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Plan Name | DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN |
Plan identification number | 004 |
401k Plan Type | Defined Contribution Pension |
Plan Features/Benefits |
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Company Name: | DELTA DENTAL PLAN OF MICHIGAN, INC. |
Employer identification number (EIN): | 381791480 |
NAIC Classification: | 524290 |
Additional information about DELTA DENTAL PLAN OF MICHIGAN, INC.
Jurisdiction of Incorporation: | Texas Secretary of State |
Incorporation Date: | 2003-10-03 |
Company Identification Number: | 0800254463 |
Legal Registered Office Address: |
PO BOX 30416 LANSING United States of America (USA) 48909 |
More information about DELTA DENTAL PLAN OF MICHIGAN, INC.
Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
---|---|---|---|---|---|
004 | 2012-01-01 | GORAN JURKOVIC | |||
004 | 2011-01-01 | GORAN JURKOVIC | |||
004 | 2010-01-01 | GORAN JURKOVIC | |||
004 | 2009-01-01 | GORAN JURKOVIC |
Measure | Date | Value |
---|---|---|
2012: DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN 2012 401k membership | ||
Total participants, beginning-of-year | 2012-01-01 | 198 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 0 |
Number of retired or separated participants receiving benefits | 2012-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2012-01-01 | 0 |
Total of all active and inactive participants | 2012-01-01 | 0 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2012-01-01 | 0 |
Total participants | 2012-01-01 | 0 |
Number of participants with account balances | 2012-01-01 | 0 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2012-01-01 | 0 |
2011: DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN 2011 401k membership | ||
Total participants, beginning-of-year | 2011-01-01 | 292 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 275 |
Number of retired or separated participants receiving benefits | 2011-01-01 | 2 |
Number of other retired or separated participants entitled to future benefits | 2011-01-01 | 23 |
Total of all active and inactive participants | 2011-01-01 | 300 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2011-01-01 | 0 |
Total participants | 2011-01-01 | 300 |
Number of participants with account balances | 2011-01-01 | 254 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2011-01-01 | 0 |
2010: DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN 2010 401k membership | ||
Total participants, beginning-of-year | 2010-01-01 | 286 |
Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 265 |
Number of retired or separated participants receiving benefits | 2010-01-01 | 2 |
Number of other retired or separated participants entitled to future benefits | 2010-01-01 | 25 |
Total of all active and inactive participants | 2010-01-01 | 292 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2010-01-01 | 0 |
Total participants | 2010-01-01 | 292 |
Number of participants with account balances | 2010-01-01 | 260 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2010-01-01 | 0 |
2009: DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN 2009 401k membership | ||
Total participants, beginning-of-year | 2009-01-01 | 327 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 257 |
Number of retired or separated participants receiving benefits | 2009-01-01 | 2 |
Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 27 |
Total of all active and inactive participants | 2009-01-01 | 286 |
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2009-01-01 | 0 |
Total participants | 2009-01-01 | 286 |
Number of participants with account balances | 2009-01-01 | 261 |
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 2009-01-01 | 0 |
Measure | Date | Value |
---|---|---|
2012 : DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN 2012 401k financial data | ||
Total transfer of assets from this plan | 2012-04-30 | $10,339,132 |
Total income from all sources (including contributions) | 2012-04-30 | $667,580 |
Total of all expenses incurred | 2012-04-30 | $335,536 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2012-04-30 | $333,226 |
Expenses. Certain deemed distributions of participant loans | 2012-04-30 | $989 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2012-04-30 | $115,850 |
Value of total assets at end of year | 2012-04-30 | $0 |
Value of total assets at beginning of year | 2012-04-30 | $10,007,088 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2012-04-30 | $1,321 |
Total interest from all sources | 2012-04-30 | $8,160 |
Total dividends received (eg from common stock, registered investment company shares) | 2012-04-30 | $16,060 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2012-04-30 | Yes |
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan | 2012-04-30 | $0 |
Total dividends received from registered investment company shares (eg mutual funds) | 2012-04-30 | $16,060 |
Was this plan covered by a fidelity bond | 2012-04-30 | Yes |
Value of fidelity bond cover | 2012-04-30 | $10,000,000 |
If this is an individual account plan, was there a blackout period | 2012-04-30 | No |
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2012-04-30 | $0 |
Were there any nonexempt tranactions with any party-in-interest | 2012-04-30 | No |
Contributions received from participants | 2012-04-30 | $115,403 |
Participant contributions at end of year | 2012-04-30 | $0 |
Participant contributions at beginning of year | 2012-04-30 | $484,780 |
Income. Received or receivable in cash from other sources (including rollovers) | 2012-04-30 | $447 |
Administrative expenses (other) incurred | 2012-04-30 | $1,321 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-04-30 | No |
Value of net income/loss | 2012-04-30 | $332,044 |
Value of net assets at end of year (total assets less liabilities) | 2012-04-30 | $0 |
Value of net assets at beginning of year (total assets less liabilities) | 2012-04-30 | $10,007,088 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2012-04-30 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2012-04-30 | No |
Were any leases to which the plan was party in default or uncollectible | 2012-04-30 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2012-04-30 | $0 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2012-04-30 | $7,016,169 |
Interest on participant loans | 2012-04-30 | $8,152 |
Value of interest in common/collective trusts at end of year | 2012-04-30 | $0 |
Value of interest in common/collective trusts at beginning of year | 2012-04-30 | $2,341,147 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2012-04-30 | $0 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2012-04-30 | $164,992 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2012-04-30 | $164,992 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2012-04-30 | $8 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2012-04-30 | $575,114 |
Net investment gain or loss from common/collective trusts | 2012-04-30 | $-47,604 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2012-04-30 | No |
Was there a failure to transmit to the plan any participant contributions | 2012-04-30 | Yes |
Has the plan failed to provide any benefit when due under the plan | 2012-04-30 | No |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2012-04-30 | $333,226 |
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2012-04-30 | No |
Did the plan have assets held for investment | 2012-04-30 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2012-04-30 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2012-04-30 | Yes |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2012-04-30 | Yes |
Opinion of an independent qualified public accountant for this plan | 2012-04-30 | Disclaimer |
Accountancy firm name | 2012-04-30 | PLANTE & MORAN |
Accountancy firm EIN | 2012-04-30 | 381357951 |
2011 : DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN 2011 401k financial data | ||
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $0 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2011-12-31 | $0 |
Total income from all sources (including contributions) | 2011-12-31 | $340,755 |
Total of all expenses incurred | 2011-12-31 | $630,070 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2011-12-31 | $613,464 |
Expenses. Certain deemed distributions of participant loans | 2011-12-31 | $12,722 |
Value of total corrective distributions | 2011-12-31 | $137 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2011-12-31 | $350,336 |
Value of total assets at end of year | 2011-12-31 | $10,007,088 |
Value of total assets at beginning of year | 2011-12-31 | $10,296,403 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2011-12-31 | $3,747 |
Total interest from all sources | 2011-12-31 | $35,050 |
Total dividends received (eg from common stock, registered investment company shares) | 2011-12-31 | $214,425 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2011-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2011-12-31 | $214,425 |
Was this plan covered by a fidelity bond | 2011-12-31 | Yes |
Value of fidelity bond cover | 2011-12-31 | $10,000,000 |
If this is an individual account plan, was there a blackout period | 2011-12-31 | No |
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2011-12-31 | $0 |
Were there any nonexempt tranactions with any party-in-interest | 2011-12-31 | No |
Contributions received from participants | 2011-12-31 | $347,902 |
Participant contributions at end of year | 2011-12-31 | $484,780 |
Participant contributions at beginning of year | 2011-12-31 | $452,141 |
Income. Received or receivable in cash from other sources (including rollovers) | 2011-12-31 | $2,434 |
Administrative expenses (other) incurred | 2011-12-31 | $3,747 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
Value of net income/loss | 2011-12-31 | $-289,315 |
Value of net assets at end of year (total assets less liabilities) | 2011-12-31 | $10,007,088 |
Value of net assets at beginning of year (total assets less liabilities) | 2011-12-31 | $10,296,403 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2011-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2011-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2011-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2011-12-31 | $7,016,169 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2011-12-31 | $7,324,841 |
Interest on participant loans | 2011-12-31 | $35,037 |
Value of interest in common/collective trusts at end of year | 2011-12-31 | $2,341,147 |
Value of interest in common/collective trusts at beginning of year | 2011-12-31 | $2,406,655 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2011-12-31 | $164,992 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2011-12-31 | $112,766 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2011-12-31 | $112,766 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2011-12-31 | $13 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2011-12-31 | $-327,809 |
Net investment gain or loss from common/collective trusts | 2011-12-31 | $68,753 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2011-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2011-12-31 | Yes |
Has the plan failed to provide any benefit when due under the plan | 2011-12-31 | No |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2011-12-31 | $613,464 |
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2011-12-31 | No |
Did the plan have assets held for investment | 2011-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2011-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2011-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2011-12-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2011-12-31 | Disclaimer |
Accountancy firm name | 2011-12-31 | PLANTE & MORAN, PLLC |
Accountancy firm EIN | 2011-12-31 | 381357951 |
2010 : DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN 2010 401k financial data | ||
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $0 |
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities) | 2010-12-31 | $0 |
Total income from all sources (including contributions) | 2010-12-31 | $1,367,907 |
Total of all expenses incurred | 2010-12-31 | $912,862 |
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others | 2010-12-31 | $891,095 |
Expenses. Certain deemed distributions of participant loans | 2010-12-31 | $18,699 |
Total contributions o plan (from employers,participants, others, non cash contrinutions) | 2010-12-31 | $407,377 |
Value of total assets at end of year | 2010-12-31 | $10,296,403 |
Value of total assets at beginning of year | 2010-12-31 | $9,841,358 |
Total of administrative expenses incurred including professional, contract, advisory and management fees | 2010-12-31 | $3,068 |
Total interest from all sources | 2010-12-31 | $38,719 |
Total dividends received (eg from common stock, registered investment company shares) | 2010-12-31 | $178,417 |
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year | 2010-12-31 | No |
Total dividends received from registered investment company shares (eg mutual funds) | 2010-12-31 | $178,417 |
Was this plan covered by a fidelity bond | 2010-12-31 | Yes |
Value of fidelity bond cover | 2010-12-31 | $10,000,000 |
If this is an individual account plan, was there a blackout period | 2010-12-31 | No |
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2010-12-31 | $0 |
Were there any nonexempt tranactions with any party-in-interest | 2010-12-31 | No |
Contributions received from participants | 2010-12-31 | $407,377 |
Participant contributions at end of year | 2010-12-31 | $452,141 |
Participant contributions at beginning of year | 2010-12-31 | $491,155 |
Participant contributions at end of year | 2010-12-31 | $0 |
Participant contributions at beginning of year | 2010-12-31 | $9,137 |
Administrative expenses (other) incurred | 2010-12-31 | $3,068 |
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
Value of net income/loss | 2010-12-31 | $455,045 |
Value of net assets at end of year (total assets less liabilities) | 2010-12-31 | $10,296,403 |
Value of net assets at beginning of year (total assets less liabilities) | 2010-12-31 | $9,841,358 |
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond) | 2010-12-31 | No |
Were any loans by the plan or fixed income obligations due to the plan in default | 2010-12-31 | No |
Were any leases to which the plan was party in default or uncollectible | 2010-12-31 | No |
Value of interest in registered invesment companies (eg mutual funds) at end of year | 2010-12-31 | $7,324,841 |
Value of interest in registered invesment companies (eg mutual funds) at beginning of year | 2010-12-31 | $6,624,447 |
Interest on participant loans | 2010-12-31 | $38,676 |
Value of interest in common/collective trusts at end of year | 2010-12-31 | $2,406,655 |
Value of interest in common/collective trusts at beginning of year | 2010-12-31 | $2,518,964 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year | 2010-12-31 | $112,766 |
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year | 2010-12-31 | $197,655 |
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year | 2010-12-31 | $197,655 |
Interest earned from interest bearing cash (including money market accounts and certificates of deposit) | 2010-12-31 | $43 |
Net investment gain/loss from registered investment companies (e.g. mutual funds) | 2010-12-31 | $643,421 |
Net investment gain or loss from common/collective trusts | 2010-12-31 | $99,973 |
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets | 2010-12-31 | No |
Was there a failure to transmit to the plan any participant contributions | 2010-12-31 | Yes |
Has the plan failed to provide any benefit when due under the plan | 2010-12-31 | No |
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers | 2010-12-31 | $891,095 |
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3 | 2010-12-31 | No |
Did the plan have assets held for investment | 2010-12-31 | Yes |
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser | 2010-12-31 | No |
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC | 2010-12-31 | No |
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d) | 2010-12-31 | Yes |
Opinion of an independent qualified public accountant for this plan | 2010-12-31 | Disclaimer |
Accountancy firm name | 2010-12-31 | PLANTE & MORAN, PLLC |
Accountancy firm EIN | 2010-12-31 | 381357951 |
2009 : DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN 2009 401k financial data | ||
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities | 2009-12-31 | $0 |
2012: DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN 2012 form 5500 responses | ||
---|---|---|
2012-01-01 | Type of plan entity | Single employer plan |
2012-01-01 | Submission has been amended | No |
2012-01-01 | This submission is the final filing | Yes |
2012-01-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
2012-01-01 | Plan is a collectively bargained plan | Yes |
2012-01-01 | Plan funding arrangement – Trust | Yes |
2012-01-01 | Plan benefit arrangement - Trust | Yes |
2011: DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN 2011 form 5500 responses | ||
2011-01-01 | Type of plan entity | Single employer plan |
2011-01-01 | Submission has been amended | No |
2011-01-01 | This submission is the final filing | No |
2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2011-01-01 | Plan is a collectively bargained plan | Yes |
2011-01-01 | Plan funding arrangement – Trust | Yes |
2011-01-01 | Plan benefit arrangement - Trust | Yes |
2010: DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN 2010 form 5500 responses | ||
2010-01-01 | Type of plan entity | Single employer plan |
2010-01-01 | Submission has been amended | No |
2010-01-01 | This submission is the final filing | No |
2010-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2010-01-01 | Plan is a collectively bargained plan | Yes |
2010-01-01 | Plan funding arrangement – Trust | Yes |
2010-01-01 | Plan benefit arrangement - Trust | Yes |
2009: DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN 2009 form 5500 responses | ||
2009-01-01 | Type of plan entity | Single employer plan |
2009-01-01 | Submission has been amended | No |
2009-01-01 | This submission is the final filing | No |
2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2009-01-01 | Plan is a collectively bargained plan | Yes |
2009-01-01 | Plan funding arrangement – Trust | Yes |
2009-01-01 | Plan benefit arrangement - Trust | Yes |