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| Plan Name | ESCAMBIA COUNTY HEALTH CARE AUTHORITY (DENTAL) |
| Plan identification number | 508 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | KIMBERLY J. WESTERMANN, D.M.D. |
| Employer identification number (EIN): | 611143638 |
| NAIC Classification: | 622000 |
| NAIC Description: | Hospitals |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 508 | 2023-01-01 | WES NALL | 2024-07-21 | ||
| 508 | 2022-01-01 | ||||
| 508 | 2022-01-01 | STEPHEN FISCHER |
| Measure | Date | Value |
|---|---|---|
| 2023: ESCAMBIA COUNTY HEALTH CARE AUTHORITY (DENTAL) 2023 401k membership | ||
| Total participants, beginning-of-year | 2023-01-01 | 340 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-01-01 | 340 |
| Total of all active and inactive participants | 2023-01-01 | 340 |
| 2022: ESCAMBIA COUNTY HEALTH CARE AUTHORITY (DENTAL) 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-01-01 | 725 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 730 |
| Total of all active and inactive participants | 2022-01-01 | 730 |
| Total participants | 2022-01-01 | 730 |
| 2023: ESCAMBIA COUNTY HEALTH CARE AUTHORITY (DENTAL) 2023 form 5500 responses | ||
|---|---|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Submission has been amended | No |
| 2023-01-01 | This submission is the final filing | No |
| 2023-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2023-01-01 | Plan is a collectively bargained plan | No |
| 2023-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2023-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2022: ESCAMBIA COUNTY HEALTH CARE AUTHORITY (DENTAL) 2022 form 5500 responses | ||
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Submission has been amended | No |
| 2022-01-01 | This submission is the final filing | No |
| 2022-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-01-01 | Plan is a collectively bargained plan | No |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| BLUE CROSS BLUE SHIELD OF ALABAMA (National Association of Insurance Commissioners NAIC id number: 55433 ) | |
| Policy contract number | 20952 |
| Policy instance | 1 |
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