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Plan Name | WELFARE BENEFIT PLAN - LIFE & AD&D |
Plan identification number | 503 |
401k Plan Type | Welfare Benefit |
Plan Features/Benefits |
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Company Name: | DYNAMIC PAIN & WELLNESS PLLC |
Employer identification number (EIN): | 475138029 |
NAIC Classification: | 621111 |
NAIC Description: | Offices of Physicians (except Mental Health Specialists) |
Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
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503 | 2021-02-01 | STEPHANIE SWINT | 2022-11-02 |
Measure | Date | Value |
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2021: WELFARE BENEFIT PLAN - LIFE & AD&D 2021 401k membership | ||
Total participants, beginning-of-year | 2021-02-01 | 184 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-02-01 | 0 |
Number of retired or separated participants receiving benefits | 2021-02-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2021-02-01 | 0 |
Total of all active and inactive participants | 2021-02-01 | 0 |
Number of employers contributing to the scheme | 2021-02-01 | 0 |
2021: WELFARE BENEFIT PLAN - LIFE & AD&D 2021 form 5500 responses | ||
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2021-02-01 | Type of plan entity | Single employer plan |
2021-02-01 | First time form 5500 has been submitted | Yes |
2021-02-01 | This submission is the final filing | Yes |
2021-02-01 | Plan funding arrangement – Insurance | Yes |
2021-02-01 | Plan benefit arrangement – Insurance | Yes |
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |||||||||||||||||||||||||||||
Policy contract number | 954491 | ||||||||||||||||||||||||||||
Policy instance | 1 | ||||||||||||||||||||||||||||
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