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OPTIMUS HEALTH CARE, INC. DENTAL PLAN 401k Plan overview

Plan NameOPTIMUS HEALTH CARE, INC. DENTAL PLAN
Plan identification number 502

OPTIMUS HEALTH CARE, INC. DENTAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Dental

401k Sponsoring company profile

OPTIMUS HEALTH CARE, INC. has sponsored the creation of one or more 401k plans.

Company Name:OPTIMUS HEALTH CARE, INC.
Employer identification number (EIN):060972166
NAIC Classification:621498
NAIC Description:All Other Outpatient Care Centers

Form 5500 Filing Information

Submission information for form 5500 for 401k plan OPTIMUS HEALTH CARE, INC. DENTAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-07-01
5022021-07-01
5022020-07-01
5022019-07-01
5022018-07-01
5022017-07-01MARIA XAVIER-DOWSKI MARIA XAVIER-DOWSKI2019-03-13
5022016-07-01MARIA XAVIER-DOWSKI
5022015-07-01MARIA XAVIER-DOWSKI
5022014-07-01MARIA XAVIER-DOWSKI
5022013-07-01MARIA XAVIER-DOWSKI
5022012-07-01LUDWIG SPINELLI
5022012-03-01MARGARITA TORRES
5022011-03-01MARGARIT TORRES
5022009-03-01MARGARITA S. TORRES
5022008-03-01MARGARITA S. TORRES
5022007-03-01MARGARITA S. TORRES
5022006-03-01MARGARITA S. TORRES
5022005-03-01MARGARITA S. TORRES
5022004-03-01MARGARITA S. TORRES
5022003-03-01MARGARITA S. TORRES
5022002-03-01MARGARITA S. TORRES

Plan Statistics for OPTIMUS HEALTH CARE, INC. DENTAL PLAN

401k plan membership statisitcs for OPTIMUS HEALTH CARE, INC. DENTAL PLAN

Measure Date Value
2022: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2022 401k membership
Total participants, beginning-of-year2022-07-01211
Total number of active participants reported on line 7a of the Form 55002022-07-01207
Number of retired or separated participants receiving benefits2022-07-011
Number of other retired or separated participants entitled to future benefits2022-07-010
Total of all active and inactive participants2022-07-01208
2021: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-07-01249
Total number of active participants reported on line 7a of the Form 55002021-07-01225
Number of retired or separated participants receiving benefits2021-07-012
Number of other retired or separated participants entitled to future benefits2021-07-0174
Total of all active and inactive participants2021-07-01301
2020: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-07-01249
Total number of active participants reported on line 7a of the Form 55002020-07-01246
Number of retired or separated participants receiving benefits2020-07-012
Number of other retired or separated participants entitled to future benefits2020-07-018
Total of all active and inactive participants2020-07-01256
2019: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-01217
Total number of active participants reported on line 7a of the Form 55002019-07-01247
Number of retired or separated participants receiving benefits2019-07-012
Number of other retired or separated participants entitled to future benefits2019-07-017
Total of all active and inactive participants2019-07-01256
2018: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-07-01240
Total number of active participants reported on line 7a of the Form 55002018-07-01217
Number of retired or separated participants receiving benefits2018-07-0112
Number of other retired or separated participants entitled to future benefits2018-07-014
Total of all active and inactive participants2018-07-01233
2017: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-07-01353
Total number of active participants reported on line 7a of the Form 55002017-07-01360
Number of retired or separated participants receiving benefits2017-07-012
Number of other retired or separated participants entitled to future benefits2017-07-014
Total of all active and inactive participants2017-07-01366
2016: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-01261
Total number of active participants reported on line 7a of the Form 55002016-07-01353
Number of retired or separated participants receiving benefits2016-07-010
Number of other retired or separated participants entitled to future benefits2016-07-010
Total of all active and inactive participants2016-07-01353
2015: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-01262
Total number of active participants reported on line 7a of the Form 55002015-07-01261
Number of retired or separated participants receiving benefits2015-07-010
Number of other retired or separated participants entitled to future benefits2015-07-010
Total of all active and inactive participants2015-07-01261
2014: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-07-01257
Total number of active participants reported on line 7a of the Form 55002014-07-01262
Number of retired or separated participants receiving benefits2014-07-010
Number of other retired or separated participants entitled to future benefits2014-07-010
Total of all active and inactive participants2014-07-01262
2013: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2013 401k membership
Total participants, beginning-of-year2013-07-01256
Total number of active participants reported on line 7a of the Form 55002013-07-01257
Number of retired or separated participants receiving benefits2013-07-010
Number of other retired or separated participants entitled to future benefits2013-07-010
Total of all active and inactive participants2013-07-01257
2012: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2012 401k membership
Total participants, beginning-of-year2012-07-01280
Total number of active participants reported on line 7a of the Form 55002012-07-01256
Number of retired or separated participants receiving benefits2012-07-010
Number of other retired or separated participants entitled to future benefits2012-07-010
Total of all active and inactive participants2012-07-01256
Total participants, beginning-of-year2012-03-01284
Total number of active participants reported on line 7a of the Form 55002012-03-01273
Number of retired or separated participants receiving benefits2012-03-017
Number of other retired or separated participants entitled to future benefits2012-03-010
Total of all active and inactive participants2012-03-01280
2011: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2011 401k membership
Total participants, beginning-of-year2011-03-01282
Total number of active participants reported on line 7a of the Form 55002011-03-01280
Number of retired or separated participants receiving benefits2011-03-014
Number of other retired or separated participants entitled to future benefits2011-03-010
Total of all active and inactive participants2011-03-01284
2009: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2009 401k membership
Total participants, beginning-of-year2009-03-01240
Total number of active participants reported on line 7a of the Form 55002009-03-01258
Number of retired or separated participants receiving benefits2009-03-011
Number of other retired or separated participants entitled to future benefits2009-03-010
Total of all active and inactive participants2009-03-01259
2008: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2008 401k membership
Total participants, beginning-of-year2008-03-01241
Total number of active participants reported on line 7a of the Form 55002008-03-01239
Number of retired or separated participants receiving benefits2008-03-011
Number of other retired or separated participants entitled to future benefits2008-03-010
Total of all active and inactive participants2008-03-01240
2007: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2007 401k membership
Total participants, beginning-of-year2007-03-01193
Total number of active participants reported on line 7a of the Form 55002007-03-01239
Number of retired or separated participants receiving benefits2007-03-012
Number of other retired or separated participants entitled to future benefits2007-03-010
Total of all active and inactive participants2007-03-01241
2006: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2006 401k membership
Total participants, beginning-of-year2006-03-01182
Total number of active participants reported on line 7a of the Form 55002006-03-01192
Number of retired or separated participants receiving benefits2006-03-011
Number of other retired or separated participants entitled to future benefits2006-03-010
Total of all active and inactive participants2006-03-01193
2005: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2005 401k membership
Total participants, beginning-of-year2005-03-01159
Total number of active participants reported on line 7a of the Form 55002005-03-01181
Number of retired or separated participants receiving benefits2005-03-011
Number of other retired or separated participants entitled to future benefits2005-03-010
Total of all active and inactive participants2005-03-01182
2004: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2004 401k membership
Total participants, beginning-of-year2004-03-01153
Total number of active participants reported on line 7a of the Form 55002004-03-01154
Number of retired or separated participants receiving benefits2004-03-015
Number of other retired or separated participants entitled to future benefits2004-03-010
Total of all active and inactive participants2004-03-01159
2003: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2003 401k membership
Total participants, beginning-of-year2003-03-01144
Total number of active participants reported on line 7a of the Form 55002003-03-01147
Number of retired or separated participants receiving benefits2003-03-016
Number of other retired or separated participants entitled to future benefits2003-03-010
Total of all active and inactive participants2003-03-01153
2002: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2002 401k membership
Total participants, beginning-of-year2002-03-01106
Total number of active participants reported on line 7a of the Form 55002002-03-01140
Number of retired or separated participants receiving benefits2002-03-014
Number of other retired or separated participants entitled to future benefits2002-03-010
Total of all active and inactive participants2002-03-01144

Form 5500 Responses for OPTIMUS HEALTH CARE, INC. DENTAL PLAN

2022: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2022 form 5500 responses
2022-07-01Type of plan entitySingle employer plan
2022-07-01Submission has been amendedNo
2022-07-01This submission is the final filingNo
2022-07-01This return/report is a short plan year return/report (less than 12 months)No
2022-07-01Plan is a collectively bargained planNo
2022-07-01Plan funding arrangement – General assets of the sponsorYes
2022-07-01Plan benefit arrangement – General assets of the sponsorYes
2021: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Submission has been amendedNo
2021-07-01This submission is the final filingNo
2021-07-01This return/report is a short plan year return/report (less than 12 months)No
2021-07-01Plan is a collectively bargained planNo
2021-07-01Plan funding arrangement – General assets of the sponsorYes
2021-07-01Plan benefit arrangement – General assets of the sponsorYes
2020: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Submission has been amendedNo
2020-07-01This submission is the final filingNo
2020-07-01This return/report is a short plan year return/report (less than 12 months)No
2020-07-01Plan is a collectively bargained planNo
2020-07-01Plan funding arrangement – General assets of the sponsorYes
2020-07-01Plan benefit arrangement – General assets of the sponsorYes
2019: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Submission has been amendedNo
2019-07-01This submission is the final filingNo
2019-07-01This return/report is a short plan year return/report (less than 12 months)No
2019-07-01Plan is a collectively bargained planNo
2019-07-01Plan funding arrangement – General assets of the sponsorYes
2019-07-01Plan benefit arrangement – General assets of the sponsorYes
2018: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Submission has been amendedNo
2018-07-01This submission is the final filingNo
2018-07-01This return/report is a short plan year return/report (less than 12 months)No
2018-07-01Plan is a collectively bargained planNo
2018-07-01Plan funding arrangement – General assets of the sponsorYes
2018-07-01Plan benefit arrangement – General assets of the sponsorYes
2017: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Submission has been amendedNo
2017-07-01This submission is the final filingNo
2017-07-01This return/report is a short plan year return/report (less than 12 months)No
2017-07-01Plan is a collectively bargained planNo
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan funding arrangement – General assets of the sponsorYes
2017-07-01Plan benefit arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – General assets of the sponsorYes
2016: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Submission has been amendedNo
2016-07-01This submission is the final filingNo
2016-07-01This return/report is a short plan year return/report (less than 12 months)No
2016-07-01Plan is a collectively bargained planNo
2016-07-01Plan funding arrangement – General assets of the sponsorYes
2016-07-01Plan benefit arrangement – General assets of the sponsorYes
2015: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01Submission has been amendedNo
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)No
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – General assets of the sponsorYes
2015-07-01Plan benefit arrangement – General assets of the sponsorYes
2014: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2014 form 5500 responses
2014-07-01Type of plan entitySingle employer plan
2014-07-01Submission has been amendedNo
2014-07-01This submission is the final filingNo
2014-07-01This return/report is a short plan year return/report (less than 12 months)No
2014-07-01Plan is a collectively bargained planNo
2014-07-01Plan funding arrangement – General assets of the sponsorYes
2014-07-01Plan benefit arrangement – General assets of the sponsorYes
2013: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2013 form 5500 responses
2013-07-01Type of plan entitySingle employer plan
2013-07-01Submission has been amendedNo
2013-07-01This submission is the final filingNo
2013-07-01This return/report is a short plan year return/report (less than 12 months)No
2013-07-01Plan is a collectively bargained planNo
2013-07-01Plan funding arrangement – General assets of the sponsorYes
2013-07-01Plan benefit arrangement – General assets of the sponsorYes
2012: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2012 form 5500 responses
2012-07-01Type of plan entitySingle employer plan
2012-07-01Submission has been amendedNo
2012-07-01This submission is the final filingNo
2012-07-01This return/report is a short plan year return/report (less than 12 months)No
2012-07-01Plan is a collectively bargained planNo
2012-07-01Plan funding arrangement – General assets of the sponsorYes
2012-07-01Plan benefit arrangement – General assets of the sponsorYes
2012-03-01Type of plan entitySingle employer plan
2012-03-01Submission has been amendedNo
2012-03-01This submission is the final filingNo
2012-03-01This return/report is a short plan year return/report (less than 12 months)Yes
2012-03-01Plan is a collectively bargained planNo
2012-03-01Plan funding arrangement – General assets of the sponsorYes
2012-03-01Plan benefit arrangement – General assets of the sponsorYes
2011: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2011 form 5500 responses
2011-03-01Type of plan entitySingle employer plan
2011-03-01Submission has been amendedNo
2011-03-01This submission is the final filingNo
2011-03-01This return/report is a short plan year return/report (less than 12 months)No
2011-03-01Plan is a collectively bargained planNo
2011-03-01Plan funding arrangement – General assets of the sponsorYes
2011-03-01Plan benefit arrangement – General assets of the sponsorYes
2009: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2009 form 5500 responses
2009-03-01Type of plan entitySingle employer plan
2009-03-01Submission has been amendedNo
2009-03-01This submission is the final filingNo
2009-03-01This return/report is a short plan year return/report (less than 12 months)No
2009-03-01Plan is a collectively bargained planNo
2009-03-01Plan funding arrangement – General assets of the sponsorYes
2009-03-01Plan benefit arrangement – General assets of the sponsorYes
2008: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2008 form 5500 responses
2008-03-01Type of plan entitySingle employer plan
2008-03-01Submission has been amendedNo
2008-03-01This submission is the final filingNo
2008-03-01This return/report is a short plan year return/report (less than 12 months)No
2008-03-01Plan is a collectively bargained planNo
2008-03-01Plan funding arrangement – General assets of the sponsorYes
2008-03-01Plan benefit arrangement – General assets of the sponsorYes
2007: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2007 form 5500 responses
2007-03-01Type of plan entitySingle employer plan
2007-03-01Submission has been amendedNo
2007-03-01This submission is the final filingNo
2007-03-01This return/report is a short plan year return/report (less than 12 months)No
2007-03-01Plan is a collectively bargained planNo
2007-03-01Plan funding arrangement – General assets of the sponsorYes
2007-03-01Plan benefit arrangement – General assets of the sponsorYes
2006: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2006 form 5500 responses
2006-03-01Type of plan entitySingle employer plan
2006-03-01Submission has been amendedNo
2006-03-01This submission is the final filingNo
2006-03-01This return/report is a short plan year return/report (less than 12 months)No
2006-03-01Plan is a collectively bargained planNo
2006-03-01Plan funding arrangement – General assets of the sponsorYes
2006-03-01Plan benefit arrangement – General assets of the sponsorYes
2005: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2005 form 5500 responses
2005-03-01Type of plan entitySingle employer plan
2005-03-01Submission has been amendedNo
2005-03-01This submission is the final filingNo
2005-03-01This return/report is a short plan year return/report (less than 12 months)No
2005-03-01Plan is a collectively bargained planNo
2005-03-01Plan funding arrangement – General assets of the sponsorYes
2005-03-01Plan benefit arrangement – General assets of the sponsorYes
2004: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2004 form 5500 responses
2004-03-01Type of plan entitySingle employer plan
2004-03-01Submission has been amendedNo
2004-03-01This submission is the final filingNo
2004-03-01This return/report is a short plan year return/report (less than 12 months)No
2004-03-01Plan is a collectively bargained planNo
2004-03-01Plan funding arrangement – General assets of the sponsorYes
2004-03-01Plan benefit arrangement – General assets of the sponsorYes
2003: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2003 form 5500 responses
2003-03-01Type of plan entitySingle employer plan
2003-03-01Submission has been amendedNo
2003-03-01This submission is the final filingNo
2003-03-01This return/report is a short plan year return/report (less than 12 months)No
2003-03-01Plan is a collectively bargained planNo
2003-03-01Plan funding arrangement – General assets of the sponsorYes
2003-03-01Plan benefit arrangement – General assets of the sponsorYes
2002: OPTIMUS HEALTH CARE, INC. DENTAL PLAN 2002 form 5500 responses
2002-03-01Type of plan entitySingle employer plan
2002-03-01First time form 5500 has been submittedYes
2002-03-01Submission has been amendedNo
2002-03-01This submission is the final filingNo
2002-03-01This return/report is a short plan year return/report (less than 12 months)No
2002-03-01Plan is a collectively bargained planNo
2002-03-01Plan funding arrangement – General assets of the sponsorYes
2002-03-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00321838
Policy instance 1
Insurance contract or identification number00321838
Number of Individuals Covered360
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $4,057
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 $16,764
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 number321838
Policy instance 1
Insurance contract or identification number321838
Number of Individuals Covered261
Insurance policy start date2015-07-01
Insurance policy end date2016-06-30
Total amount of commissions paid to insurance brokerUSD $5,279
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 $20,949
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,279
Insurance broker organization code?3
Insurance broker nameSCHAEFER FINANCIAL GROUP, INC.
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number321838
Policy instance 1
Insurance contract or identification number321838
Number of Individuals Covered262
Insurance policy start date2014-07-01
Insurance policy end date2015-06-30
Total amount of commissions paid to insurance brokerUSD $4,419
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 $17,535
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,419
Insurance broker organization code?3
Insurance broker nameSCHAEFER FINANCIAL GROUP, INC.
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberKC399
Policy instance 1
Insurance contract or identification numberKC399
Number of Individuals Covered257
Insurance policy start date2013-07-01
Insurance policy end date2014-06-30
Total amount of commissions paid to insurance brokerUSD $5,029
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 $19,958
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,029
Insurance broker organization code?3
Insurance broker nameBLUEPOINT FINANCIAL GROUP, INC.
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract numberKC399
Policy instance 1
Insurance contract or identification numberKC399
Number of Individuals Covered256
Insurance policy start date2012-07-01
Insurance policy end date2013-06-30
Total amount of commissions paid to insurance brokerUSD $4,355
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 $17,386
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,355
Insurance broker organization code?3
Insurance broker nameSCHAEFER FINANCIAL GROUP, INC.

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