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PRIMARY CARE ASSOCIATES OF APPLETON LTD DENTAL PLAN 401k Plan overview

Plan NamePRIMARY CARE ASSOCIATES OF APPLETON LTD DENTAL PLAN
Plan identification number 501

PRIMARY CARE ASSOCIATES OF APPLETON LTD DENTAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Dental

401k Sponsoring company profile

PRIMARY CARE ASSOCIATES OF APPLETON LTD has sponsored the creation of one or more 401k plans.

Company Name:PRIMARY CARE ASSOCIATES OF APPLETON LTD
Employer identification number (EIN):391988565
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PRIMARY CARE ASSOCIATES OF APPLETON LTD DENTAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012017-01-01JAMES R VANDERMISSEN
5012016-01-01JAMES R VANDERMISSEN
5012015-01-01JAMES VANDERMISSEN
5012014-01-01JAMES VANDERMISSEN
5012013-01-01JAMES VANDERMISSEN
5012012-01-01JAMES VANDERMISSEN
5012011-01-01JAMES VANDERMISSEN

Plan Statistics for PRIMARY CARE ASSOCIATES OF APPLETON LTD DENTAL PLAN

401k plan membership statisitcs for PRIMARY CARE ASSOCIATES OF APPLETON LTD DENTAL PLAN

Measure Date Value
2017: PRIMARY CARE ASSOCIATES OF APPLETON LTD DENTAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01106
Total number of active participants reported on line 7a of the Form 55002017-01-010
Total of all active and inactive participants2017-01-010
2016: PRIMARY CARE ASSOCIATES OF APPLETON LTD DENTAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01106
Total number of active participants reported on line 7a of the Form 55002016-01-01106
Total of all active and inactive participants2016-01-01106
2015: PRIMARY CARE ASSOCIATES OF APPLETON LTD DENTAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01103
Total number of active participants reported on line 7a of the Form 55002015-01-01106
Total of all active and inactive participants2015-01-01106
2014: PRIMARY CARE ASSOCIATES OF APPLETON LTD DENTAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01105
Total number of active participants reported on line 7a of the Form 55002014-01-01103
Total of all active and inactive participants2014-01-01103
2013: PRIMARY CARE ASSOCIATES OF APPLETON LTD DENTAL PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01105
Total number of active participants reported on line 7a of the Form 55002013-01-01105
Total of all active and inactive participants2013-01-01105
2012: PRIMARY CARE ASSOCIATES OF APPLETON LTD DENTAL PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01101
Total number of active participants reported on line 7a of the Form 55002012-01-01105
Total of all active and inactive participants2012-01-01105
2011: PRIMARY CARE ASSOCIATES OF APPLETON LTD DENTAL PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-0199
Total number of active participants reported on line 7a of the Form 55002011-01-01101
Total of all active and inactive participants2011-01-01101
Total participants2011-01-01101

Form 5500 Responses for PRIMARY CARE ASSOCIATES OF APPLETON LTD DENTAL PLAN

2017: PRIMARY CARE ASSOCIATES OF APPLETON LTD DENTAL PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01This submission is the final filingYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: PRIMARY CARE ASSOCIATES OF APPLETON LTD DENTAL PLAN 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: PRIMARY CARE ASSOCIATES OF APPLETON LTD DENTAL PLAN 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: PRIMARY CARE ASSOCIATES OF APPLETON LTD DENTAL PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: PRIMARY CARE ASSOCIATES OF APPLETON LTD DENTAL PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: PRIMARY CARE ASSOCIATES OF APPLETON LTD DENTAL PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: PRIMARY CARE ASSOCIATES OF APPLETON LTD DENTAL PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01First time form 5500 has been submittedYes
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number00001D031447
Policy instance 1
Insurance contract or identification number00001D031447
Number of Individuals Covered0
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $11,211
Total amount of fees paid to insurance companyUSD $1,220
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $112,109
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,544
Amount paid for insurance broker fees1220
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameJOHNSON INSURANCE SERVICES LLC
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number00514 00000
Policy instance 1
Insurance contract or identification number00514 00000
Number of Individuals Covered106
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $15,185
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 $15,185
Insurance broker organization code?3
Insurance broker nameROBERTSON RYAN & ASSOCIATES INC
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number00514 00000
Policy instance 1
Insurance contract or identification number00514 00000
Number of Individuals Covered103
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $13,310
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 $13,310
Insurance broker organization code?3
Insurance broker nameROBERTSON RYAN & ASSOCIATES INC
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF1D1193
Policy instance 1
Insurance contract or identification numberF1D1193
Number of Individuals Covered105
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $3,623
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
Welfare Benefit Premiums Paid to CarrierUSD $105,078
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,623
Insurance broker organization code?3
Insurance broker nameROBERTSON RYAN & ASSOCIATES INC
DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )
Policy contract numberF1D1193
Policy instance 1
Insurance contract or identification numberF1D1193
Number of Individuals Covered105
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $3,586
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
Welfare Benefit Premiums Paid to CarrierUSD $103,686
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,586
Insurance broker organization code?3
Insurance broker nameROBERTSON RYAN & ASSOCIATES INC
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1009227
Policy instance 1
Insurance contract or identification number1009227
Number of Individuals Covered101
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $5,376
Total amount of fees paid to insurance companyUSD $1,565
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $107,523
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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