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GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 401k Plan overview

Plan NameGROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER
Plan identification number 507

GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Dental
  • Vision

401k Sponsoring company profile

BURNETT MEDICAL CENTER has sponsored the creation of one or more 401k plans.

Company Name:BURNETT MEDICAL CENTER
Employer identification number (EIN):390938661
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5072023-01-01JULIE MCKENZIE2024-07-25 JULIE MCKENZIE2024-07-25
5072022-01-01JULIE MCKENZIE2023-07-18 JULIE MCKENZIE2023-07-18
5072021-01-01JULIE MCKENZIE2022-07-15 JULIE MCKENZIE2022-07-15
5072020-01-01JULIE MCKENZIE2021-07-22 JULIE MCKENZIE2021-07-22
5072019-01-01SANDRA HINRICHS2020-07-02 SANDRA HINRICHS2020-07-02
5072018-01-01SANDRA HINRICHS2019-07-25 SANDRA HINRICHS2019-07-25
5072017-01-01
5072016-01-01
5072015-01-01
5072014-01-01
5072013-01-01
5072012-01-01SANDRA HINNICHS
5072011-01-01SANDRA HINRICHS
5072010-01-01SANDY HINRICHS

Plan Statistics for GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER

401k plan membership statisitcs for GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER

Measure Date Value
2023: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2023 401k membership
Total participants, beginning-of-year2023-01-01104
Total number of active participants reported on line 7a of the Form 55002023-01-01109
Number of retired or separated participants receiving benefits2023-01-010
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-01109
Total participants2023-01-01109
2022: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2022 401k membership
Total participants, beginning-of-year2022-01-01108
Total number of active participants reported on line 7a of the Form 55002022-01-01104
Total of all active and inactive participants2022-01-01104
Total participants2022-01-01104
2021: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2021 401k membership
Total participants, beginning-of-year2021-01-01115
Total number of active participants reported on line 7a of the Form 55002021-01-01108
Total of all active and inactive participants2021-01-01108
Total participants2021-01-01108
2020: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2020 401k membership
Total participants, beginning-of-year2020-01-01110
Total number of active participants reported on line 7a of the Form 55002020-01-01115
Total of all active and inactive participants2020-01-01115
Total participants2020-01-01115
2019: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2019 401k membership
Total participants, beginning-of-year2019-01-01127
Total number of active participants reported on line 7a of the Form 55002019-01-01110
Total of all active and inactive participants2019-01-01110
Total participants2019-01-01110
2018: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2018 401k membership
Total participants, beginning-of-year2018-01-01118
Total number of active participants reported on line 7a of the Form 55002018-01-01127
Total of all active and inactive participants2018-01-01127
Total participants2018-01-01127
2017: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2017 401k membership
Total participants, beginning-of-year2017-01-01112
Total number of active participants reported on line 7a of the Form 55002017-01-01118
Total of all active and inactive participants2017-01-01118
Total participants2017-01-01118
2016: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2016 401k membership
Total participants, beginning-of-year2016-01-01120
Total number of active participants reported on line 7a of the Form 55002016-01-01112
Total of all active and inactive participants2016-01-01112
Total participants2016-01-01112
2015: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2015 401k membership
Total participants, beginning-of-year2015-01-01110
Total number of active participants reported on line 7a of the Form 55002015-01-01120
Total of all active and inactive participants2015-01-01120
Total participants2015-01-01120
2014: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2014 401k membership
Total participants, beginning-of-year2014-01-01109
Total number of active participants reported on line 7a of the Form 55002014-01-01110
Total of all active and inactive participants2014-01-01110
Total participants2014-01-01110
2013: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2013 401k membership
Total participants, beginning-of-year2013-01-01107
Total number of active participants reported on line 7a of the Form 55002013-01-01109
Total of all active and inactive participants2013-01-01109
Total participants2013-01-01109
2012: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2012 401k membership
Total participants, beginning-of-year2012-01-01111
Total number of active participants reported on line 7a of the Form 55002012-01-01107
Total of all active and inactive participants2012-01-01107
Total participants2012-01-01107
2011: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2011 401k membership
Total participants, beginning-of-year2011-01-01111
Total number of active participants reported on line 7a of the Form 55002011-01-01111
Total of all active and inactive participants2011-01-01111
Total participants2011-01-01111
2010: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2010 401k membership
Total participants, beginning-of-year2010-01-01111
Total number of active participants reported on line 7a of the Form 55002010-01-01111
Total of all active and inactive participants2010-01-01111
Total participants2010-01-01111

Form 5500 Responses for GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER

2023: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – InsuranceYes
2022: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01First time form 5500 has been submittedYes
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54003 )
Policy contract numberDD1118
Policy instance 1
Insurance contract or identification numberDD1118
Number of Individuals Covered188
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $9,290
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $93,949
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54003 )
Policy contract numberDD1118
Policy instance 1
Insurance contract or identification numberDD1118
Number of Individuals Covered183
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $82,614
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54003 )
Policy contract number123088
Policy instance 1
BLUE CROSS BLUE SHIELD OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54003 )
Policy contract number123088
Policy instance 1
BLUE CROSS BLUE SHIELD OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54003 )
Policy contract number123088
Policy instance 1
AMERITAS LIFE INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-044461
Policy instance 1
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number3615
Policy instance 1
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number51014
Policy instance 2
NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 )
Policy contract number51014
Policy instance 2
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00482067
Policy instance 1
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00482067
Policy instance 1
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-034796
Policy instance 1
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-034796
Policy instance 1
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-034796
Policy instance 1

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