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| Plan Name | BADGER CUSTOM PALLETS, INC. DELTA DENTAL OF WISCONSIN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | BADGER CUSTOM PALLETS |
| Employer identification number (EIN): | 391985548 |
| NAIC Classification: | 321900 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2017-03-01 | JEFF MATHWIG | |||
| 501 | 2016-03-01 | JEFF MATHWIG |
| Measure | Date | Value |
|---|---|---|
| 2017: BADGER CUSTOM PALLETS, INC. DELTA DENTAL OF WISCONSIN 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-03-01 | 39 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-03-01 | 36 |
| Total of all active and inactive participants | 2017-03-01 | 36 |
| 2016: BADGER CUSTOM PALLETS, INC. DELTA DENTAL OF WISCONSIN 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-03-01 | 39 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-03-01 | 39 |
| Total of all active and inactive participants | 2016-03-01 | 39 |
| 2017: BADGER CUSTOM PALLETS, INC. DELTA DENTAL OF WISCONSIN 2017 form 5500 responses | ||
|---|---|---|
| 2017-03-01 | Type of plan entity | Single employer plan |
| 2017-03-01 | Plan funding arrangement – Insurance | Yes |
| 2017-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: BADGER CUSTOM PALLETS, INC. DELTA DENTAL OF WISCONSIN 2016 form 5500 responses | ||
| 2016-03-01 | Type of plan entity | Single employer plan |
| 2016-03-01 | First time form 5500 has been submitted | Yes |
| 2016-03-01 | Plan funding arrangement – Insurance | Yes |
| 2016-03-01 | Plan benefit arrangement – Insurance | Yes |
| DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) | |||||||||||||||||||||||||
| Policy contract number | 2380801059 | ||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||
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| DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) | |||||||||||||||||||||||||
| Policy contract number | 2380801059 | ||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||
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