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BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA DENTAL PLAN 401k Plan overview

Plan NameBLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA DENTAL PLAN
Plan identification number 501

BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA DENTAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Dental

401k Sponsoring company profile

CEI LABS, INC. has sponsored the creation of one or more 401k plans.

Company Name:CEI LABS, INC.
Employer identification number (EIN):561868823
NAIC Classification:812990
NAIC Description:All Other Personal Services

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA DENTAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012017-01-01GREG HANFORD

Plan Statistics for BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA DENTAL PLAN

401k plan membership statisitcs for BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA DENTAL PLAN

Measure Date Value
2017: BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA DENTAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-0114
Total number of active participants reported on line 7a of the Form 55002017-01-0114
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 participants2017-01-0114
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-0114

Form 5500 Responses for BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA DENTAL PLAN

2017: BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA DENTAL PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )
Policy contract number23031
Policy instance 1
Insurance contract or identification number23031
Number of Individuals Covered14
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $782
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $7,820
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker nameINSURANCE PROFESSIONALS INC

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