCE GROUP INC
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number11377
Policy instance 1
Insurance contract or identification number11377
Number of Individuals Covered200
Insurance policy start date2011-07-01
Insurance policy end date2012-06-30
Total amount of commissions paid to insurance brokerUSD $1,317
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF PENNSYLVANIA (National Association of Insurance Commissioners NAIC id number: 54798 )
Policy contract number11377
Policy instance 1
Insurance contract or identification number11377
Number of Individuals Covered208
Insurance policy start date2010-07-01
Insurance policy end date2011-06-30
Total amount of commissions paid to insurance brokerUSD $1,318
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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