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FOUR WINDS HEALTH LLC DBA WELLSTREET URGENT CARE DENTAL PLAN 401k Plan overview

Plan NameFOUR WINDS HEALTH LLC DBA WELLSTREET URGENT CARE DENTAL PLAN
Plan identification number 502

FOUR WINDS HEALTH LLC DBA WELLSTREET URGENT CARE DENTAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Dental

401k Sponsoring company profile

FOUR WINDS HEALTH LLC has sponsored the creation of one or more 401k plans.

Company Name:FOUR WINDS HEALTH LLC
Employer identification number (EIN):451273930
NAIC Classification:621399
NAIC Description:Offices of All Other Miscellaneous Health Practitioners

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FOUR WINDS HEALTH LLC DBA WELLSTREET URGENT CARE DENTAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022021-01-01JENNIFER HALL2022-07-27
5022020-01-01JENNIFER HALL2021-09-28
5022019-01-01JAIME MITCHELL2020-06-22
5022018-01-01JAIME MITCHELL2019-09-27
5022017-01-01
5022016-01-01DAVE CRUSSELL

Plan Statistics for FOUR WINDS HEALTH LLC DBA WELLSTREET URGENT CARE DENTAL PLAN

401k plan membership statisitcs for FOUR WINDS HEALTH LLC DBA WELLSTREET URGENT CARE DENTAL PLAN

Measure Date Value
2021: FOUR WINDS HEALTH LLC DBA WELLSTREET URGENT CARE DENTAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01210
Total number of active participants reported on line 7a of the Form 55002021-01-010
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 participants2021-01-010
Number of employers contributing to the scheme2021-01-010
2020: FOUR WINDS HEALTH LLC DBA WELLSTREET URGENT CARE DENTAL PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-01246
Total number of active participants reported on line 7a of the Form 55002020-01-01208
Number of retired or separated participants receiving benefits2020-01-012
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01210
Number of employers contributing to the scheme2020-01-010
2019: FOUR WINDS HEALTH LLC DBA WELLSTREET URGENT CARE DENTAL PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01168
Total number of active participants reported on line 7a of the Form 55002019-01-01187
Number of retired or separated participants receiving benefits2019-01-011
Number of other retired or separated participants entitled to future benefits2019-01-0115
Total of all active and inactive participants2019-01-01203
Number of employers contributing to the scheme2019-01-010
2018: FOUR WINDS HEALTH LLC DBA WELLSTREET URGENT CARE DENTAL PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01119
Total number of active participants reported on line 7a of the Form 55002018-01-01167
Number of retired or separated participants receiving benefits2018-01-011
Number of other retired or separated participants entitled to future benefits2018-01-017
Total of all active and inactive participants2018-01-01175
Number of employers contributing to the scheme2018-01-010
2017: FOUR WINDS HEALTH LLC DBA WELLSTREET URGENT CARE DENTAL PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01128
Total number of active participants reported on line 7a of the Form 55002017-01-01126
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 participants2017-01-01126
2016: FOUR WINDS HEALTH LLC DBA WELLSTREET URGENT CARE DENTAL PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01104
Total number of active participants reported on line 7a of the Form 55002016-01-01128
Number of retired or separated participants receiving benefits2016-01-012
Number of other retired or separated participants entitled to future benefits2016-01-012
Total of all active and inactive participants2016-01-01132

Form 5500 Responses for FOUR WINDS HEALTH LLC DBA WELLSTREET URGENT CARE DENTAL PLAN

2021: FOUR WINDS HEALTH LLC DBA WELLSTREET URGENT CARE DENTAL PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01This submission is the final filingYes
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: FOUR WINDS HEALTH LLC DBA WELLSTREET URGENT CARE DENTAL PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: FOUR WINDS HEALTH LLC DBA WELLSTREET URGENT CARE DENTAL PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: FOUR WINDS HEALTH LLC DBA WELLSTREET URGENT CARE DENTAL PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: FOUR WINDS HEALTH LLC DBA WELLSTREET URGENT CARE DENTAL PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: FOUR WINDS HEALTH LLC DBA WELLSTREET URGENT CARE DENTAL PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01First time form 5500 has been submittedYes
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-049666
Policy instance 1
Insurance contract or identification number010-049666
Number of Individuals Covered1203
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $35,146
Total amount of fees paid to insurance companyUSD $491
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $351,463
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,286
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerFEES
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-049666
Policy instance 1
Insurance contract or identification number010-049666
Number of Individuals Covered455
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $18,115
Total amount of fees paid to insurance companyUSD $397
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $181,152
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,115
Amount paid for insurance broker fees397
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-049666
Policy instance 1
Insurance contract or identification number010-049666
Number of Individuals Covered411
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $12,470
Total amount of fees paid to insurance companyUSD $677
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $124,702
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,470
Amount paid for insurance broker fees677
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC/ (G0385) (National Association of Insurance Commissioners NAIC id number: 54801 )
Policy contract numberGA8417
Policy instance 1
Insurance contract or identification numberGA8417
Number of Individuals Covered314
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $8,232
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $102,509
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,232
Amount paid for insurance broker fees0
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )
Policy contract numberGA8417
Policy instance 1
Insurance contract or identification numberGA8417
Number of Individuals Covered255
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $6,691
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $90,308
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $6,691
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameCOBBS ALLEN AND HALL

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