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| Plan Name | ACCESS DENTAL SERVICES, LLC SEVERANCE PLAN |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | ACCESS DENTAL SERVICES, LLC |
| Employer identification number (EIN): | 471272105 |
| NAIC Classification: | 524140 |
Additional information about ACCESS DENTAL SERVICES, LLC
| Jurisdiction of Incorporation: | California Department of State |
| Incorporation Date: | |
| Company Identification Number: | 201419010342 |
More information about ACCESS DENTAL SERVICES, LLC
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2018-01-01 | ROXANNE ADAMS | 2019-10-03 | ||
| 502 | 2017-01-01 |
| 2018: ACCESS DENTAL SERVICES, LLC SEVERANCE PLAN 2018 form 5500 responses | ||
|---|---|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: ACCESS DENTAL SERVICES, LLC SEVERANCE PLAN 2017 form 5500 responses | ||
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | First time form 5500 has been submitted | Yes |
| 2017-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |
| Policy contract number | 913134 |
| Policy instance | 1 |
| PREMIER ACCESS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60237 ) | |
| Policy contract number | 16000 |
| Policy instance | 2 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 522612 |
| Policy instance | 3 |
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