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DENTISTRY FOR CHILDREN DENTAL MEDICAL AND VISION PLAN 401k Plan overview

Plan NameDENTISTRY FOR CHILDREN DENTAL MEDICAL AND VISION PLAN
Plan identification number 502

DENTISTRY FOR CHILDREN DENTAL MEDICAL AND VISION PLAN Benefits

401k Plan Type
Plan Features/Benefits

    401k Sponsoring company profile

    D4C DENTAL BRANDS, INC. has sponsored the creation of one or more 401k plans.

    Company Name:D4C DENTAL BRANDS, INC.
    Employer identification number (EIN):273864352
    NAIC Classification:621111
    NAIC Description:Offices of Physicians (except Mental Health Specialists)

    Additional information about D4C DENTAL BRANDS, INC.

    Jurisdiction of Incorporation: State of Delaware Division of Corporations
    Incorporation Date:
    Company Identification Number: 4892700

    More information about D4C DENTAL BRANDS, INC.

    Form 5500 Filing Information

    Submission information for form 5500 for 401k plan DENTISTRY FOR CHILDREN DENTAL MEDICAL AND VISION PLAN

    Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
    5022016-01-01ALISTAIR MADLE
    5022015-01-01ALISTAIR MADLE
    5022014-06-01ALISTAIR MADLE
    5022013-06-01JEFFREY BATZEL
    5022012-06-01STEVEN E. RUSSELL
    5022011-06-01STEVEN E. RUSSEU

    Plan Statistics for DENTISTRY FOR CHILDREN DENTAL MEDICAL AND VISION PLAN

    401k plan membership statisitcs for DENTISTRY FOR CHILDREN DENTAL MEDICAL AND VISION PLAN

    Measure Date Value
    2016
    Total participants, beginning-of-year2016-01-01281
    Total number of active participants reported on line 7a of the Form 55002016-01-010
    Number of retired or separated participants receiving benefits2016-01-010
    Total of all active and inactive participants2016-01-010
    2015
    Total participants, beginning-of-year2015-01-01251
    Total number of active participants reported on line 7a of the Form 55002015-01-01279
    Number of retired or separated participants receiving benefits2015-01-012
    Total of all active and inactive participants2015-01-01281
    2014
    Total participants, beginning-of-year2014-06-01261
    Total number of active participants reported on line 7a of the Form 55002014-06-01249
    Number of retired or separated participants receiving benefits2014-06-012
    Total of all active and inactive participants2014-06-01251
    2013
    Total participants, beginning-of-year2013-06-01266
    Total number of active participants reported on line 7a of the Form 55002013-06-01750
    Total of all active and inactive participants2013-06-01750
    2012
    Total participants, beginning-of-year2012-06-01261
    Total number of active participants reported on line 7a of the Form 55002012-06-01266
    Number of retired or separated participants receiving benefits2012-06-010
    Number of other retired or separated participants entitled to future benefits2012-06-010
    Total of all active and inactive participants2012-06-01266
    2011
    Total participants, beginning-of-year2011-06-01100
    Total number of active participants reported on line 7a of the Form 55002011-06-01261
    Number of retired or separated participants receiving benefits2011-06-010
    Number of other retired or separated participants entitled to future benefits2011-06-010
    Total of all active and inactive participants2011-06-01261

    Form 5500 Responses

    2016
    2016-01-01Type of plan entitySingle employer plan
    2016-01-01Submission has been amendedNo
    2016-01-01This submission is the final filingYes
    2016-01-01This return/report is a short plan year return/report (less than 12 months)Yes
    2016-01-01Plan is a collectively bargained planNo
    2016-01-01Plan funding arrangement – InsuranceYes
    2016-01-01Plan benefit arrangement – InsuranceYes
    2015
    2015-01-01Type of plan entitySingle employer plan
    2015-01-01Submission has been amendedNo
    2015-01-01This submission is the final filingNo
    2015-01-01This return/report is a short plan year return/report (less than 12 months)No
    2015-01-01Plan is a collectively bargained planNo
    2015-01-01Plan funding arrangement – InsuranceYes
    2015-01-01Plan benefit arrangement – InsuranceYes
    2014
    2014-06-01Type of plan entitySingle employer plan
    2014-06-01Submission has been amendedNo
    2014-06-01This submission is the final filingNo
    2014-06-01This return/report is a short plan year return/report (less than 12 months)Yes
    2014-06-01Plan is a collectively bargained planNo
    2014-06-01Plan funding arrangement – InsuranceYes
    2014-06-01Plan benefit arrangement – InsuranceYes
    2013
    2013-06-01Type of plan entitySingle employer plan
    2013-06-01Submission has been amendedNo
    2013-06-01This submission is the final filingNo
    2013-06-01This return/report is a short plan year return/report (less than 12 months)No
    2013-06-01Plan is a collectively bargained planNo
    2013-06-01Plan funding arrangement – InsuranceYes
    2013-06-01Plan benefit arrangement – InsuranceYes
    2012
    2012-06-01Type of plan entityMulitple employer plan
    2012-06-01Submission has been amendedNo
    2012-06-01This submission is the final filingNo
    2012-06-01This return/report is a short plan year return/report (less than 12 months)No
    2012-06-01Plan is a collectively bargained planNo
    2012-06-01Plan funding arrangement – InsuranceYes
    2012-06-01Plan benefit arrangement – InsuranceYes
    2011
    2011-06-01Type of plan entityMulitple employer plan
    2011-06-01First time form 5500 has been submittedYes
    2011-06-01Submission has been amendedNo
    2011-06-01This submission is the final filingNo
    2011-06-01This return/report is a short plan year return/report (less than 12 months)No
    2011-06-01Plan is a collectively bargained planNo
    2011-06-01Plan funding arrangement – InsuranceYes
    2011-06-01Plan benefit arrangement – InsuranceYes

    Insurance Providers Used on plan

    AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
    Policy contract number835078
    Policy instance 1
    Insurance contract or identification number835078
    Number of Individuals Covered671
    Insurance policy start date2016-01-01
    Insurance policy end date2016-03-31
    Total amount of commissions paid to insurance brokerUSD $4,970
    Total amount of fees paid to insurance companyUSD $0
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $150,066
    Commission paid to Insurance BrokerUSD $4,970
    Insurance broker organization code?3
    Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
    AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
    Policy contract number0835078
    Policy instance 1
    Insurance contract or identification number0835078
    Number of Individuals Covered494
    Insurance policy start date2015-01-01
    Insurance policy end date2015-12-31
    Total amount of commissions paid to insurance brokerUSD $19,717
    Total amount of fees paid to insurance companyUSD $3,935
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $201,834
    Commission paid to Insurance BrokerUSD $1,477
    Insurance broker organization code?3
    Amount paid for insurance broker fees3935
    Additional information about fees paid to insurance brokerENGAGEMENT CREDIT
    Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
    AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
    Policy contract number0835078
    Policy instance 1
    Insurance contract or identification number0835078
    Number of Individuals Covered448
    Insurance policy start date2014-06-01
    Insurance policy end date2014-12-31
    Total amount of commissions paid to insurance brokerUSD $7,817
    Total amount of fees paid to insurance companyUSD $0
    Dental Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $78,786
    Commission paid to Insurance BrokerUSD $7,817
    Insurance broker organization code?3
    Insurance broker nameWELLS FARGO INSURANCE SERVICES USA
    AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
    Policy contract number0835078
    Policy instance 1
    Insurance contract or identification number0835078
    Number of Individuals Covered750
    Insurance policy start date2013-06-01
    Insurance policy end date2014-05-31
    Total amount of commissions paid to insurance brokerUSD $11,970
    Total amount of fees paid to insurance companyUSD $741
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitYes
    Welfare Benefit Premiums Paid to CarrierUSD $130,704
    Commission paid to Insurance BrokerUSD $1,132
    Amount paid for insurance broker fees70
    Additional information about fees paid to insurance brokerPM CROSS-SALE
    Insurance broker organization code?3
    Insurance broker nameWELLS FARGO INSURANCE SERVICES USA
    CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
    Policy contract number3334369
    Policy instance 1
    Insurance contract or identification number3334369
    Number of Individuals Covered266
    Insurance policy start date2012-06-01
    Insurance policy end date2013-05-31
    Total amount of commissions paid to insurance brokerUSD $8,042
    Total amount of fees paid to insurance companyUSD $37,442
    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 BenefitYes
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitYes
    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 $1,370,443
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $8,042
    Amount paid for insurance broker fees37442
    Additional information about fees paid to insurance brokerBENEFIT ADVISOR PAYMENTS
    Insurance broker organization code?3
    Insurance broker nameWELLS FARGO INSURANCE SERVICES
    CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
    Policy contract number3334369
    Policy instance 1
    Insurance contract or identification number3334369
    Number of Individuals Covered261
    Insurance policy start date2011-06-01
    Insurance policy end date2012-05-31
    Total amount of commissions paid to insurance brokerUSD $66,079
    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 BenefitYes
    Dental Insurance Welfare BenefitYes
    Vision Insurance Welfare BenefitYes
    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 $1,281,481
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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