401k Plan data: D'ADDARIO & CO. INC. (DENTAL) plan

D'ADDARIO & CO. INC. (DENTAL) 401k Plan overview

Plan Name	D'ADDARIO & CO. INC. (DENTAL)
Plan identification number	506

D'ADDARIO & CO. INC. (DENTAL) Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Dental

401k Sponsoring company profile

D'ADDARIO & COMPANY, INC. has sponsored the creation of one or more 401k plans.

Company Name: D'ADDARIO & COMPANY, INC.

Employer identification number (EIN): 112288999

NAIC Classification: 524140

Form 5500 Filing Information

Submission information for form 5500 for 401k plan D'ADDARIO & CO. INC. (DENTAL)

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
506 2015-01-01 RAY IRIZARRY JOHN BURKE JR 2016-10-17
506 2014-01-01 RAY IRIZARRY ROB DODARO 2015-07-23
506 2013-01-01 RAY IRIZARRY

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
506	2015-01-01	RAY IRIZARRY	JOHN BURKE JR	2016-10-17
506	2014-01-01	RAY IRIZARRY	ROB DODARO	2015-07-23
506	2013-01-01	RAY IRIZARRY

Plan Statistics for D'ADDARIO & CO. INC. (DENTAL)

401k plan membership statisitcs for D'ADDARIO & CO. INC. (DENTAL)

Measure Date Value
2015: D'ADDARIO & CO. INC. (DENTAL) 2015 401k membership
Total participants, beginning-of-year 2015-01-01 618
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 0
Total of all active and inactive participants 2015-01-01 0
2014: D'ADDARIO & CO. INC. (DENTAL) 2014 401k membership
Total participants, beginning-of-year 2014-01-01 575
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 618
Total of all active and inactive participants 2014-01-01 618
2013: D'ADDARIO & CO. INC. (DENTAL) 2013 401k membership
Total participants, beginning-of-year 2013-01-01 572
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 575
Total of all active and inactive participants 2013-01-01 575

Measure	Date	Value
2015: D'ADDARIO & CO. INC. (DENTAL) 2015 401k membership
Total participants, beginning-of-year	2015-01-01	618
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	0
Total of all active and inactive participants	2015-01-01	0
2014: D'ADDARIO & CO. INC. (DENTAL) 2014 401k membership
Total participants, beginning-of-year	2014-01-01	575
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	618
Total of all active and inactive participants	2014-01-01	618
2013: D'ADDARIO & CO. INC. (DENTAL) 2013 401k membership
Total participants, beginning-of-year	2013-01-01	572
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	575
Total of all active and inactive participants	2013-01-01	575

Form 5500 Responses for D'ADDARIO & CO. INC. (DENTAL)

2015: D'ADDARIO & CO. INC. (DENTAL) 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	This submission is the final filing	Yes
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2014: D'ADDARIO & CO. INC. (DENTAL) 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: D'ADDARIO & CO. INC. (DENTAL) 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

808873

Policy instance

Insurance contract or identification number	808873
Number of Individuals Covered	328
Insurance policy start date	2014-12-01
Insurance policy end date	2015-11-30
Total amount of commissions paid to insurance broker	USD $16,160
Total amount of fees paid to insurance company	USD $0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $175,746
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $16,160
Additional information about fees paid to insurance broker	COMMISSIONS PAID TO AGENTS AND BROKERS
Insurance broker organization code?	3
Insurance broker name	GALLAGHER BENEFIT SERVICES INC

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

808873

Policy instance

Insurance contract or identification number	808873
Number of Individuals Covered	618
Insurance policy start date	2013-12-01
Insurance policy end date	2014-11-30
Total amount of commissions paid to insurance broker	USD $15,600
Total amount of fees paid to insurance company	USD $4,075
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $170,280
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $15,600
Insurance broker organization code?	3
Amount paid for insurance broker fees	4075
Additional information about fees paid to insurance broker	2013/2014 MM P3 BONUS
Insurance broker name	GALLAGHER BENEFIT SERVICES INC

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

808873

Policy instance

Insurance contract or identification number	808873
Number of Individuals Covered	575
Insurance policy start date	2012-12-01
Insurance policy end date	2013-11-30
Total amount of commissions paid to insurance broker	USD $14,810
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Dental Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $160,867
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,810
Insurance broker organization code?	3
Insurance broker name	GALLAGHER BENEFIT SERVICES INC

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Company Name:	D'ADDARIO & COMPANY, INC.
Employer identification number (EIN):	112288999
NAIC Classification:	524140