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DENTISTRY FOR CHILDREN LIFE AND ADD PLAN 401k Plan overview

Plan NameDENTISTRY FOR CHILDREN LIFE AND ADD PLAN
Plan identification number 504

DENTISTRY FOR CHILDREN LIFE AND ADD PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

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:621210
NAIC Description:Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DENTISTRY FOR CHILDREN LIFE AND ADD PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042016-01-01ALISTAIR MADLE
5042015-01-01ALISTAIR MADLE
5042014-06-01ALISTAIR MADLE
5042013-06-01JEFFREY BATZEL
5042012-06-01STEVEN E. RUSSELL
5042011-06-01STEVEN E. RUSSEU

Plan Statistics for DENTISTRY FOR CHILDREN LIFE AND ADD PLAN

401k plan membership statisitcs for DENTISTRY FOR CHILDREN LIFE AND ADD PLAN

Measure Date Value
2016: DENTISTRY FOR CHILDREN LIFE AND ADD PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01639
Total number of active participants reported on line 7a of the Form 55002016-01-010
Total of all active and inactive participants2016-01-010
2015: DENTISTRY FOR CHILDREN LIFE AND ADD PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01589
Total number of active participants reported on line 7a of the Form 55002015-01-01639
Total of all active and inactive participants2015-01-01639
2014: DENTISTRY FOR CHILDREN LIFE AND ADD PLAN 2014 401k membership
Total participants, beginning-of-year2014-06-01545
Total number of active participants reported on line 7a of the Form 55002014-06-01589
Total of all active and inactive participants2014-06-01589
2013: DENTISTRY FOR CHILDREN LIFE AND ADD PLAN 2013 401k membership
Total participants, beginning-of-year2013-06-01266
Total number of active participants reported on line 7a of the Form 55002013-06-01545
Total of all active and inactive participants2013-06-01545
2012: DENTISTRY FOR CHILDREN LIFE AND ADD PLAN 2012 401k membership
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: DENTISTRY FOR CHILDREN LIFE AND ADD PLAN 2011 401k membership
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 for DENTISTRY FOR CHILDREN LIFE AND ADD PLAN

2016: DENTISTRY FOR CHILDREN LIFE AND ADD PLAN 2016 form 5500 responses
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: DENTISTRY FOR CHILDREN LIFE AND ADD PLAN 2015 form 5500 responses
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: DENTISTRY FOR CHILDREN LIFE AND ADD PLAN 2014 form 5500 responses
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: DENTISTRY FOR CHILDREN LIFE AND ADD PLAN 2013 form 5500 responses
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: DENTISTRY FOR CHILDREN LIFE AND ADD PLAN 2012 form 5500 responses
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: DENTISTRY FOR CHILDREN LIFE AND ADD PLAN 2011 form 5500 responses
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

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM601879
Policy instance 1
Insurance contract or identification numberSGM601879
Number of Individuals Covered654
Insurance policy start date2016-01-01
Insurance policy end date2016-03-31
Total amount of commissions paid to insurance brokerUSD $2,208
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $14,719
Commission paid to Insurance BrokerUSD $2,208
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM601879
Policy instance 1
Insurance contract or identification numberSGM601879
Number of Individuals Covered639
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $8,072
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedSUPP. LIFE, DEPENDENT LIFE, AD&D
Welfare Benefit Premiums Paid to CarrierUSD $53,813
Commission paid to Insurance BrokerUSD $7,476
Insurance broker organization code?3
Insurance broker nameWILLS FARGO INSURANCE SERVICES
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSOK601119
Policy instance 2
Insurance contract or identification numberSOK601119
Insurance policy start date2015-06-01
Insurance policy end date2016-05-31
Total amount of commissions paid to insurance brokerUSD $795
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedVOLUNTARY AD&D
Welfare Benefit Premiums Paid to CarrierUSD $5,294
Commission paid to Insurance BrokerUSD $129
Insurance broker organization code?3
Insurance broker nameNORTHWESTERN BENEFIT CORP OF GA
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM601879
Policy instance 1
Insurance contract or identification numberSGM601879
Number of Individuals Covered589
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $4,086
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedSUPP. LIFE, DEPENDENT LIFE, AD&D
Welfare Benefit Premiums Paid to CarrierUSD $27,241
Commission paid to Insurance BrokerUSD $4,086
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SER
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSOK601119
Policy instance 2
Insurance contract or identification numberSOK601119
Number of Individuals Covered118
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $456
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedVOLUNTARY AD&D
Welfare Benefit Premiums Paid to CarrierUSD $3,039
Commission paid to Insurance BrokerUSD $456
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SER
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM601879
Policy instance 1
Insurance contract or identification numberSGM601879
Number of Individuals Covered545
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $5,151
Total amount of fees paid to insurance companyUSD $695
Life Insurance Welfare BenefitYes
Other welfare benefits providedSUPP. LIFE, DEPENDENT LIFE, AD&D
Welfare Benefit Premiums Paid to CarrierUSD $34,341
Commission paid to Insurance BrokerUSD $5,151
Amount paid for insurance broker fees695
Additional information about fees paid to insurance brokerSALES & SERVICE
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SER
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSOK601119
Policy instance 2
Insurance contract or identification numberSOK601119
Number of Individuals Covered89
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $537
Total amount of fees paid to insurance companyUSD $91
Other welfare benefits providedVOLUNTARY AD&D
Welfare Benefit Premiums Paid to CarrierUSD $3,582
Commission paid to Insurance BrokerUSD $537
Amount paid for insurance broker fees91
Additional information about fees paid to insurance brokerSALES & SERVICE
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SER
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM601879
Policy instance 1
Insurance contract or identification numberSGM601879
Number of Individuals Covered266
Insurance policy start date2012-06-01
Insurance policy end date2013-05-31
Total amount of commissions paid to insurance brokerUSD $5,889
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 BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $39,258
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $5,889
Insurance broker organization code?3
Insurance broker nameWELLS FARGO INSURANCE SERVICES
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberSGM601879
Policy instance 1
Insurance contract or identification numberSGM601879
Number of Individuals Covered261
Insurance policy start date2011-06-01
Insurance policy end date2012-05-31
Total amount of commissions paid to insurance brokerUSD $5,779
Total amount of fees paid to insurance companyUSD $669
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 BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
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 $38,525
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes

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