401k Plan data: GREENHECK FAN CORP DENTAL INSURANCE PLAN plan

GREENHECK FAN CORP DENTAL INSURANCE PLAN 401k Plan overview

Plan Name	GREENHECK FAN CORP DENTAL INSURANCE PLAN
Plan identification number	508

GREENHECK FAN CORP DENTAL INSURANCE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Dental

401k Sponsoring company profile

GREENHECK FAN CORPORATION has sponsored the creation of one or more 401k plans.

Company Name: GREENHECK FAN CORPORATION

Employer identification number (EIN): 390920319

NAIC Classification: 335310

Additional information about GREENHECK FAN CORPORATION

Jurisdiction of Incorporation: Oregon Secretary of State Corporations Division

Incorporation Date: 2017-11-14

Company Identification Number: 137922092

Legal Registered Office Address: 13242 NW GLENRIDGE DR

PORTLAND
United States of America (USA)
97229

More information about GREENHECK FAN CORPORATION

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GREENHECK FAN CORP DENTAL INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
508 2023-01-01 BRIANNE PETRUZALEK 2024-09-10
508 2022-01-01
508 2022-01-01 SEAN O'HARA

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
508	2023-01-01	BRIANNE PETRUZALEK	2024-09-10
508	2022-01-01
508	2022-01-01	SEAN O'HARA

Form 5500 Responses for GREENHECK FAN CORP DENTAL INSURANCE PLAN

2023: GREENHECK FAN CORP DENTAL INSURANCE PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	Submission has been amended	No
2023-01-01	This submission is the final filing	Yes
2023-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2023-01-01	Plan is a collectively bargained plan	No
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2022: GREENHECK FAN CORP DENTAL INSURANCE PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	First time form 5500 has been submitted	Yes
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )

Policy contract number

20948

Policy instance

Insurance contract or identification number	20948
Number of Individuals Covered	184
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Are there contracts with allocated funds for individual policies?	0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $84,649
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )

Policy contract number

20948

Policy instance

Insurance contract or identification number	20948
Number of Individuals Covered	329
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Are there contracts with allocated funds for individual policies?	0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $94,361
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	GREENHECK FAN CORPORATION
Employer identification number (EIN):	390920319
NAIC Classification:	335310

Jurisdiction of Incorporation:	Oregon Secretary of State Corporations Division
Incorporation Date:	2017-11-14
Company Identification Number:	137922092
Legal Registered Office Address:	13242 NW GLENRIDGE DR PORTLAND United States of America (USA) 97229