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WESTERN WASHINGTON MEDICAL GROUP INSURANCE PLANS 401k Plan overview

Plan NameWESTERN WASHINGTON MEDICAL GROUP INSURANCE PLANS
Plan identification number 505

WESTERN WASHINGTON MEDICAL GROUP INSURANCE PLANS Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

WESTERN WASHINGTON MEDICAL GROUP has sponsored the creation of one or more 401k plans.

Company Name:WESTERN WASHINGTON MEDICAL GROUP
Employer identification number (EIN):911602128
NAIC Classification:621112
NAIC Description:Offices of Physicians, Mental Health Specialists

Additional information about WESTERN WASHINGTON MEDICAL GROUP

Jurisdiction of Incorporation: Washington Secretary of State Corporations Division
Incorporation Date: 1993-06-21
Company Identification Number: 601474013
Legal Registered Office Address: 901 5TH AVE STE 3500

SEATTLE
United States of America (USA)
981642059

More information about WESTERN WASHINGTON MEDICAL GROUP

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WESTERN WASHINGTON MEDICAL GROUP INSURANCE PLANS

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5052021-10-01HEATHER CULVER2023-02-24
5052020-10-01HEATHER CULVER2022-01-06
5052019-10-01HEATHER CULVER2021-03-03
5052018-10-01SANDRA POSSIN2020-04-20
5052017-10-01DAVID RUSSIAN2019-06-27
5052016-10-01
5052016-10-01SANDRA POSSIN2019-11-06
5052015-10-01SANDRA POSSIN
5052014-10-01DAVID A RUSSIAN
5052013-10-01JEROME A. TILLINGER
5052012-10-01JEROME TILLINGER
5052012-05-01JEROME TILLINGER
5052011-05-01JEROME TILLINGER
5052009-05-01JEROME TILLINGER

Plan Statistics for WESTERN WASHINGTON MEDICAL GROUP INSURANCE PLANS

401k plan membership statisitcs for WESTERN WASHINGTON MEDICAL GROUP INSURANCE PLANS

Measure Date Value
2021: WESTERN WASHINGTON MEDICAL GROUP INSURANCE PLANS 2021 401k membership
Total participants, beginning-of-year2021-10-01276
Total number of active participants reported on line 7a of the Form 55002021-10-01312
Number of retired or separated participants receiving benefits2021-10-015
Number of other retired or separated participants entitled to future benefits2021-10-010
Total of all active and inactive participants2021-10-01317
Number of employers contributing to the scheme2021-10-010
2020: WESTERN WASHINGTON MEDICAL GROUP INSURANCE PLANS 2020 401k membership
Total participants, beginning-of-year2020-10-01261
Total number of active participants reported on line 7a of the Form 55002020-10-01276
Number of retired or separated participants receiving benefits2020-10-010
Number of other retired or separated participants entitled to future benefits2020-10-010
Total of all active and inactive participants2020-10-01276
Number of employers contributing to the scheme2020-10-010
2019: WESTERN WASHINGTON MEDICAL GROUP INSURANCE PLANS 2019 401k membership
Total participants, beginning-of-year2019-10-01254
Total number of active participants reported on line 7a of the Form 55002019-10-01261
Number of retired or separated participants receiving benefits2019-10-010
Number of other retired or separated participants entitled to future benefits2019-10-010
Total of all active and inactive participants2019-10-01261
Number of employers contributing to the scheme2019-10-010
2018: WESTERN WASHINGTON MEDICAL GROUP INSURANCE PLANS 2018 401k membership
Total participants, beginning-of-year2018-10-01254
Total number of active participants reported on line 7a of the Form 55002018-10-01254
Number of retired or separated participants receiving benefits2018-10-010
Number of other retired or separated participants entitled to future benefits2018-10-010
Total of all active and inactive participants2018-10-01254
Number of employers contributing to the scheme2018-10-010
2017: WESTERN WASHINGTON MEDICAL GROUP INSURANCE PLANS 2017 401k membership
Total participants, beginning-of-year2017-10-01254
Total number of active participants reported on line 7a of the Form 55002017-10-01254
Number of retired or separated participants receiving benefits2017-10-010
Number of other retired or separated participants entitled to future benefits2017-10-010
Total of all active and inactive participants2017-10-01254
Number of employers contributing to the scheme2017-10-010
2016: WESTERN WASHINGTON MEDICAL GROUP INSURANCE PLANS 2016 401k membership
Total participants, beginning-of-year2016-10-01226
Total number of active participants reported on line 7a of the Form 55002016-10-01254
Number of retired or separated participants receiving benefits2016-10-010
Number of other retired or separated participants entitled to future benefits2016-10-010
Total of all active and inactive participants2016-10-01254
Number of employers contributing to the scheme2016-10-010
2015: WESTERN WASHINGTON MEDICAL GROUP INSURANCE PLANS 2015 401k membership
Total participants, beginning-of-year2015-10-01236
Total number of active participants reported on line 7a of the Form 55002015-10-01226
Number of retired or separated participants receiving benefits2015-10-010
Number of other retired or separated participants entitled to future benefits2015-10-010
Total of all active and inactive participants2015-10-01226
2014: WESTERN WASHINGTON MEDICAL GROUP INSURANCE PLANS 2014 401k membership
Total participants, beginning-of-year2014-10-01230
Total number of active participants reported on line 7a of the Form 55002014-10-01236
Number of retired or separated participants receiving benefits2014-10-010
Number of other retired or separated participants entitled to future benefits2014-10-010
Total of all active and inactive participants2014-10-01236
2013: WESTERN WASHINGTON MEDICAL GROUP INSURANCE PLANS 2013 401k membership
Total participants, beginning-of-year2013-10-01262
Total number of active participants reported on line 7a of the Form 55002013-10-01230
Number of retired or separated participants receiving benefits2013-10-010
Number of other retired or separated participants entitled to future benefits2013-10-010
Total of all active and inactive participants2013-10-01230
2012: WESTERN WASHINGTON MEDICAL GROUP INSURANCE PLANS 2012 401k membership
Total participants, beginning-of-year2012-10-01219
Total number of active participants reported on line 7a of the Form 55002012-10-01262
Number of retired or separated participants receiving benefits2012-10-010
Number of other retired or separated participants entitled to future benefits2012-10-010
Total of all active and inactive participants2012-10-01262
Total participants, beginning-of-year2012-05-01234
Total number of active participants reported on line 7a of the Form 55002012-05-01219
Number of retired or separated participants receiving benefits2012-05-010
Number of other retired or separated participants entitled to future benefits2012-05-010
Total of all active and inactive participants2012-05-01219
2011: WESTERN WASHINGTON MEDICAL GROUP INSURANCE PLANS 2011 401k membership
Total participants, beginning-of-year2011-05-01235
Total number of active participants reported on line 7a of the Form 55002011-05-01232
Number of retired or separated participants receiving benefits2011-05-012
Number of other retired or separated participants entitled to future benefits2011-05-010
Total of all active and inactive participants2011-05-01234
2009: WESTERN WASHINGTON MEDICAL GROUP INSURANCE PLANS 2009 401k membership
Total participants, beginning-of-year2009-05-01347
Total number of active participants reported on line 7a of the Form 55002009-05-01235
Number of retired or separated participants receiving benefits2009-05-012
Number of other retired or separated participants entitled to future benefits2009-05-010
Total of all active and inactive participants2009-05-01237

Form 5500 Responses for WESTERN WASHINGTON MEDICAL GROUP INSURANCE PLANS

2021: WESTERN WASHINGTON MEDICAL GROUP INSURANCE PLANS 2021 form 5500 responses
2021-10-01Type of plan entitySingle employer plan
2021-10-01Plan funding arrangement – InsuranceYes
2021-10-01Plan funding arrangement – General assets of the sponsorYes
2021-10-01Plan benefit arrangement – InsuranceYes
2021-10-01Plan benefit arrangement – General assets of the sponsorYes
2020: WESTERN WASHINGTON MEDICAL GROUP INSURANCE PLANS 2020 form 5500 responses
2020-10-01Type of plan entitySingle employer plan
2020-10-01Plan funding arrangement – InsuranceYes
2020-10-01Plan funding arrangement – General assets of the sponsorYes
2020-10-01Plan benefit arrangement – InsuranceYes
2020-10-01Plan benefit arrangement – General assets of the sponsorYes
2019: WESTERN WASHINGTON MEDICAL GROUP INSURANCE PLANS 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01Plan funding arrangement – InsuranceYes
2019-10-01Plan funding arrangement – General assets of the sponsorYes
2019-10-01Plan benefit arrangement – InsuranceYes
2019-10-01Plan benefit arrangement – General assets of the sponsorYes
2018: WESTERN WASHINGTON MEDICAL GROUP INSURANCE PLANS 2018 form 5500 responses
2018-10-01Type of plan entitySingle employer plan
2018-10-01Plan funding arrangement – InsuranceYes
2018-10-01Plan funding arrangement – General assets of the sponsorYes
2018-10-01Plan benefit arrangement – InsuranceYes
2018-10-01Plan benefit arrangement – General assets of the sponsorYes
2017: WESTERN WASHINGTON MEDICAL GROUP INSURANCE PLANS 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01Plan funding arrangement – InsuranceYes
2017-10-01Plan funding arrangement – General assets of the sponsorYes
2017-10-01Plan benefit arrangement – InsuranceYes
2017-10-01Plan benefit arrangement – General assets of the sponsorYes
2016: WESTERN WASHINGTON MEDICAL GROUP INSURANCE PLANS 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01Submission has been amendedNo
2016-10-01This submission is the final filingNo
2016-10-01This return/report is a short plan year return/report (less than 12 months)No
2016-10-01Plan is a collectively bargained planNo
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan funding arrangement – General assets of the sponsorYes
2016-10-01Plan benefit arrangement – InsuranceYes
2016-10-01Plan benefit arrangement – General assets of the sponsorYes
2015: WESTERN WASHINGTON MEDICAL GROUP INSURANCE PLANS 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01Submission has been amendedNo
2015-10-01This submission is the final filingNo
2015-10-01This return/report is a short plan year return/report (less than 12 months)No
2015-10-01Plan is a collectively bargained planNo
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan funding arrangement – General assets of the sponsorYes
2015-10-01Plan benefit arrangement – InsuranceYes
2015-10-01Plan benefit arrangement – General assets of the sponsorYes
2014: WESTERN WASHINGTON MEDICAL GROUP INSURANCE PLANS 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01Submission has been amendedNo
2014-10-01This submission is the final filingNo
2014-10-01This return/report is a short plan year return/report (less than 12 months)No
2014-10-01Plan is a collectively bargained planNo
2014-10-01Plan funding arrangement – InsuranceYes
2014-10-01Plan funding arrangement – General assets of the sponsorYes
2014-10-01Plan benefit arrangement – InsuranceYes
2014-10-01Plan benefit arrangement – General assets of the sponsorYes
2013: WESTERN WASHINGTON MEDICAL GROUP INSURANCE PLANS 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01Submission has been amendedNo
2013-10-01This submission is the final filingNo
2013-10-01This return/report is a short plan year return/report (less than 12 months)No
2013-10-01Plan is a collectively bargained planNo
2013-10-01Plan funding arrangement – InsuranceYes
2013-10-01Plan funding arrangement – General assets of the sponsorYes
2013-10-01Plan benefit arrangement – InsuranceYes
2013-10-01Plan benefit arrangement – General assets of the sponsorYes
2012: WESTERN WASHINGTON MEDICAL GROUP INSURANCE PLANS 2012 form 5500 responses
2012-10-01Type of plan entitySingle employer plan
2012-10-01Submission has been amendedNo
2012-10-01This submission is the final filingNo
2012-10-01This return/report is a short plan year return/report (less than 12 months)No
2012-10-01Plan is a collectively bargained planNo
2012-10-01Plan funding arrangement – InsuranceYes
2012-10-01Plan funding arrangement – General assets of the sponsorYes
2012-10-01Plan benefit arrangement – InsuranceYes
2012-10-01Plan benefit arrangement – General assets of the sponsorYes
2012-05-01Type of plan entitySingle employer plan
2012-05-01Submission has been amendedNo
2012-05-01This submission is the final filingNo
2012-05-01This return/report is a short plan year return/report (less than 12 months)Yes
2012-05-01Plan is a collectively bargained planNo
2012-05-01Plan funding arrangement – InsuranceYes
2012-05-01Plan funding arrangement – General assets of the sponsorYes
2012-05-01Plan benefit arrangement – InsuranceYes
2012-05-01Plan benefit arrangement – General assets of the sponsorYes
2011: WESTERN WASHINGTON MEDICAL GROUP INSURANCE PLANS 2011 form 5500 responses
2011-05-01Type of plan entitySingle employer plan
2011-05-01Submission has been amendedNo
2011-05-01This submission is the final filingNo
2011-05-01This return/report is a short plan year return/report (less than 12 months)No
2011-05-01Plan is a collectively bargained planNo
2011-05-01Plan funding arrangement – InsuranceYes
2011-05-01Plan benefit arrangement – InsuranceYes
2009: WESTERN WASHINGTON MEDICAL GROUP INSURANCE PLANS 2009 form 5500 responses
2009-05-01Type of plan entitySingle employer plan
2009-05-01Submission has been amendedNo
2009-05-01This submission is the final filingNo
2009-05-01This return/report is a short plan year return/report (less than 12 months)No
2009-05-01Plan is a collectively bargained planNo
2009-05-01Plan funding arrangement – InsuranceYes
2009-05-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

WILLAMETTE DENTAL OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 47050 )
Policy contract numberWA589
Policy instance 2
Insurance contract or identification numberWA589
Number of Individuals Covered77
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $2,105
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,105
Amount paid for insurance broker fees0
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30012640
Policy instance 1
Insurance contract or identification number30012640
Number of Individuals Covered286
Insurance policy start date2021-10-01
Insurance policy end date2022-09-30
Total amount of commissions paid to insurance brokerUSD $1,480
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,891
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,480
Amount paid for insurance broker fees0
Insurance broker organization code?3
WILLAMETTE DENTAL OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 47050 )
Policy contract numberWA589
Policy instance 2
Insurance contract or identification numberWA589
Number of Individuals Covered74
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $2,040
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $2,040
Amount paid for insurance broker fees0
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30012640
Policy instance 1
Insurance contract or identification number30012640
Number of Individuals Covered293
Insurance policy start date2020-10-01
Insurance policy end date2021-09-30
Total amount of commissions paid to insurance brokerUSD $1,448
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,301
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,448
Amount paid for insurance broker fees0
Insurance broker organization code?3
WILLAMETTE DENTAL OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 47050 )
Policy contract numberWA589
Policy instance 2
Insurance contract or identification numberWA589
Number of Individuals Covered76
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $2,031
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $2,031
Amount paid for insurance broker fees0
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30012640
Policy instance 1
Insurance contract or identification number30012640
Number of Individuals Covered261
Insurance policy start date2019-10-01
Insurance policy end date2020-09-30
Total amount of commissions paid to insurance brokerUSD $1,390
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,169
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,390
Amount paid for insurance broker fees0
Insurance broker organization code?3
WILLAMETTE DENTAL OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 47050 )
Policy contract numberWA589
Policy instance 2
Insurance contract or identification numberWA589
Number of Individuals Covered68
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $1,947
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $1,947
Amount paid for insurance broker fees0
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30012640
Policy instance 1
Insurance contract or identification number30012640
Number of Individuals Covered298
Insurance policy start date2018-10-01
Insurance policy end date2019-09-30
Total amount of commissions paid to insurance brokerUSD $1,477
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $32,305
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,477
Amount paid for insurance broker fees0
Insurance broker organization code?3
WILLAMETTE DENTAL OF WASHINGTON, INC. (National Association of Insurance Commissioners NAIC id number: 47050 )
Policy contract numberWA589
Policy instance 2
Insurance contract or identification numberWA589
Number of Individuals Covered38
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $993
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )
Policy contract number30012640
Policy instance 1
Insurance contract or identification number30012640
Number of Individuals Covered288
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $1,382
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,689
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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