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| Plan Name | DENTAL HEALTH GROUP, P.A. WELFARE AND FRINGE BENEFIT PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | DENTAL HEALTH GROUP, P.A. |
| Employer identification number (EIN): | 650719035 |
| NAIC Classification: | 621210 |
| NAIC Description: | Offices of Dentists |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2022-01-01 | ERIC MAGNUSSEN | 2023-07-25 | ||
| 501 | 2021-01-01 | DENTAL HEALTH GROUP, P.A. | 2023-05-23 |
| Measure | Date | Value |
|---|---|---|
| 2022: DENTAL HEALTH GROUP, P.A. WELFARE AND FRINGE BENEFIT PLAN 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-01-01 | 409 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 387 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 387 |
| Total participants | 2022-01-01 | 387 |
| 2021: DENTAL HEALTH GROUP, P.A. WELFARE AND FRINGE BENEFIT PLAN 2021 401k membership | ||
| Total participants, beginning-of-year | 2021-01-01 | 405 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 423 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 3 |
| Total of all active and inactive participants | 2021-01-01 | 426 |
| Total participants | 2021-01-01 | 426 |
| 2022: DENTAL HEALTH GROUP, P.A. WELFARE AND FRINGE BENEFIT PLAN 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 funding arrangement – General assets of the sponsor | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: DENTAL HEALTH GROUP, P.A. WELFARE AND FRINGE BENEFIT PLAN 2021 form 5500 responses | ||
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Submission has been amended | No |
| 2021-01-01 | This submission is the final filing | No |
| 2021-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-01-01 | Plan is a collectively bargained plan | No |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 30028622 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
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| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 963259/9632558 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
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| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 961087/961900 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
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| LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 969850/971292 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 4 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
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| METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 0216529 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 00344975 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 30028622 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
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