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| Plan Name | UNIVERSAL PEDIATRIC SERVICES - DENTAL PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | UNIVERSAL PEDIATRIC SERVICES, INC. |
| Employer identification number (EIN): | 421251522 |
| NAIC Classification: | 621610 |
| NAIC Description: | Home Health Care Services |
Additional information about UNIVERSAL PEDIATRIC SERVICES, INC.
| Jurisdiction of Incorporation: | Iowa Secretary of State Business Entities |
| Incorporation Date: | 1985-05-21 |
| Company Identification Number: | 102320 |
| Legal Registered Office Address: |
700 WALNUT STREET SUITE 1600 DES MOINES United States of America (USA) 50309 |
More information about UNIVERSAL PEDIATRIC SERVICES, INC.
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2022-01-01 | STEVEN TUCKER ANDERSON | 2023-06-23 | ||
| 501 | 2021-01-01 | STEVEN TUCKER ANDERSON | 2022-05-20 | ||
| 501 | 2020-08-01 | STEVEN TUCKER ANDERSON | 2021-08-24 | ||
| 501 | 2019-08-01 | STEVEN TUCKER ANDERSON | 2021-08-24 | ||
| 501 | 2018-08-01 | TUCKER ANDERSON | 2020-03-02 | TUCKER ANDERSON | 2020-03-02 |
| 501 | 2017-08-01 | KRISTOPHER BURCLAW |
| Measure | Date | Value |
|---|---|---|
| 2022: UNIVERSAL PEDIATRIC SERVICES - DENTAL PLAN 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-01-01 | 116 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 90 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 90 |
| 2021: UNIVERSAL PEDIATRIC SERVICES - DENTAL PLAN 2021 401k membership | ||
| Total participants, beginning-of-year | 2021-01-01 | 142 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 110 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 2 |
| Total of all active and inactive participants | 2021-01-01 | 112 |
| 2020: UNIVERSAL PEDIATRIC SERVICES - DENTAL PLAN 2020 401k membership | ||
| Total participants, beginning-of-year | 2020-08-01 | 140 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-08-01 | 138 |
| Number of retired or separated participants receiving benefits | 2020-08-01 | 3 |
| Total of all active and inactive participants | 2020-08-01 | 141 |
| 2019: UNIVERSAL PEDIATRIC SERVICES - DENTAL PLAN 2019 401k membership | ||
| Total participants, beginning-of-year | 2019-08-01 | 112 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-08-01 | 128 |
| Number of retired or separated participants receiving benefits | 2019-08-01 | 1 |
| Total of all active and inactive participants | 2019-08-01 | 129 |
| 2018: UNIVERSAL PEDIATRIC SERVICES - DENTAL PLAN 2018 401k membership | ||
| Total participants, beginning-of-year | 2018-08-01 | 113 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-08-01 | 112 |
| Total of all active and inactive participants | 2018-08-01 | 112 |
| Total participants | 2018-08-01 | 112 |
| 2017: UNIVERSAL PEDIATRIC SERVICES - DENTAL PLAN 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-08-01 | 108 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-08-01 | 100 |
| Total of all active and inactive participants | 2017-08-01 | 100 |
| Total participants | 2017-08-01 | 100 |
| 2022: UNIVERSAL PEDIATRIC SERVICES - DENTAL PLAN 2022 form 5500 responses | ||
|---|---|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: UNIVERSAL PEDIATRIC SERVICES - DENTAL PLAN 2021 form 5500 responses | ||
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: UNIVERSAL PEDIATRIC SERVICES - DENTAL PLAN 2020 form 5500 responses | ||
| 2020-08-01 | Type of plan entity | Single employer plan |
| 2020-08-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2020-08-01 | Plan funding arrangement – Insurance | Yes |
| 2020-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: UNIVERSAL PEDIATRIC SERVICES - DENTAL PLAN 2019 form 5500 responses | ||
| 2019-08-01 | Type of plan entity | Single employer plan |
| 2019-08-01 | Plan funding arrangement – Insurance | Yes |
| 2019-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: UNIVERSAL PEDIATRIC SERVICES - DENTAL PLAN 2018 form 5500 responses | ||
| 2018-08-01 | Type of plan entity | Single employer plan |
| 2018-08-01 | Submission has been amended | No |
| 2018-08-01 | This submission is the final filing | No |
| 2018-08-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-08-01 | Plan is a collectively bargained plan | No |
| 2018-08-01 | Plan funding arrangement – Insurance | Yes |
| 2018-08-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: UNIVERSAL PEDIATRIC SERVICES - DENTAL PLAN 2017 form 5500 responses | ||
| 2017-08-01 | Type of plan entity | Single employer plan |
| 2017-08-01 | First time form 5500 has been submitted | Yes |
| 2017-08-01 | Submission has been amended | No |
| 2017-08-01 | This submission is the final filing | No |
| 2017-08-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-08-01 | Plan is a collectively bargained plan | No |
| 2017-08-01 | Plan funding arrangement – Insurance | Yes |
| 2017-08-01 | Plan benefit arrangement – Insurance | Yes |
| DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 33524 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 33524 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 33524 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 33524 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 33524 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| DELTA DENTAL OF IOWA (National Association of Insurance Commissioners NAIC id number: 55786 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 33524 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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