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LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 401k Plan overview

Plan NameLASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST
Plan identification number 001

LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Money purchase (other than target benefit)
  • Profit-sharing
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
  • Participant-directed brokerage accounts provided as an investment option under the plan.

401k Sponsoring company profile

LA SALLE ORAL SURGERY has sponsored the creation of one or more 401k plans.

Company Name:LA SALLE ORAL SURGERY
Employer identification number (EIN):363350273
NAIC Classification:621210
NAIC Description:Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01
0012021-01-01
0012020-01-01
0012019-01-01
0012018-01-01
0012017-01-01JOHN P. LAVIERI
0012016-01-01JOHN P. LAVIERI
0012015-01-01JOHN P. LAVIERI
0012014-01-01JOHN P. LAVIERI
0012013-01-01JOHN P. LAVIERI
0012012-01-01JOHN P. LAVIERI
0012011-01-01JOHN P. LAVIERI
0012010-01-01JOHN P. LAVIERI
0012009-01-01JOHN P. LAVIERI
0012009-01-01PAUL DANEKAS
0012009-01-01JOHN P. LAVIERI

Plan Statistics for LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST

401k plan membership statisitcs for LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST

Measure Date Value
2022: LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2022 401k membership
Total participants, beginning-of-year2022-01-016
Total number of active participants reported on line 7a of the Form 55002022-01-016
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-016
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-016
Number of participants with account balances2022-01-016
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2021 401k membership
Total participants, beginning-of-year2021-01-015
Total number of active participants reported on line 7a of the Form 55002021-01-016
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-016
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-016
Number of participants with account balances2021-01-016
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2020 401k membership
Total participants, beginning-of-year2020-01-015
Total number of active participants reported on line 7a of the Form 55002020-01-015
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-015
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-015
Number of participants with account balances2020-01-015
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2019 401k membership
Total participants, beginning-of-year2019-01-015
Total number of active participants reported on line 7a of the Form 55002019-01-015
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-015
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-015
Number of participants with account balances2019-01-015
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2018 401k membership
Total participants, beginning-of-year2018-01-016
Total number of active participants reported on line 7a of the Form 55002018-01-015
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-015
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-015
Number of participants with account balances2018-01-015
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2017 401k membership
Total participants, beginning-of-year2017-01-017
Total number of active participants reported on line 7a of the Form 55002017-01-014
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-014
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-014
Number of participants with account balances2017-01-016
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010
2016: LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2016 401k membership
Total participants, beginning-of-year2016-01-014
Total number of active participants reported on line 7a of the Form 55002016-01-014
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-014
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-014
Number of participants with account balances2016-01-016
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-01-010
2015: LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2015 401k membership
Total participants, beginning-of-year2015-01-016
Total number of active participants reported on line 7a of the Form 55002015-01-014
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-014
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-01-010
Total participants2015-01-014
Number of participants with account balances2015-01-016
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-01-010
2014: LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2014 401k membership
Total participants, beginning-of-year2014-01-015
Total number of active participants reported on line 7a of the Form 55002014-01-016
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-016
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-01-010
Total participants2014-01-016
Number of participants with account balances2014-01-015
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-01-010
2013: LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2013 401k membership
Total participants, beginning-of-year2013-01-015
Total number of active participants reported on line 7a of the Form 55002013-01-015
Number of retired or separated participants receiving benefits2013-01-010
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-015
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-01-010
Total participants2013-01-015
Number of participants with account balances2013-01-015
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-01-010
2012: LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2012 401k membership
Total participants, beginning-of-year2012-01-015
Total number of active participants reported on line 7a of the Form 55002012-01-015
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-015
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-015
Number of participants with account balances2012-01-015
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2011 401k membership
Total participants, beginning-of-year2011-01-015
Total number of active participants reported on line 7a of the Form 55002011-01-015
Number of retired or separated participants receiving benefits2011-01-010
Number of other retired or separated participants entitled to future benefits2011-01-010
Total of all active and inactive participants2011-01-015
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-015
Number of participants with account balances2011-01-015
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2010 401k membership
Total participants, beginning-of-year2010-01-015
Total number of active participants reported on line 7a of the Form 55002010-01-015
Number of retired or separated participants receiving benefits2010-01-010
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-015
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-015
Number of participants with account balances2010-01-016
2009: LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2009 401k membership
Total participants, beginning-of-year2009-01-016
Total number of active participants reported on line 7a of the Form 55002009-01-015
Number of retired or separated participants receiving benefits2009-01-010
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-015
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-015
Number of participants with account balances2009-01-016

Financial Data on LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST

Measure Date Value
2022 : LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2022 401k financial data
Total income from all sources2022-12-31$-72,024
Expenses. Total of all expenses incurred2022-12-31$5,022
Total plan assets at end of year2022-12-31$767,829
Total plan assets at beginning of year2022-12-31$844,875
Expenses. Other expenses not covered elsewhere2022-12-31$5,022
Other income received2022-12-31$-93,596
Net income (gross income less expenses)2022-12-31$-77,046
Net plan assets at end of year (total assets less liabilities)2022-12-31$767,829
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$844,875
Total contributions received or receivable from employer(s)2022-12-31$21,572
2021 : LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2021 401k financial data
Total income from all sources2021-12-31$111,367
Expenses. Total of all expenses incurred2021-12-31$4,799
Total plan assets at end of year2021-12-31$844,875
Total plan assets at beginning of year2021-12-31$738,307
Expenses. Other expenses not covered elsewhere2021-12-31$4,799
Other income received2021-12-31$88,698
Net income (gross income less expenses)2021-12-31$106,568
Net plan assets at end of year (total assets less liabilities)2021-12-31$844,875
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$738,307
Total contributions received or receivable from employer(s)2021-12-31$22,669
2020 : LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2020 401k financial data
Total income from all sources2020-12-31$53,063
Expenses. Total of all expenses incurred2020-12-31$3,656
Total plan assets at end of year2020-12-31$738,307
Total plan assets at beginning of year2020-12-31$688,900
Expenses. Other expenses not covered elsewhere2020-12-31$3,656
Other income received2020-12-31$37,815
Net income (gross income less expenses)2020-12-31$49,407
Net plan assets at end of year (total assets less liabilities)2020-12-31$738,307
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$688,900
Total contributions received or receivable from employer(s)2020-12-31$15,248
2019 : LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2019 401k financial data
Total income from all sources2019-12-31$110,470
Expenses. Total of all expenses incurred2019-12-31$4,021
Total plan assets at end of year2019-12-31$688,900
Total plan assets at beginning of year2019-12-31$582,451
Expenses. Other expenses not covered elsewhere2019-12-31$4,021
Other income received2019-12-31$90,967
Net income (gross income less expenses)2019-12-31$106,449
Net plan assets at end of year (total assets less liabilities)2019-12-31$688,900
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$582,451
Total contributions received or receivable from employer(s)2019-12-31$19,503
2018 : LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2018 401k financial data
Total income from all sources2018-12-31$-11,556
Expenses. Total of all expenses incurred2018-12-31$5,418
Benefits paid (including direct rollovers)2018-12-31$1,997
Total plan assets at end of year2018-12-31$582,451
Total plan assets at beginning of year2018-12-31$599,425
Expenses. Other expenses not covered elsewhere2018-12-31$3,421
Other income received2018-12-31$-39,849
Net income (gross income less expenses)2018-12-31$-16,974
Net plan assets at end of year (total assets less liabilities)2018-12-31$582,451
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$599,425
Total contributions received or receivable from employer(s)2018-12-31$28,293
2017 : LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2017 401k financial data
Total income from all sources2017-12-31$85,157
Expenses. Total of all expenses incurred2017-12-31$5,667
Benefits paid (including direct rollovers)2017-12-31$4,675
Total plan assets at end of year2017-12-31$599,425
Total plan assets at beginning of year2017-12-31$519,935
Expenses. Other expenses not covered elsewhere2017-12-31$992
Other income received2017-12-31$57,225
Net income (gross income less expenses)2017-12-31$79,490
Net plan assets at end of year (total assets less liabilities)2017-12-31$599,425
Net plan assets at beginning of year (total assets less liabilities)2017-12-31$519,935
Total contributions received or receivable from employer(s)2017-12-31$27,932
2016 : LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2016 401k financial data
Total income from all sources2016-12-31$54,615
Expenses. Total of all expenses incurred2016-12-31$485
Total plan assets at end of year2016-12-31$519,935
Total plan assets at beginning of year2016-12-31$465,805
Expenses. Other expenses not covered elsewhere2016-12-31$485
Other income received2016-12-31$30,443
Net income (gross income less expenses)2016-12-31$54,130
Net plan assets at end of year (total assets less liabilities)2016-12-31$519,935
Net plan assets at beginning of year (total assets less liabilities)2016-12-31$465,805
Total contributions received or receivable from employer(s)2016-12-31$24,172
2015 : LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2015 401k financial data
Total income from all sources2015-12-31$-3,915
Expenses. Total of all expenses incurred2015-12-31$420
Total plan assets at end of year2015-12-31$465,805
Total plan assets at beginning of year2015-12-31$470,140
Expenses. Other expenses not covered elsewhere2015-12-31$420
Other income received2015-12-31$-27,353
Net income (gross income less expenses)2015-12-31$-4,335
Net plan assets at end of year (total assets less liabilities)2015-12-31$465,805
Net plan assets at beginning of year (total assets less liabilities)2015-12-31$470,140
Total contributions received or receivable from employer(s)2015-12-31$23,438
2014 : LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2014 401k financial data
Total income from all sources2014-12-31$36,653
Expenses. Total of all expenses incurred2014-12-31$1,716
Total plan assets at end of year2014-12-31$470,140
Total plan assets at beginning of year2014-12-31$435,203
Expenses. Other expenses not covered elsewhere2014-12-31$1,716
Other income received2014-12-31$16,813
Net income (gross income less expenses)2014-12-31$34,937
Net plan assets at end of year (total assets less liabilities)2014-12-31$470,140
Net plan assets at beginning of year (total assets less liabilities)2014-12-31$435,203
Total contributions received or receivable from employer(s)2014-12-31$19,840
2013 : LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2013 401k financial data
Total income from all sources2013-12-31$80,077
Expenses. Total of all expenses incurred2013-12-31$1,701
Total plan assets at end of year2013-12-31$435,203
Total plan assets at beginning of year2013-12-31$356,827
Expenses. Other expenses not covered elsewhere2013-12-31$1,701
Other income received2013-12-31$63,250
Net income (gross income less expenses)2013-12-31$78,376
Net plan assets at end of year (total assets less liabilities)2013-12-31$435,203
Net plan assets at beginning of year (total assets less liabilities)2013-12-31$356,827
Total contributions received or receivable from employer(s)2013-12-31$16,827
2012 : LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2012 401k financial data
Total income from all sources2012-12-31$55,478
Expenses. Total of all expenses incurred2012-12-31$1,498
Total plan assets at end of year2012-12-31$356,827
Total plan assets at beginning of year2012-12-31$302,847
Expenses. Other expenses not covered elsewhere2012-12-31$1,498
Other income received2012-12-31$37,107
Net income (gross income less expenses)2012-12-31$53,980
Net plan assets at end of year (total assets less liabilities)2012-12-31$356,827
Net plan assets at beginning of year (total assets less liabilities)2012-12-31$302,847
Total contributions received or receivable from employer(s)2012-12-31$18,371
2011 : LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2011 401k financial data
Total income from all sources2011-12-31$2,421
Expenses. Total of all expenses incurred2011-12-31$35,408
Benefits paid (including direct rollovers)2011-12-31$34,027
Total plan assets at end of year2011-12-31$302,847
Total plan assets at beginning of year2011-12-31$335,834
Expenses. Other expenses not covered elsewhere2011-12-31$1,381
Other income received2011-12-31$-17,490
Net income (gross income less expenses)2011-12-31$-32,987
Net plan assets at end of year (total assets less liabilities)2011-12-31$302,847
Net plan assets at beginning of year (total assets less liabilities)2011-12-31$335,834
Total contributions received or receivable from employer(s)2011-12-31$19,911
2010 : LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2010 401k financial data
Total income from all sources2010-12-31$54,752
Expenses. Total of all expenses incurred2010-12-31$50
Total plan assets at end of year2010-12-31$335,834
Total plan assets at beginning of year2010-12-31$281,132
Expenses. Other expenses not covered elsewhere2010-12-31$50
Other income received2010-12-31$31,965
Net income (gross income less expenses)2010-12-31$54,702
Net plan assets at end of year (total assets less liabilities)2010-12-31$335,834
Net plan assets at beginning of year (total assets less liabilities)2010-12-31$281,132
Total contributions received or receivable from employer(s)2010-12-31$22,787

Form 5500 Responses for LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST

2022: LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement - TrustYes
2021: LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement - TrustYes
2020: LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement - TrustYes
2019: LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement - TrustYes
2018: LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement - TrustYes
2017: LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement - TrustYes
2016: LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – TrustYes
2016-01-01Plan benefit arrangement - TrustYes
2015: LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – TrustYes
2015-01-01Plan benefit arrangement - TrustYes
2014: LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – TrustYes
2014-01-01Plan benefit arrangement - TrustYes
2013: LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – TrustYes
2013-01-01Plan benefit arrangement - TrustYes
2012: LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement - TrustYes
2011: LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement - TrustYes
2010: LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement - TrustYes
2009: LASALLE ORAL SURGERY PROFIT SHARING PLAN & TRUST 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

DELAWARE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79065 )
Policy contract number501201250168299
Policy instance 1
Insurance contract or identification number501201250168299
Number of Individuals Covered6
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of fees paid to insurance companyUSD $428
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees428
DELAWARE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79065 )
Policy contract number501201250168299
Policy instance 1
Insurance contract or identification number501201250168299
Number of Individuals Covered6
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of fees paid to insurance companyUSD $408
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Amount paid for insurance broker fees408
DELAWARE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79065 )
Policy contract number501201250168299
Policy instance 1
Insurance contract or identification number501201250168299
Number of Individuals Covered5
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $1,412
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,412
DELAWARE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79065 )
Policy contract number501201250168299
Policy instance 1
Insurance contract or identification number501201250168299
Number of Individuals Covered5
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $1,325
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,325
DELAWARE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79065 )
Policy contract number501201250168299
Policy instance 1
Insurance contract or identification number501201250168299
Number of Individuals Covered6
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Insurance broker nameWILLIAM REILLY

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