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FOUR RIVERS RESOURCE SERVICES, INC. GROUP DENTAL PLAN 401k Plan overview

Plan NameFOUR RIVERS RESOURCE SERVICES, INC. GROUP DENTAL PLAN
Plan identification number 501

FOUR RIVERS RESOURCE SERVICES, INC. GROUP DENTAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental

401k Sponsoring company profile

FOUR RIVERS RESOURCE SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name:FOUR RIVERS RESOURCE SERVICES, INC.
Employer identification number (EIN):351665140
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FOUR RIVERS RESOURCE SERVICES, INC. GROUP DENTAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012014-01-01STEVE SACKSTEDER
5012013-01-01STEVE SACKSTEDER
5012012-01-01STEVE SACKSTEDER
5012011-01-01STEVE SACKSTEDER
5012010-01-01STEVE SACKSTEDER
5012009-01-01STEVE SACKSTEDER

Plan Statistics for FOUR RIVERS RESOURCE SERVICES, INC. GROUP DENTAL PLAN

401k plan membership statisitcs for FOUR RIVERS RESOURCE SERVICES, INC. GROUP DENTAL PLAN

Measure Date Value
2014: FOUR RIVERS RESOURCE SERVICES, INC. GROUP DENTAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01204
Total number of active participants reported on line 7a of the Form 55002014-01-01220
Total of all active and inactive participants2014-01-01220
Total participants2014-01-010
2013: FOUR RIVERS RESOURCE SERVICES, INC. GROUP DENTAL PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01212
Total number of active participants reported on line 7a of the Form 55002013-01-01204
Total of all active and inactive participants2013-01-01204
Total participants2013-01-010
2012: FOUR RIVERS RESOURCE SERVICES, INC. GROUP DENTAL PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01207
Total number of active participants reported on line 7a of the Form 55002012-01-01212
Total of all active and inactive participants2012-01-01212
Total participants2012-01-010
2011: FOUR RIVERS RESOURCE SERVICES, INC. GROUP DENTAL PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01217
Total number of active participants reported on line 7a of the Form 55002011-01-01207
Total of all active and inactive participants2011-01-01207
Total participants2011-01-01207
2010: FOUR RIVERS RESOURCE SERVICES, INC. GROUP DENTAL PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01258
Total number of active participants reported on line 7a of the Form 55002010-01-01217
Total of all active and inactive participants2010-01-01217
Total participants2010-01-01217
2009: FOUR RIVERS RESOURCE SERVICES, INC. GROUP DENTAL PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01176
Total number of active participants reported on line 7a of the Form 55002009-01-01258
Total of all active and inactive participants2009-01-01258
Total participants2009-01-01258

Form 5500 Responses for FOUR RIVERS RESOURCE SERVICES, INC. GROUP DENTAL PLAN

2014: FOUR RIVERS RESOURCE SERVICES, INC. GROUP DENTAL PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01This submission is the final filingYes
2014-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: FOUR RIVERS RESOURCE SERVICES, INC. GROUP DENTAL PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: FOUR RIVERS RESOURCE SERVICES, INC. GROUP DENTAL PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: FOUR RIVERS RESOURCE SERVICES, INC. GROUP DENTAL PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2010: FOUR RIVERS RESOURCE SERVICES, INC. GROUP DENTAL PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – InsuranceYes
2009: FOUR RIVERS RESOURCE SERVICES, INC. GROUP DENTAL PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00389667
Policy instance 1
Insurance contract or identification number00389667
Number of Individuals Covered220
Insurance policy start date2014-01-01
Insurance policy end date2014-08-31
Total amount of commissions paid to insurance brokerUSD $5,879
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $68,453
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,879
Insurance broker organization code?3
Insurance broker nameDAVID B. SPITLER
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00389667
Policy instance 1
Insurance contract or identification number00389667
Number of Individuals Covered204
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $5,032
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $73,733
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,032
Insurance broker organization code?3
Insurance broker nameDAVID B. SPITLER
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00389667
Policy instance 1
Insurance contract or identification number00389667
Number of Individuals Covered212
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $5,259
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $73,957
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,259
Insurance broker organization code?3
Insurance broker nameDAVID B. SPITLER
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00389667
Policy instance 1
Insurance contract or identification number00389667
Number of Individuals Covered207
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $5,245
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $73,580
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00389667
Policy instance 1
Insurance contract or identification number00389667
Number of Individuals Covered217
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $5,515
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $80,692
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,515
Insurance broker organization code?3
Insurance broker nameDAVID B. SPITLER

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