| Plan Name | THE NORTH STATE DENTAL PARTNERS HEALTH & WELFARE P |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | NORTH STATE DENTAL PARTNERS, INC. |
| Employer identification number (EIN): | 263879799 |
| NAIC Classification: | 561110 |
| NAIC Description: | Office Administrative Services |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2023-12-01 | PAIGE ALLISON | |||
| 501 | 2022-12-01 | ||||
| 501 | 2022-12-01 | PAIGE ALLISON | |||
| 501 | 2021-12-01 | ||||
| 501 | 2021-12-01 | PAIGE ALLISON |
| 2022: THE NORTH STATE DENTAL PARTNERS HEALTH & WELFARE P 2022 form 5500 responses | ||
|---|---|---|
| 2022-12-01 | Type of plan entity | Single employer plan |
| 2022-12-01 | Plan funding arrangement – Insurance | Yes |
| 2022-12-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-12-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: THE NORTH STATE DENTAL PARTNERS HEALTH & WELFARE P 2021 form 5500 responses | ||
| 2021-12-01 | Type of plan entity | Single employer plan |
| 2021-12-01 | Plan funding arrangement – Insurance | Yes |
| 2021-12-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-12-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| COMMUNITY EYE CARE (National Association of Insurance Commissioners NAIC id number: 52429 ) | |
| Policy contract number | TPO35012 |
| Policy instance | 5 |
| BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) | |
| Policy contract number | 14165104 |
| Policy instance | 4 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |
| Policy contract number | G000AY7R |
| Policy instance | 3 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |
| Policy contract number | G000AY7R |
| Policy instance | 2 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |
| Policy contract number | G000AY7R |
| Policy instance | 1 |
| COMMUNITY EYE CARE (National Association of Insurance Commissioners NAIC id number: 52429 ) | |
| Policy contract number | TPO35012 |
| Policy instance | 5 |
| BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 ) | |
| Policy contract number | 14165104 |
| Policy instance | 4 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |
| Policy contract number | G000AY7R |
| Policy instance | 3 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |
| Policy contract number | G000AY7R |
| Policy instance | 2 |
| MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 ) | |
| Policy contract number | G000AY7R |
| Policy instance | 1 |