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SOURCE MEDICAL SOLUTIONS, INC. DENTAL AND VISION PLAN 401k Plan overview

Plan NameSOURCE MEDICAL SOLUTIONS, INC. DENTAL AND VISION PLAN
Plan identification number 505

SOURCE MEDICAL SOLUTIONS, INC. DENTAL AND VISION PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Dental
  • Vision

401k Sponsoring company profile

SOURCE MEDICAL SOLUTIONS, INC. has sponsored the creation of one or more 401k plans.

Company Name:SOURCE MEDICAL SOLUTIONS, INC.
Employer identification number (EIN):631262943
NAIC Classification:541519
NAIC Description:Other Computer Related Services

Additional information about SOURCE MEDICAL SOLUTIONS, INC.

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 3312760

More information about SOURCE MEDICAL SOLUTIONS, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SOURCE MEDICAL SOLUTIONS, INC. DENTAL AND VISION PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5052017-01-01
5052016-01-01LAURA O'TUEL
5052015-01-01
5052014-01-01
5052013-01-01
5052012-01-01PLAN ADMINISTRATOR
5052011-01-01PLAN ADMINISTRATOR
5052009-01-01PLAN ADMINISTRATOR

Plan Statistics for SOURCE MEDICAL SOLUTIONS, INC. DENTAL AND VISION PLAN

401k plan membership statisitcs for SOURCE MEDICAL SOLUTIONS, INC. DENTAL AND VISION PLAN

Measure Date Value
2017: SOURCE MEDICAL SOLUTIONS, INC. DENTAL AND VISION PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01245
Total number of active participants reported on line 7a of the Form 55002017-01-010
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 participants2017-01-010
2016: SOURCE MEDICAL SOLUTIONS, INC. DENTAL AND VISION PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01386
Total number of active participants reported on line 7a of the Form 55002016-01-01245
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 participants2016-01-01245
2015: SOURCE MEDICAL SOLUTIONS, INC. DENTAL AND VISION PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01432
Total number of active participants reported on line 7a of the Form 55002015-01-01386
Total of all active and inactive participants2015-01-01386
2014: SOURCE MEDICAL SOLUTIONS, INC. DENTAL AND VISION PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01448
Total number of active participants reported on line 7a of the Form 55002014-01-01432
Total of all active and inactive participants2014-01-01432
2013: SOURCE MEDICAL SOLUTIONS, INC. DENTAL AND VISION PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01414
Total number of active participants reported on line 7a of the Form 55002013-01-01448
Total of all active and inactive participants2013-01-01448
2012: SOURCE MEDICAL SOLUTIONS, INC. DENTAL AND VISION PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01363
Total number of active participants reported on line 7a of the Form 55002012-01-01414
Total of all active and inactive participants2012-01-01414
2011: SOURCE MEDICAL SOLUTIONS, INC. DENTAL AND VISION PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01330
Total number of active participants reported on line 7a of the Form 55002011-01-01363
Total of all active and inactive participants2011-01-01363
2009: SOURCE MEDICAL SOLUTIONS, INC. DENTAL AND VISION PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01239
Total number of active participants reported on line 7a of the Form 55002009-01-01234
Total of all active and inactive participants2009-01-01234

Form 5500 Responses for SOURCE MEDICAL SOLUTIONS, INC. DENTAL AND VISION PLAN

2017: SOURCE MEDICAL SOLUTIONS, INC. DENTAL AND VISION 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 filingYes
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
2016: SOURCE MEDICAL SOLUTIONS, INC. DENTAL AND VISION PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: SOURCE MEDICAL SOLUTIONS, INC. DENTAL AND VISION PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: SOURCE MEDICAL SOLUTIONS, INC. DENTAL AND VISION PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: SOURCE MEDICAL SOLUTIONS, INC. DENTAL AND VISION PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: SOURCE MEDICAL SOLUTIONS, INC. DENTAL AND VISION PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: SOURCE MEDICAL SOLUTIONS, INC. DENTAL AND VISION PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: SOURCE MEDICAL SOLUTIONS, INC. DENTAL AND VISION PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00433693
Policy instance 1
Insurance contract or identification number00433693
Number of Individuals Covered206
Insurance policy start date2017-01-01
Insurance policy end date2017-06-30
Total amount of commissions paid to insurance brokerUSD $1,486
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 BenefitYes
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 $27,501
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,029
Insurance broker organization code?3
Insurance broker nameWILLIS OF ALABAMA INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00433693
Policy instance 1
Insurance contract or identification number00433693
Number of Individuals Covered386
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $4,592
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $80,744
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,592
Insurance broker organization code?3
Insurance broker nameWILLIS OF ALABAMA INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00433693
Policy instance 1
Insurance contract or identification number00433693
Number of Individuals Covered432
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $85,967
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00433693
Policy instance 1
Insurance contract or identification number00433693
Number of Individuals Covered448
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,366
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $86,580
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees3366
Additional information about fees paid to insurance brokerOTHER FEES
Insurance broker organization code?3
Insurance broker nameS S NESBITT & CO INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00433693
Policy instance 1
Insurance contract or identification number00433693
Number of Individuals Covered414
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $2,414
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $71,658
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,387
Insurance broker organization code?3
Insurance broker nameTHE MATHIS-HILL-ROBERTSON AGENCY
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00433693
Policy instance 1
Insurance contract or identification number00433693
Number of Individuals Covered363
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $1,618
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $71,047
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00433693
Policy instance 1
Insurance contract or identification number00433693
Number of Individuals Covered330
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $11,504
Total amount of fees paid to insurance companyUSD $6,468
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $140,858
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,531
Amount paid for insurance broker fees6468
Additional information about fees paid to insurance brokerOTHER FEES
Insurance broker organization code?3
Insurance broker nameS S NESBITT & CO INC
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00433693
Policy instance 1
Insurance contract or identification number00433693
Number of Individuals Covered234
Insurance policy start date2009-01-01
Insurance policy end date2009-12-31
Total amount of commissions paid to insurance brokerUSD $19,175
Total amount of fees paid to insurance companyUSD $7,547
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $198,376
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,077
Amount paid for insurance broker fees7547
Additional information about fees paid to insurance brokerOTHER FEES
Insurance broker organization code?3
Insurance broker nameTHE MATHIS-HILL-ROBERTSON
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00433693
Policy instance 1
Insurance contract or identification number00433693
Number of Individuals Covered239
Insurance policy start date2008-01-01
Insurance policy end date2008-12-31
Total amount of commissions paid to insurance brokerUSD $19,397
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $186,886
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,044
Insurance broker organization code?3
Insurance broker nameTHE MATHIS-HILL-ROBERTSON

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