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GROUP DENTAL DELTA PREMIER 401k Plan overview

Plan NameGROUP DENTAL DELTA PREMIER
Plan identification number 515

GROUP DENTAL DELTA PREMIER Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Dental

401k Sponsoring company profile

FAIRVIEW HEALTH SERVICES has sponsored the creation of one or more 401k plans.

Company Name:FAIRVIEW HEALTH SERVICES
Employer identification number (EIN):410991680
NAIC Classification:622000
NAIC Description: Hospitals

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP DENTAL DELTA PREMIER

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5152019-01-01
5152018-01-01
5152017-01-01CAROLYN JACOBSON CAROLYN JACOBSON2018-10-11
5152016-01-01CAROLYN JACOBSON CAROLYN JACOBSON2017-10-16
5152015-01-01CAROLYN JACOBSON CAROLYN JACOBSON2016-08-05
5152014-01-01CAROLYN JACOBSON CAROLYN JACOBSON2015-05-07
5152013-01-01CAROLYN JACOBSON CAROLYN JACOBSON2014-09-15
5152012-01-01PAULA PHILLIPPE
5152011-01-01PAULA PHILLIPPE
5152010-01-01PAULA PHILLIPPE
5152009-01-01PAULA PHILLIPPE

Plan Statistics for GROUP DENTAL DELTA PREMIER

401k plan membership statisitcs for GROUP DENTAL DELTA PREMIER

Measure Date Value
2019: GROUP DENTAL DELTA PREMIER 2019 401k membership
Total participants, beginning-of-year2019-01-018,019
Total number of active participants reported on line 7a of the Form 55002019-01-010
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-010
2018: GROUP DENTAL DELTA PREMIER 2018 401k membership
Total participants, beginning-of-year2018-01-017,970
Total number of active participants reported on line 7a of the Form 55002018-01-018,019
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-018,019
2017: GROUP DENTAL DELTA PREMIER 2017 401k membership
Total participants, beginning-of-year2017-01-017,889
Total number of active participants reported on line 7a of the Form 55002017-01-017,970
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-017,970
2016: GROUP DENTAL DELTA PREMIER 2016 401k membership
Total participants, beginning-of-year2016-01-017,826
Total number of active participants reported on line 7a of the Form 55002016-01-017,889
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-017,889
2015: GROUP DENTAL DELTA PREMIER 2015 401k membership
Total participants, beginning-of-year2015-01-018,218
Total number of active participants reported on line 7a of the Form 55002015-01-017,826
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-017,826
2014: GROUP DENTAL DELTA PREMIER 2014 401k membership
Total participants, beginning-of-year2014-01-013,996
Total number of active participants reported on line 7a of the Form 55002014-01-018,218
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-018,218
2013: GROUP DENTAL DELTA PREMIER 2013 401k membership
Total participants, beginning-of-year2013-01-014,350
Total number of active participants reported on line 7a of the Form 55002013-01-013,996
Total of all active and inactive participants2013-01-013,996
2012: GROUP DENTAL DELTA PREMIER 2012 401k membership
Total participants, beginning-of-year2012-01-014,511
Total number of active participants reported on line 7a of the Form 55002012-01-014,350
Total of all active and inactive participants2012-01-014,350
2011: GROUP DENTAL DELTA PREMIER 2011 401k membership
Total participants, beginning-of-year2011-01-014,639
Total number of active participants reported on line 7a of the Form 55002011-01-014,511
Total of all active and inactive participants2011-01-014,511
2010: GROUP DENTAL DELTA PREMIER 2010 401k membership
Total participants, beginning-of-year2010-01-014,601
Total number of active participants reported on line 7a of the Form 55002010-01-014,639
Total of all active and inactive participants2010-01-014,639
2009: GROUP DENTAL DELTA PREMIER 2009 401k membership
Total participants, beginning-of-year2009-01-014,400
Total number of active participants reported on line 7a of the Form 55002009-01-014,601
Total of all active and inactive participants2009-01-014,601

Financial Data on GROUP DENTAL DELTA PREMIER

Measure Date Value
2012 : GROUP DENTAL DELTA PREMIER 2012 401k financial data
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-12-31No
Was this plan covered by a fidelity bond2012-12-31No
If this is an individual account plan, was there a blackout period2012-12-31No
Were there any nonexempt tranactions with any party-in-interest2012-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2012-12-31No
Were any leases to which the plan was party in default or uncollectible2012-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-12-31No
Was there a failure to transmit to the plan any participant contributions2012-12-31No
Has the plan failed to provide any benefit when due under the plan2012-12-31No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-12-31No
Did the plan have assets held for investment2012-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-12-31No
2011 : GROUP DENTAL DELTA PREMIER 2011 401k financial data
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Was this plan covered by a fidelity bond2011-12-31No
If this is an individual account plan, was there a blackout period2011-12-31No
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31No
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-12-31No
Did the plan have assets held for investment2011-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
2010 : GROUP DENTAL DELTA PREMIER 2010 401k financial data
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Was this plan covered by a fidelity bond2010-12-31No
If this is an individual account plan, was there a blackout period2010-12-31No
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31No
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32010-12-31No
Did the plan have assets held for investment2010-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No

Form 5500 Responses for GROUP DENTAL DELTA PREMIER

2019: GROUP DENTAL DELTA PREMIER 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01This submission is the final filingYes
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: GROUP DENTAL DELTA PREMIER 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: GROUP DENTAL DELTA PREMIER 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: GROUP DENTAL DELTA PREMIER 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: GROUP DENTAL DELTA PREMIER 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: GROUP DENTAL DELTA PREMIER 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 – General assets of the sponsorYes
2013: GROUP DENTAL DELTA PREMIER 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 – General assets of the sponsorYes
2012: GROUP DENTAL DELTA PREMIER 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: GROUP DENTAL DELTA PREMIER 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: GROUP DENTAL DELTA PREMIER 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: GROUP DENTAL DELTA PREMIER 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

DELTA DENTAL PLAN OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number001156
Policy instance 1
Insurance contract or identification number001156
Number of Individuals Covered8041
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Welfare Benefit Premiums Paid to CarrierUSD $2,611,606
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
DELTA DENTAL PLAN OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number001156
Policy instance 1
Insurance contract or identification number001156
Number of Individuals Covered8019
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Welfare Benefit Premiums Paid to CarrierUSD $2,664,380
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
DELTA DENTAL PLAN OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number001156
Policy instance 1
Insurance contract or identification number001156
Number of Individuals Covered7970
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Welfare Benefit Premiums Paid to CarrierUSD $2,602,923
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker organization code?3
Insurance broker nameDELTA DENTAL OF MINNESOTA
DELTA DENTAL PLAN OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number001156
Policy instance 1
Insurance contract or identification number001156
Number of Individuals Covered7826
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of fees paid to insurance companyUSD $113,279
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees113279
Insurance broker organization code?3
Insurance broker nameDELTA DENTAL OF MINNESOTA
DELTA DENTAL PLAN OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number001156
Policy instance 1
Insurance contract or identification number001156
Number of Individuals Covered8218
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of fees paid to insurance companyUSD $171,075
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees171075
Insurance broker organization code?3
Insurance broker nameDELTA DENTAL OF MINNESOTA
DELTA DENTAL PLAN OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number001156
Policy instance 1
Insurance contract or identification number001156
Number of Individuals Covered3996
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of fees paid to insurance companyUSD $146,859
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees146859
Insurance broker organization code?3
Insurance broker nameDELTA DENTAL OF MINNESOTA
DELTA DENTAL PLAN OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number001156
Policy instance 1
Insurance contract or identification number001156
Number of Individuals Covered4350
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $161,311
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
Amount paid for insurance broker fees161311
Insurance broker organization code?3
Insurance broker name
DELTA DENTAL PLAN OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number001156
Policy instance 1
Insurance contract or identification number001156
Number of Individuals Covered4511
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $165,598
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 PLAN OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number001156
Policy instance 1
Insurance contract or identification number001156
Number of Individuals Covered4639
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $167,207
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
Amount paid for insurance broker fees167207
Additional information about fees paid to insurance brokerADMINISTRATIVE SERVICES
Insurance broker organization code?3
Insurance broker name

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