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HEALTHCARE ALTERNATIVE SYSTEMS 401k Plan overview

Plan NameHEALTHCARE ALTERNATIVE SYSTEMS
Plan identification number 501

HEALTHCARE ALTERNATIVE SYSTEMS Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Dental

401k Sponsoring company profile

HEALTHCARE ALTERNATIVE SYSTEMS, INC. has sponsored the creation of one or more 401k plans.

Company Name:HEALTHCARE ALTERNATIVE SYSTEMS, INC.
Employer identification number (EIN):237432930
NAIC Classification:624200

Form 5500 Filing Information

Submission information for form 5500 for 401k plan HEALTHCARE ALTERNATIVE SYSTEMS

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012015-07-01MANUEL GARCIA
5012015-07-01MANUEL GARCIA
5012014-07-01MANUEL GARCIA
5012013-07-01MANUEL GARCIA
5012012-07-01MANUEL GARCIA MANUEL GARCIA2015-10-21
5012011-07-01MANUEL GARCIA
5012010-07-01MANUEL GARCIA
5012009-07-01MANUEL GARCIA
5012008-07-01MANUEL GARCIA
5012007-07-01MANUEL GARCIA

Plan Statistics for HEALTHCARE ALTERNATIVE SYSTEMS

401k plan membership statisitcs for HEALTHCARE ALTERNATIVE SYSTEMS

Measure Date Value
2015: HEALTHCARE ALTERNATIVE SYSTEMS 2015 401k membership
Total participants, beginning-of-year2015-07-0161
Total number of active participants reported on line 7a of the Form 55002015-07-0161
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 participants2015-07-0161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-07-010
Total participants2015-07-0161
Number of participants with account balances2015-07-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-07-010
Number of employers contributing to the scheme2015-07-010
2014: HEALTHCARE ALTERNATIVE SYSTEMS 2014 401k membership
Total participants, beginning-of-year2014-07-0158
Total number of active participants reported on line 7a of the Form 55002014-07-0161
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 participants2014-07-0161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-07-010
Total participants2014-07-0161
Number of participants with account balances2014-07-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-07-010
Number of employers contributing to the scheme2014-07-010
2013: HEALTHCARE ALTERNATIVE SYSTEMS 2013 401k membership
Total participants, beginning-of-year2013-07-0157
Total number of active participants reported on line 7a of the Form 55002013-07-0158
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 participants2013-07-0158
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-07-010
Total participants2013-07-0158
Number of participants with account balances2013-07-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-07-010
Number of employers contributing to the scheme2013-07-010
2012: HEALTHCARE ALTERNATIVE SYSTEMS 2012 401k membership
Total participants, beginning-of-year2012-07-0164
Total number of active participants reported on line 7a of the Form 55002012-07-0157
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 participants2012-07-0157
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-07-010
Total participants2012-07-0157
Number of participants with account balances2012-07-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-07-010
Number of employers contributing to the scheme2012-07-010
2011: HEALTHCARE ALTERNATIVE SYSTEMS 2011 401k membership
Total participants, beginning-of-year2011-07-0160
Total number of active participants reported on line 7a of the Form 55002011-07-0164
Number of retired or separated participants receiving benefits2011-07-010
Number of other retired or separated participants entitled to future benefits2011-07-010
Total of all active and inactive participants2011-07-0164
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-07-010
Total participants2011-07-0164
Number of participants with account balances2011-07-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-07-010
Number of employers contributing to the scheme2011-07-010
2010: HEALTHCARE ALTERNATIVE SYSTEMS 2010 401k membership
Total participants, beginning-of-year2010-07-0162
Total number of active participants reported on line 7a of the Form 55002010-07-0160
Number of retired or separated participants receiving benefits2010-07-010
Number of other retired or separated participants entitled to future benefits2010-07-010
Total of all active and inactive participants2010-07-0160
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-07-010
Total participants2010-07-0160
Number of participants with account balances2010-07-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-07-010
Number of employers contributing to the scheme2010-07-010
2009: HEALTHCARE ALTERNATIVE SYSTEMS 2009 401k membership
Total participants, beginning-of-year2009-07-0171
Total number of active participants reported on line 7a of the Form 55002009-07-0162
Number of retired or separated participants receiving benefits2009-07-010
Number of other retired or separated participants entitled to future benefits2009-07-010
Total of all active and inactive participants2009-07-0162
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-07-010
Total participants2009-07-0162
Number of participants with account balances2009-07-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-07-010
Number of employers contributing to the scheme2009-07-010
2008: HEALTHCARE ALTERNATIVE SYSTEMS 2008 401k membership
Total participants, beginning-of-year2008-07-0182
Total number of active participants reported on line 7a of the Form 55002008-07-0171
Number of retired or separated participants receiving benefits2008-07-010
Number of other retired or separated participants entitled to future benefits2008-07-010
Total of all active and inactive participants2008-07-0171
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2008-07-010
Total participants2008-07-0171
Number of participants with account balances2008-07-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2008-07-010
Number of employers contributing to the scheme2008-07-010
2007: HEALTHCARE ALTERNATIVE SYSTEMS 2007 401k membership
Total participants, beginning-of-year2007-07-0178
Total number of active participants reported on line 7a of the Form 55002007-07-0182
Number of retired or separated participants receiving benefits2007-07-010
Number of other retired or separated participants entitled to future benefits2007-07-010
Total of all active and inactive participants2007-07-0182
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2007-07-010
Total participants2007-07-0182
Number of participants with account balances2007-07-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2007-07-010
Number of employers contributing to the scheme2007-07-010

Financial Data on HEALTHCARE ALTERNATIVE SYSTEMS

Measure Date Value
2015 : HEALTHCARE ALTERNATIVE SYSTEMS 2015 401k financial data
Transfers to/from the plan2015-07-31$0
Total plan liabilities at end of year2015-07-31$0
Total plan liabilities at beginning of year2015-07-31$0
Total income from all sources2015-07-31$23,451
Expenses. Total of all expenses incurred2015-07-31$1,107
Benefits paid (including direct rollovers)2015-07-31$0
Total plan assets at end of year2015-07-31$22,344
Total plan assets at beginning of year2015-07-31$0
Total contributions received or receivable from participants2015-07-31$11,183
Expenses. Other expenses not covered elsewhere2015-07-31$0
Contributions received from other sources (not participants or employers)2015-07-31$0
Other income received2015-07-31$0
Noncash contributions received2015-07-31$0
Net income (gross income less expenses)2015-07-31$22,344
Net plan assets at end of year (total assets less liabilities)2015-07-31$22,344
Net plan assets at beginning of year (total assets less liabilities)2015-07-31$0
Total contributions received or receivable from employer(s)2015-07-31$12,268
Value of certain deemed distributions of participant loans2015-07-31$0
Value of corrective distributions2015-07-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2015-07-31$1,107
Transfers to/from the plan2015-06-30$0
Total plan liabilities at end of year2015-06-30$0
Total plan liabilities at beginning of year2015-06-30$0
Total income from all sources2015-06-30$62,021
Expenses. Total of all expenses incurred2015-06-30$2,453
Benefits paid (including direct rollovers)2015-06-30$0
Total plan assets at end of year2015-06-30$59,568
Total contributions received or receivable from participants2015-06-30$29,312
Expenses. Other expenses not covered elsewhere2015-06-30$0
Contributions received from other sources (not participants or employers)2015-06-30$0
Other income received2015-06-30$0
Noncash contributions received2015-06-30$0
Net income (gross income less expenses)2015-06-30$59,568
Net plan assets at end of year (total assets less liabilities)2015-06-30$59,568
Net plan assets at beginning of year (total assets less liabilities)2015-06-30$0
Total contributions received or receivable from employer(s)2015-06-30$32,709
Value of certain deemed distributions of participant loans2015-06-30$0
Value of corrective distributions2015-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2015-06-30$2,453
2014 : HEALTHCARE ALTERNATIVE SYSTEMS 2014 401k financial data
Transfers to/from the plan2014-06-30$0
Total plan liabilities at end of year2014-06-30$0
Total plan liabilities at beginning of year2014-06-30$0
Total income from all sources2014-06-30$52,863
Expenses. Total of all expenses incurred2014-06-30$1,801
Benefits paid (including direct rollovers)2014-06-30$0
Total plan assets at end of year2014-06-30$51,062
Total plan assets at beginning of year2014-06-30$0
Total contributions received or receivable from participants2014-06-30$26,586
Expenses. Other expenses not covered elsewhere2014-06-30$0
Contributions received from other sources (not participants or employers)2014-06-30$0
Other income received2014-06-30$0
Noncash contributions received2014-06-30$0
Net income (gross income less expenses)2014-06-30$51,062
Net plan assets at end of year (total assets less liabilities)2014-06-30$51,062
Net plan assets at beginning of year (total assets less liabilities)2014-06-30$0
Total contributions received or receivable from employer(s)2014-06-30$26,277
Value of certain deemed distributions of participant loans2014-06-30$0
Value of corrective distributions2014-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2014-06-30$1,801
2013 : HEALTHCARE ALTERNATIVE SYSTEMS 2013 401k financial data
Transfers to/from the plan2013-06-30$0
Total plan liabilities at end of year2013-06-30$0
Total plan liabilities at beginning of year2013-06-30$0
Total income from all sources2013-06-30$54,858
Expenses. Total of all expenses incurred2013-06-30$2,161
Benefits paid (including direct rollovers)2013-06-30$0
Total plan assets at end of year2013-06-30$0
Total plan assets at beginning of year2013-06-30$0
Total contributions received or receivable from participants2013-06-30$26,070
Expenses. Other expenses not covered elsewhere2013-06-30$0
Contributions received from other sources (not participants or employers)2013-06-30$0
Other income received2013-06-30$0
Noncash contributions received2013-06-30$0
Net income (gross income less expenses)2013-06-30$52,697
Net plan assets at end of year (total assets less liabilities)2013-06-30$0
Net plan assets at beginning of year (total assets less liabilities)2013-06-30$0
Total contributions received or receivable from employer(s)2013-06-30$28,788
Value of certain deemed distributions of participant loans2013-06-30$0
Value of corrective distributions2013-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2013-06-30$2,161
2012 : HEALTHCARE ALTERNATIVE SYSTEMS 2012 401k financial data
Transfers to/from the plan2012-06-30$0
Total plan liabilities at end of year2012-06-30$0
Total plan liabilities at beginning of year2012-06-30$0
Total income from all sources2012-06-30$47,143
Expenses. Total of all expenses incurred2012-06-30$1,968
Benefits paid (including direct rollovers)2012-06-30$0
Total plan assets at end of year2012-06-30$0
Total plan assets at beginning of year2012-06-30$0
Total contributions received or receivable from participants2012-06-30$23,151
Expenses. Other expenses not covered elsewhere2012-06-30$0
Contributions received from other sources (not participants or employers)2012-06-30$0
Other income received2012-06-30$0
Noncash contributions received2012-06-30$0
Net income (gross income less expenses)2012-06-30$45,175
Net plan assets at end of year (total assets less liabilities)2012-06-30$0
Net plan assets at beginning of year (total assets less liabilities)2012-06-30$0
Total contributions received or receivable from employer(s)2012-06-30$23,992
Value of certain deemed distributions of participant loans2012-06-30$0
Value of corrective distributions2012-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2012-06-30$1,968
2011 : HEALTHCARE ALTERNATIVE SYSTEMS 2011 401k financial data
Transfers to/from the plan2011-06-30$0
Total plan liabilities at end of year2011-06-30$0
Total plan liabilities at beginning of year2011-06-30$0
Total income from all sources2011-06-30$54,296
Expenses. Total of all expenses incurred2011-06-30$1,757
Benefits paid (including direct rollovers)2011-06-30$0
Total plan assets at end of year2011-06-30$0
Total plan assets at beginning of year2011-06-30$0
Total contributions received or receivable from participants2011-06-30$28,602
Expenses. Other expenses not covered elsewhere2011-06-30$0
Contributions received from other sources (not participants or employers)2011-06-30$0
Other income received2011-06-30$0
Noncash contributions received2011-06-30$0
Net income (gross income less expenses)2011-06-30$52,539
Net plan assets at end of year (total assets less liabilities)2011-06-30$0
Net plan assets at beginning of year (total assets less liabilities)2011-06-30$0
Total contributions received or receivable from employer(s)2011-06-30$25,694
Value of certain deemed distributions of participant loans2011-06-30$0
Value of corrective distributions2011-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2011-06-30$1,757
2010 : HEALTHCARE ALTERNATIVE SYSTEMS 2010 401k financial data
Transfers to/from the plan2010-06-30$0
Total plan liabilities at end of year2010-06-30$0
Total plan liabilities at beginning of year2010-06-30$0
Total income from all sources2010-06-30$61,076
Expenses. Total of all expenses incurred2010-06-30$2,371
Benefits paid (including direct rollovers)2010-06-30$0
Total plan assets at end of year2010-06-30$0
Total plan assets at beginning of year2010-06-30$0
Total contributions received or receivable from participants2010-06-30$31,682
Expenses. Other expenses not covered elsewhere2010-06-30$0
Contributions received from other sources (not participants or employers)2010-06-30$0
Other income received2010-06-30$0
Noncash contributions received2010-06-30$0
Net income (gross income less expenses)2010-06-30$58,705
Net plan assets at end of year (total assets less liabilities)2010-06-30$0
Net plan assets at beginning of year (total assets less liabilities)2010-06-30$0
Total contributions received or receivable from employer(s)2010-06-30$29,394
Value of certain deemed distributions of participant loans2010-06-30$0
Value of corrective distributions2010-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2010-06-30$2,371
2009 : HEALTHCARE ALTERNATIVE SYSTEMS 2009 401k financial data
Transfers to/from the plan2009-06-30$0
Total plan liabilities at end of year2009-06-30$0
Total plan liabilities at beginning of year2009-06-30$0
Total income from all sources2009-06-30$59,566
Expenses. Total of all expenses incurred2009-06-30$2,316
Benefits paid (including direct rollovers)2009-06-30$0
Total plan assets at end of year2009-06-30$0
Total plan assets at beginning of year2009-06-30$0
Total contributions received or receivable from participants2009-06-30$28,685
Expenses. Other expenses not covered elsewhere2009-06-30$0
Contributions received from other sources (not participants or employers)2009-06-30$0
Other income received2009-06-30$0
Noncash contributions received2009-06-30$0
Net income (gross income less expenses)2009-06-30$57,250
Net plan assets at end of year (total assets less liabilities)2009-06-30$0
Net plan assets at beginning of year (total assets less liabilities)2009-06-30$0
Total contributions received or receivable from employer(s)2009-06-30$30,881
Value of certain deemed distributions of participant loans2009-06-30$0
Value of corrective distributions2009-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2009-06-30$2,316
2008 : HEALTHCARE ALTERNATIVE SYSTEMS 2008 401k financial data
Transfers to/from the plan2008-06-30$0
Total plan liabilities at end of year2008-06-30$0
Total plan liabilities at beginning of year2008-06-30$0
Total income from all sources2008-06-30$37,028
Expenses. Total of all expenses incurred2008-06-30$2,848
Benefits paid (including direct rollovers)2008-06-30$0
Total plan assets at end of year2008-06-30$0
Total plan assets at beginning of year2008-06-30$0
Total contributions received or receivable from participants2008-06-30$27,630
Expenses. Other expenses not covered elsewhere2008-06-30$0
Contributions received from other sources (not participants or employers)2008-06-30$0
Other income received2008-06-30$0
Noncash contributions received2008-06-30$0
Net income (gross income less expenses)2008-06-30$34,180
Net plan assets at end of year (total assets less liabilities)2008-06-30$0
Net plan assets at beginning of year (total assets less liabilities)2008-06-30$0
Total contributions received or receivable from employer(s)2008-06-30$9,398
Value of certain deemed distributions of participant loans2008-06-30$0
Value of corrective distributions2008-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2008-06-30$2,848

Form 5500 Responses for HEALTHCARE ALTERNATIVE SYSTEMS

2015: HEALTHCARE ALTERNATIVE SYSTEMS 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)Yes
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan benefit arrangement – InsuranceYes
2014: HEALTHCARE ALTERNATIVE SYSTEMS 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 – InsuranceYes
2014-07-01Plan benefit arrangement – InsuranceYes
2013: HEALTHCARE ALTERNATIVE SYSTEMS 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 – InsuranceYes
2013-07-01Plan benefit arrangement – InsuranceYes
2012: HEALTHCARE ALTERNATIVE SYSTEMS 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 – InsuranceYes
2012-07-01Plan benefit arrangement – InsuranceYes
2011: HEALTHCARE ALTERNATIVE SYSTEMS 2011 form 5500 responses
2011-07-01Type of plan entitySingle employer plan
2011-07-01Submission has been amendedNo
2011-07-01This submission is the final filingNo
2011-07-01This return/report is a short plan year return/report (less than 12 months)No
2011-07-01Plan is a collectively bargained planNo
2011-07-01Plan funding arrangement – InsuranceYes
2011-07-01Plan benefit arrangement – InsuranceYes
2010: HEALTHCARE ALTERNATIVE SYSTEMS 2010 form 5500 responses
2010-07-01Type of plan entitySingle employer plan
2010-07-01Submission has been amendedNo
2010-07-01This submission is the final filingNo
2010-07-01This return/report is a short plan year return/report (less than 12 months)No
2010-07-01Plan is a collectively bargained planNo
2010-07-01Plan funding arrangement – InsuranceYes
2010-07-01Plan benefit arrangement – InsuranceYes
2009: HEALTHCARE ALTERNATIVE SYSTEMS 2009 form 5500 responses
2009-07-01Type of plan entitySingle employer plan
2009-07-01Submission has been amendedNo
2009-07-01This submission is the final filingNo
2009-07-01This return/report is a short plan year return/report (less than 12 months)No
2009-07-01Plan is a collectively bargained planNo
2009-07-01Plan benefit arrangement – InsuranceYes
2008: HEALTHCARE ALTERNATIVE SYSTEMS 2008 form 5500 responses
2008-07-01Type of plan entitySingle employer plan
2008-07-01Submission has been amendedNo
2008-07-01This submission is the final filingNo
2008-07-01This return/report is a short plan year return/report (less than 12 months)No
2008-07-01Plan is a collectively bargained planNo
2008-07-01Plan benefit arrangement – InsuranceYes
2007: HEALTHCARE ALTERNATIVE SYSTEMS 2007 form 5500 responses
2007-07-01Type of plan entitySingle employer plan
2007-07-01Submission has been amendedNo
2007-07-01This submission is the final filingNo
2007-07-01This return/report is a short plan year return/report (less than 12 months)No
2007-07-01Plan is a collectively bargained planNo
2007-07-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

DELTA DENTAL OF ILLINOIS (National Association of Insurance Commissioners NAIC id number: 47589 )
Policy contract number10178
Policy instance 1
Insurance contract or identification number10178
Number of Individuals Covered61
Insurance policy start date2015-03-01
Insurance policy end date2015-07-31
Total amount of commissions paid to insurance brokerUSD $1,107
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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $755
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerNONE
Insurance broker organization code?1
Insurance broker nameBABBITT MUNICIPALITIES INC
DELTA DENTAL OF ILLINOIS (National Association of Insurance Commissioners NAIC id number: 47589 )
Policy contract number10178
Policy instance 1
Insurance contract or identification number10178
Number of Individuals Covered61
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Total amount of commissions paid to insurance brokerUSD $2,453
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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,453
Amount paid for insurance broker fees3
Additional information about fees paid to insurance brokerNONE
Insurance broker nameBABBITT MUNICIPALITIES INC
DELTA DENTAL OF ILLINOIS (National Association of Insurance Commissioners NAIC id number: 47589 )
Policy contract number10178
Policy instance 1
Insurance contract or identification number10178
Number of Individuals Covered58
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $1,801
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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,801
Amount paid for insurance broker fees3
Additional information about fees paid to insurance brokerNONE
Insurance broker nameBABBITT MUNICIPALITIES INC
DELTA DENTAL OF ILLINOIS (National Association of Insurance Commissioners NAIC id number: 47589 )
Policy contract number10178
Policy instance 1
Insurance contract or identification number10178
Number of Individuals Covered57
Insurance policy start date2012-03-01
Insurance policy end date2013-02-28
Total amount of commissions paid to insurance brokerUSD $2,161
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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $888
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerNONE
Insurance broker organization code?3
Insurance broker nameVISTA INSURANCE SOLUTIONS, INC
DELTA DENTAL OF ILLINOIS (National Association of Insurance Commissioners NAIC id number: 47589 )
Policy contract number10178
Policy instance 1
Insurance contract or identification number10178
Number of Individuals Covered64
Insurance policy start date2011-03-01
Insurance policy end date2012-02-29
Total amount of commissions paid to insurance brokerUSD $1,968
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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL OF ILLINOIS (National Association of Insurance Commissioners NAIC id number: 47589 )
Policy contract number10178
Policy instance 1
Insurance contract or identification number10178
Number of Individuals Covered60
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Total amount of commissions paid to insurance brokerUSD $1,757
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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,757
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerNONE
Insurance broker organization code?3
Insurance broker nameVISTA INSURANCE SOLUTIONS INC
DELTA DENTAL OF ILLINOIS (National Association of Insurance Commissioners NAIC id number: 47589 )
Policy contract number10178
Policy instance 1
Insurance contract or identification number10178
Number of Individuals Covered62
Insurance policy start date2009-03-01
Insurance policy end date2010-02-28
Total amount of commissions paid to insurance brokerUSD $2,371
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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,371
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerNONE
Insurance broker organization code?3
Insurance broker nameVISTA INSURANCE SOLUTIONS INC
DELTA DENTAL OF ILLINOIS (National Association of Insurance Commissioners NAIC id number: 47589 )
Policy contract number10178
Policy instance 1
Insurance contract or identification number10178
Number of Individuals Covered71
Insurance policy start date2008-03-01
Insurance policy end date2009-02-28
Total amount of commissions paid to insurance brokerUSD $2,316
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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,168
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerNONE
Insurance broker organization code?3
Insurance broker nameTHE BENEFIT SOURCE
DELTA DENTAL OF ILLINOIS (National Association of Insurance Commissioners NAIC id number: 47589 )
Policy contract number10178
Policy instance 1
Insurance contract or identification number10178
Number of Individuals Covered82
Insurance policy start date2007-03-01
Insurance policy end date2008-02-28
Total amount of commissions paid to insurance brokerUSD $2,848
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 $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,848
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerNONE
Insurance broker organization code?3
Insurance broker nameTHE BENEFIT SOURCE

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