| Plan Name | THE CHAMPION COMPANIES DENTAL PLAN |
| Plan identification number | 503 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | THE CHAMPION COMPANIES |
| Employer identification number (EIN): | 311253370 |
| NAIC Classification: | 339900 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 503 | 2022-01-01 | TRACY BEACHY | 2023-07-14 | ||
| 503 | 2022-01-01 | TRACY BEACHY | 2024-06-05 | ||
| 503 | 2020-01-01 | TRACY BEACHY | 2021-11-15 | ||
| 503 | 2019-01-01 | TRACY BEACHY | 2021-11-15 | ||
| 503 | 2018-01-01 | TRACY BEACHY | 2021-11-15 |
| 2022: THE CHAMPION COMPANIES DENTAL PLAN 2022 form 5500 responses | ||
|---|---|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Submission has been amended | Yes |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: THE CHAMPION COMPANIES DENTAL PLAN 2020 form 5500 responses | ||
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: THE CHAMPION COMPANIES DENTAL PLAN 2019 form 5500 responses | ||
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: THE CHAMPION COMPANIES DENTAL PLAN 2018 form 5500 responses | ||
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | First time form 5500 has been submitted | Yes |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| SUPERIOR DENTAL CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96280 ) | |
| Policy contract number | D3311,D3312 |
| Policy instance | 1 |
| SUPERIOR DENTAL CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96280 ) | |
| Policy contract number | D3311,D3312 |
| Policy instance | 1 |
| SUPERIOR DENTAL CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96280 ) | |
| Policy contract number | D3311,D3312 |
| Policy instance | 1 |