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GROUP DENTAL DELTA PREFERRED OPTION 401k Plan overview

Plan NameGROUP DENTAL DELTA PREFERRED OPTION
Plan identification number 522

GROUP DENTAL DELTA PREFERRED OPTION 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 PREFERRED OPTION

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5222019-01-01
5222018-01-01
5222017-01-01CAROLYN JACOBSON CAROLYN JACOBSON2018-10-11
5222016-01-01CAROLYN JACOBSON CAROLYN JACOBSON2017-10-16
5222015-01-01CAROLYN JACOBSON CAROLYN JACOBSON2016-08-05
5222014-01-01CAROLYN JACOBSON CAROLYN JACOBSON2015-05-07
5222013-01-01CAROLYN JACOBSON CAROLYN JACOBSON2014-10-03
5222012-01-01PAULA PHILLIPPE
5222011-01-01PAULA PHILLIPPE
5222009-01-01PAULA PHILLIPPE

Plan Statistics for GROUP DENTAL DELTA PREFERRED OPTION

401k plan membership statisitcs for GROUP DENTAL DELTA PREFERRED OPTION

Measure Date Value
2019: GROUP DENTAL DELTA PREFERRED OPTION 2019 401k membership
Total participants, beginning-of-year2019-01-0124,200
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 PREFERRED OPTION 2018 401k membership
Total participants, beginning-of-year2018-01-0123,849
Total number of active participants reported on line 7a of the Form 55002018-01-0124,200
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 participants2018-01-0124,200
2017: GROUP DENTAL DELTA PREFERRED OPTION 2017 401k membership
Total participants, beginning-of-year2017-01-0122,995
Total number of active participants reported on line 7a of the Form 55002017-01-0123,849
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 participants2017-01-0123,849
2016: GROUP DENTAL DELTA PREFERRED OPTION 2016 401k membership
Total participants, beginning-of-year2016-01-0121,886
Total number of active participants reported on line 7a of the Form 55002016-01-0122,995
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 participants2016-01-0122,995
2015: GROUP DENTAL DELTA PREFERRED OPTION 2015 401k membership
Total participants, beginning-of-year2015-01-0121,221
Total number of active participants reported on line 7a of the Form 55002015-01-0121,886
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 participants2015-01-0121,886
2014: GROUP DENTAL DELTA PREFERRED OPTION 2014 401k membership
Total participants, beginning-of-year2014-01-019,910
Total number of active participants reported on line 7a of the Form 55002014-01-0121,221
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 participants2014-01-0121,221
2013: GROUP DENTAL DELTA PREFERRED OPTION 2013 401k membership
Total participants, beginning-of-year2013-01-019,319
Total number of active participants reported on line 7a of the Form 55002013-01-019,910
Total of all active and inactive participants2013-01-019,910
2012: GROUP DENTAL DELTA PREFERRED OPTION 2012 401k membership
Total participants, beginning-of-year2012-01-018,879
Total number of active participants reported on line 7a of the Form 55002012-01-019,319
Total of all active and inactive participants2012-01-019,319
2011: GROUP DENTAL DELTA PREFERRED OPTION 2011 401k membership
Total participants, beginning-of-year2011-01-018,212
Total number of active participants reported on line 7a of the Form 55002011-01-018,879
Total of all active and inactive participants2011-01-018,879
2009: GROUP DENTAL DELTA PREFERRED OPTION 2009 401k membership
Total participants, beginning-of-year2009-01-018,221
Total number of active participants reported on line 7a of the Form 55002009-01-018,341
Total of all active and inactive participants2009-01-018,341

Financial Data on GROUP DENTAL DELTA PREFERRED OPTION

Measure Date Value
2012 : GROUP DENTAL DELTA PREFERRED OPTION 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 PREFERRED OPTION 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 PREFERRED OPTION 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 PREFERRED OPTION

2019: GROUP DENTAL DELTA PREFERRED OPTION 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 – InsuranceYes
2019-01-01Plan benefit arrangement – General assets of the sponsorYes
2018: GROUP DENTAL DELTA PREFERRED OPTION 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 – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: GROUP DENTAL DELTA PREFERRED OPTION 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 – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: GROUP DENTAL DELTA PREFERRED OPTION 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 – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: GROUP DENTAL DELTA PREFERRED OPTION 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 – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: GROUP DENTAL DELTA PREFERRED OPTION 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: GROUP DENTAL DELTA PREFERRED OPTION 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: GROUP DENTAL DELTA PREFERRED OPTION 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 PREFERRED OPTION 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
2009: GROUP DENTAL DELTA PREFERRED OPTION 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 OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 )
Policy contract number006081
Policy instance 1
Insurance contract or identification number006081
Number of Individuals Covered25434
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Welfare Benefit Premiums Paid to CarrierUSD $10,588,316
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 OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 )
Policy contract number006081
Policy instance 1
Insurance contract or identification number006081
Number of Individuals Covered24200
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Welfare Benefit Premiums Paid to CarrierUSD $10,010,393
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 OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 )
Policy contract number006081
Policy instance 1
Insurance contract or identification number006081
Number of Individuals Covered23849
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Welfare Benefit Premiums Paid to CarrierUSD $9,435,340
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 OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 )
Policy contract number006081
Policy instance 1
Insurance contract or identification number006081
Number of Individuals Covered21886
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of fees paid to insurance companyUSD $298,053
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees298053
Insurance broker organization code?3
Insurance broker nameDELTA DENTAL OF MINNESOTA
DELTA DENTAL OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 )
Policy contract number006081
Policy instance 1
Insurance contract or identification number006081
Number of Individuals Covered21221
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of fees paid to insurance companyUSD $473,224
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees473224
Insurance broker organization code?3
Insurance broker nameDELTA DENTAL OF MINNESOTA
DELTA DENTAL OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 )
Policy contract number006081
Policy instance 1
Insurance contract or identification number006081
Number of Individuals Covered9910
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of fees paid to insurance companyUSD $359,920
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees359920
Insurance broker organization code?3
Insurance broker nameDELTA DENTAL OF MINNESOTA
DELTA DENTAL OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 )
Policy contract number006081
Policy instance 1
Insurance contract or identification number006081
Number of Individuals Covered9319
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 $336,242
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 fees336242
Insurance broker organization code?3
Insurance broker nameDELTA DENTAL OF MINNESOTA
DELTA DENTAL OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 )
Policy contract number006081
Policy instance 1
Insurance contract or identification number006081
Number of Individuals Covered8879
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 $320,865
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 OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 )
Policy contract number
Policy instance 1
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 $297,422
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 fees297422
Additional information about fees paid to insurance brokerADMINISTRATIVE SERVICES
Insurance broker organization code?3
Insurance broker nameDELTA DENTAL OF MINNESOTA

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