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INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan NameINDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN
Plan identification number 001

INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • 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(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • 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.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
  • Life insurance

401k Sponsoring company profile

INDEPENDENCE DENTAL EXCELLENCE, INC has sponsored the creation of one or more 401k plans.

Company Name:INDEPENDENCE DENTAL EXCELLENCE, INC
Employer identification number (EIN):430797549
NAIC Classification:621210
NAIC Description:Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012021-10-01MARIA DANKENBRING2023-07-10
0012020-10-01MARIA DANKENBRING2022-04-14
0012019-10-01MARIA DANKENBRING2021-06-03
0012018-10-01MARIA DANKENBRING2020-05-21
0012017-10-01MARIA DANKENBRING MATTHEW WILEY2019-03-15
0012016-10-01DAVID LIVINGSTON MATTHEW WILEY2018-04-27
0012015-10-01DAVID LIVINGSTON MATTHEW WILEY2017-05-04
0012014-10-01DAVID LIVINGSTON MATTHEW WILEY2016-04-07
0012013-10-01DAVID LIVINGSTON MATTHEW WILEY2015-04-28
0012012-10-01DAVID LIVINGSTON MATTHEW WILEY2014-04-18
0012011-10-01DAVID LIVINGSTON MATTHEW WILEY2013-04-25
0012010-10-01DAVID LIVINGSTON MATTHEW WILEY2012-04-26
0012009-10-01DAVID LIVINGSTON MATTHEW WILEY2011-04-28

Plan Statistics for INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2017: INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year2017-10-0152
Total number of active participants reported on line 7a of the Form 55002017-10-0138
Number of retired or separated participants receiving benefits2017-10-010
Number of other retired or separated participants entitled to future benefits2017-10-0112
Total of all active and inactive participants2017-10-0150
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-10-010
Total participants2017-10-0150
Number of participants with account balances2017-10-0147
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-10-010
2016: INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year2016-10-0149
Total number of active participants reported on line 7a of the Form 55002016-10-0138
Number of retired or separated participants receiving benefits2016-10-011
Number of other retired or separated participants entitled to future benefits2016-10-0110
Total of all active and inactive participants2016-10-0149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-10-010
Total participants2016-10-0149
Number of participants with account balances2016-10-0149
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2016-10-010
2015: INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year2015-10-0147
Total number of active participants reported on line 7a of the Form 55002015-10-0134
Number of retired or separated participants receiving benefits2015-10-010
Number of other retired or separated participants entitled to future benefits2015-10-0114
Total of all active and inactive participants2015-10-0148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2015-10-010
Total participants2015-10-0148
Number of participants with account balances2015-10-0143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2015-10-011
2014: INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year2014-10-0148
Total number of active participants reported on line 7a of the Form 55002014-10-0132
Number of retired or separated participants receiving benefits2014-10-010
Number of other retired or separated participants entitled to future benefits2014-10-0113
Total of all active and inactive participants2014-10-0145
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2014-10-010
Total participants2014-10-0145
Number of participants with account balances2014-10-0145
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2014-10-010
2013: INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year2013-10-0150
Total number of active participants reported on line 7a of the Form 55002013-10-0133
Number of retired or separated participants receiving benefits2013-10-012
Number of other retired or separated participants entitled to future benefits2013-10-0113
Total of all active and inactive participants2013-10-0148
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2013-10-010
Total participants2013-10-0148
Number of participants with account balances2013-10-0143
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2013-10-010
2012: INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN 2012 401k membership
Total participants, beginning-of-year2012-10-0147
Total number of active participants reported on line 7a of the Form 55002012-10-0135
Number of retired or separated participants receiving benefits2012-10-010
Number of other retired or separated participants entitled to future benefits2012-10-0112
Total of all active and inactive participants2012-10-0147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-10-010
Total participants2012-10-0147
Number of participants with account balances2012-10-0146
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-10-010
2011: INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN 2011 401k membership
Total participants, beginning-of-year2011-10-0149
Total number of active participants reported on line 7a of the Form 55002011-10-0135
Number of retired or separated participants receiving benefits2011-10-0112
Number of other retired or separated participants entitled to future benefits2011-10-010
Total of all active and inactive participants2011-10-0147
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-10-010
Total participants2011-10-0147
Number of participants with account balances2011-10-0146
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-10-010
2010: INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year2010-10-0150
Total number of active participants reported on line 7a of the Form 55002010-10-0136
Number of retired or separated participants receiving benefits2010-10-010
Number of other retired or separated participants entitled to future benefits2010-10-0113
Total of all active and inactive participants2010-10-0149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-10-010
Total participants2010-10-0149
Number of participants with account balances2010-10-0148
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-10-010
2009: INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year2009-10-0149
Total number of active participants reported on line 7a of the Form 55002009-10-0137
Number of retired or separated participants receiving benefits2009-10-010
Number of other retired or separated participants entitled to future benefits2009-10-0112
Total of all active and inactive participants2009-10-0149
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-10-010
Total participants2009-10-0149
Number of participants with account balances2009-10-0147
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-10-014

Financial Data on INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2018 : INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN 2018 401k financial data
Total income from all sources2018-09-30$1,118,142
Expenses. Total of all expenses incurred2018-09-30$1,747,738
Benefits paid (including direct rollovers)2018-09-30$1,687,568
Total plan assets at end of year2018-09-30$7,171,411
Total plan assets at beginning of year2018-09-30$7,801,007
Value of fidelity bond covering the plan2018-09-30$500,000
Total contributions received or receivable from participants2018-09-30$170,461
Contributions received from other sources (not participants or employers)2018-09-30$11,862
Other income received2018-09-30$687,232
Net income (gross income less expenses)2018-09-30$-629,596
Net plan assets at end of year (total assets less liabilities)2018-09-30$7,171,411
Net plan assets at beginning of year (total assets less liabilities)2018-09-30$7,801,007
Assets. Value of participant loans2018-09-30$75,182
Total contributions received or receivable from employer(s)2018-09-30$248,587
Expenses. Administrative service providers (salaries,fees and commissions)2018-09-30$60,170
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-09-30$0
2017 : INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources2017-09-30$1,307,263
Expenses. Total of all expenses incurred2017-09-30$166,556
Benefits paid (including direct rollovers)2017-09-30$111,754
Total plan assets at end of year2017-09-30$7,801,007
Total plan assets at beginning of year2017-09-30$6,660,300
Value of fidelity bond covering the plan2017-09-30$500,000
Total contributions received or receivable from participants2017-09-30$53,110
Other income received2017-09-30$965,602
Net income (gross income less expenses)2017-09-30$1,140,707
Net plan assets at end of year (total assets less liabilities)2017-09-30$7,801,007
Net plan assets at beginning of year (total assets less liabilities)2017-09-30$6,660,300
Assets. Value of participant loans2017-09-30$88,944
Total contributions received or receivable from employer(s)2017-09-30$288,551
Expenses. Administrative service providers (salaries,fees and commissions)2017-09-30$54,802
2016 : INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources2016-09-30$921,128
Expenses. Total of all expenses incurred2016-09-30$446,390
Benefits paid (including direct rollovers)2016-09-30$396,980
Total plan assets at end of year2016-09-30$6,660,300
Total plan assets at beginning of year2016-09-30$6,185,562
Value of fidelity bond covering the plan2016-09-30$500,000
Total contributions received or receivable from participants2016-09-30$226,786
Other income received2016-09-30$535,755
Net income (gross income less expenses)2016-09-30$474,738
Net plan assets at end of year (total assets less liabilities)2016-09-30$6,660,300
Net plan assets at beginning of year (total assets less liabilities)2016-09-30$6,185,562
Assets. Value of participant loans2016-09-30$14,189
Total contributions received or receivable from employer(s)2016-09-30$158,587
Expenses. Administrative service providers (salaries,fees and commissions)2016-09-30$49,410
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2016-09-30$0
2015 : INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources2015-09-30$191,099
Expenses. Total of all expenses incurred2015-09-30$283,472
Benefits paid (including direct rollovers)2015-09-30$230,997
Total plan assets at end of year2015-09-30$6,185,562
Total plan assets at beginning of year2015-09-30$6,277,935
Value of fidelity bond covering the plan2015-09-30$500,000
Total contributions received or receivable from participants2015-09-30$107,653
Other income received2015-09-30$-165,755
Net income (gross income less expenses)2015-09-30$-92,373
Net plan assets at end of year (total assets less liabilities)2015-09-30$6,185,562
Net plan assets at beginning of year (total assets less liabilities)2015-09-30$6,277,935
Assets. Value of participant loans2015-09-30$39,911
Total contributions received or receivable from employer(s)2015-09-30$249,201
Expenses. Administrative service providers (salaries,fees and commissions)2015-09-30$52,475
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2015-09-30$0
2014 : INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources2014-09-30$878,974
Expenses. Total of all expenses incurred2014-09-30$524,366
Benefits paid (including direct rollovers)2014-09-30$473,635
Total plan assets at end of year2014-09-30$6,277,935
Total plan assets at beginning of year2014-09-30$5,923,327
Value of fidelity bond covering the plan2014-09-30$500,000
Total contributions received or receivable from participants2014-09-30$126,679
Other income received2014-09-30$382,215
Net income (gross income less expenses)2014-09-30$354,608
Net plan assets at end of year (total assets less liabilities)2014-09-30$6,277,935
Net plan assets at beginning of year (total assets less liabilities)2014-09-30$5,923,327
Assets. Value of participant loans2014-09-30$67,575
Total contributions received or receivable from employer(s)2014-09-30$370,080
Expenses. Administrative service providers (salaries,fees and commissions)2014-09-30$50,731
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2014-09-30$0
2013 : INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources2013-09-30$1,328,665
Expenses. Total of all expenses incurred2013-09-30$326,516
Benefits paid (including direct rollovers)2013-09-30$281,410
Total plan assets at end of year2013-09-30$5,923,327
Total plan assets at beginning of year2013-09-30$4,921,178
Value of fidelity bond covering the plan2013-09-30$500,000
Total contributions received or receivable from participants2013-09-30$125,838
Other income received2013-09-30$972,827
Net income (gross income less expenses)2013-09-30$1,002,149
Net plan assets at end of year (total assets less liabilities)2013-09-30$5,923,327
Net plan assets at beginning of year (total assets less liabilities)2013-09-30$4,921,178
Assets. Value of participant loans2013-09-30$68,789
Total contributions received or receivable from employer(s)2013-09-30$230,000
Expenses. Administrative service providers (salaries,fees and commissions)2013-09-30$45,106
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2013-09-30$0
2012 : INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN 2012 401k financial data
Total income from all sources2012-09-30$1,199,901
Expenses. Total of all expenses incurred2012-09-30$687,525
Benefits paid (including direct rollovers)2012-09-30$646,930
Total plan assets at end of year2012-09-30$4,921,178
Total plan assets at beginning of year2012-09-30$4,408,802
Value of fidelity bond covering the plan2012-09-30$440,000
Total contributions received or receivable from participants2012-09-30$145,126
Other income received2012-09-30$776,908
Net income (gross income less expenses)2012-09-30$512,376
Net plan assets at end of year (total assets less liabilities)2012-09-30$4,921,178
Net plan assets at beginning of year (total assets less liabilities)2012-09-30$4,408,802
Assets. Value of participant loans2012-09-30$73,068
Total contributions received or receivable from employer(s)2012-09-30$277,867
Expenses. Administrative service providers (salaries,fees and commissions)2012-09-30$40,595
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-09-30$0
2011 : INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN 2011 401k financial data
Total income from all sources2011-09-30$261,024
Expenses. Total of all expenses incurred2011-09-30$104,771
Benefits paid (including direct rollovers)2011-09-30$63,668
Total plan assets at end of year2011-09-30$4,408,802
Total plan assets at beginning of year2011-09-30$4,252,549
Value of fidelity bond covering the plan2011-09-30$425,000
Total contributions received or receivable from participants2011-09-30$141,104
Other income received2011-09-30$-130,080
Net income (gross income less expenses)2011-09-30$156,253
Net plan assets at end of year (total assets less liabilities)2011-09-30$4,408,802
Net plan assets at beginning of year (total assets less liabilities)2011-09-30$4,252,549
Total contributions received or receivable from employer(s)2011-09-30$250,000
Expenses. Administrative service providers (salaries,fees and commissions)2011-09-30$41,103

Form 5500 Responses for INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN

2017: INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01Submission has been amendedNo
2017-10-01This submission is the final filingNo
2017-10-01This return/report is a short plan year return/report (less than 12 months)No
2017-10-01Plan is a collectively bargained planNo
2017-10-01Plan funding arrangement – InsuranceYes
2017-10-01Plan funding arrangement – TrustYes
2017-10-01Plan benefit arrangement – InsuranceYes
2017-10-01Plan benefit arrangement - TrustYes
2016: INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01Submission has been amendedNo
2016-10-01This submission is the final filingNo
2016-10-01This return/report is a short plan year return/report (less than 12 months)No
2016-10-01Plan is a collectively bargained planNo
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan funding arrangement – TrustYes
2016-10-01Plan benefit arrangement – InsuranceYes
2016-10-01Plan benefit arrangement - TrustYes
2015: INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01Submission has been amendedNo
2015-10-01This submission is the final filingNo
2015-10-01This return/report is a short plan year return/report (less than 12 months)No
2015-10-01Plan is a collectively bargained planNo
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan funding arrangement – TrustYes
2015-10-01Plan benefit arrangement – InsuranceYes
2015-10-01Plan benefit arrangement - TrustYes
2014: INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01Submission has been amendedNo
2014-10-01This submission is the final filingNo
2014-10-01This return/report is a short plan year return/report (less than 12 months)No
2014-10-01Plan is a collectively bargained planNo
2014-10-01Plan funding arrangement – InsuranceYes
2014-10-01Plan funding arrangement – TrustYes
2014-10-01Plan benefit arrangement – InsuranceYes
2014-10-01Plan benefit arrangement - TrustYes
2013: INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01Submission has been amendedNo
2013-10-01This submission is the final filingNo
2013-10-01This return/report is a short plan year return/report (less than 12 months)No
2013-10-01Plan is a collectively bargained planNo
2013-10-01Plan funding arrangement – InsuranceYes
2013-10-01Plan funding arrangement – TrustYes
2013-10-01Plan benefit arrangement – InsuranceYes
2013-10-01Plan benefit arrangement - TrustYes
2012: INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN 2012 form 5500 responses
2012-10-01Type of plan entitySingle employer plan
2012-10-01Submission has been amendedNo
2012-10-01This submission is the final filingNo
2012-10-01This return/report is a short plan year return/report (less than 12 months)No
2012-10-01Plan is a collectively bargained planNo
2012-10-01Plan funding arrangement – InsuranceYes
2012-10-01Plan funding arrangement – TrustYes
2012-10-01Plan benefit arrangement – InsuranceYes
2012-10-01Plan benefit arrangement - TrustYes
2011: INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN 2011 form 5500 responses
2011-10-01Type of plan entitySingle employer plan
2011-10-01Submission has been amendedNo
2011-10-01This submission is the final filingNo
2011-10-01This return/report is a short plan year return/report (less than 12 months)No
2011-10-01Plan is a collectively bargained planNo
2011-10-01Plan funding arrangement – InsuranceYes
2011-10-01Plan funding arrangement – TrustYes
2011-10-01Plan benefit arrangement – InsuranceYes
2011-10-01Plan benefit arrangement - TrustYes
2010: INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN 2010 form 5500 responses
2010-10-01Type of plan entitySingle employer plan
2010-10-01Submission has been amendedNo
2010-10-01This submission is the final filingNo
2010-10-01This return/report is a short plan year return/report (less than 12 months)No
2010-10-01Plan is a collectively bargained planNo
2010-10-01Plan funding arrangement – InsuranceYes
2010-10-01Plan funding arrangement – TrustYes
2010-10-01Plan benefit arrangement – InsuranceYes
2010-10-01Plan benefit arrangement - TrustYes
2009: INDEPENDENCE DENTAL EXCELLENCE, INC. 401(K) PROFIT SHARING PLAN 2009 form 5500 responses
2009-10-01Type of plan entitySingle employer plan
2009-10-01Submission has been amendedNo
2009-10-01This submission is the final filingNo
2009-10-01This return/report is a short plan year return/report (less than 12 months)No
2009-10-01Plan is a collectively bargained planNo
2009-10-01Plan funding arrangement – InsuranceYes
2009-10-01Plan funding arrangement – TrustYes
2009-10-01Plan benefit arrangement – InsuranceYes
2009-10-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract numberP 0224
Policy instance 1
Insurance contract or identification numberP 0224
Number of Individuals Covered1
Insurance policy start date2017-10-01
Insurance policy end date2018-09-30
Total amount of commissions paid to insurance brokerUSD $7
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?1
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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