ACCESS DENTAL SERVICES, LLC WELFARE PLAN 401k Plan overview
Plan Name | ACCESS DENTAL SERVICES, LLC WELFARE PLAN |
Plan identification number | 501 |
ACCESS DENTAL SERVICES, LLC WELFARE PLAN Benefits
401k Plan Type | Welfare Benefit |
Plan Features/Benefits | - Health (other than dental or vision)
- Life insurance
- Dental
- Vision
- Long-term disability cover
- Death benefits (include travel accident but not life insurance)
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401k Sponsoring company profile
ACCESS DENTAL SERVICES, LLC has sponsored the creation of one or more 401k plans.
Additional information about ACCESS DENTAL SERVICES, LLC
Jurisdiction of Incorporation: | California Department of State |
Incorporation Date: | |
Company Identification Number: | 201419010342 |
More information about ACCESS DENTAL SERVICES, LLC
Form 5500 Filing Information
Submission information for form 5500 for 401k plan ACCESS DENTAL SERVICES, LLC WELFARE PLAN
Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
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501 | 2017-12-01 | | | | |
501 | 2016-12-01 | | | | |
501 | 2015-12-01 | ROXANNE K ADAMS | | | |
Plan Statistics for ACCESS DENTAL SERVICES, LLC WELFARE PLAN
401k plan membership statisitcs for ACCESS DENTAL SERVICES, LLC WELFARE PLAN
Measure | Date | Value |
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2017: ACCESS DENTAL SERVICES, LLC WELFARE PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-12-01 | 269 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-12-01 | 0 |
Number of retired or separated participants receiving benefits | 2017-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2017-12-01 | 0 |
Total of all active and inactive participants | 2017-12-01 | 0 |
2016: ACCESS DENTAL SERVICES, LLC WELFARE PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-12-01 | 184 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-12-01 | 269 |
Number of retired or separated participants receiving benefits | 2016-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2016-12-01 | 0 |
Total of all active and inactive participants | 2016-12-01 | 269 |
2015: ACCESS DENTAL SERVICES, LLC WELFARE PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-12-01 | 100 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-12-01 | 184 |
Number of retired or separated participants receiving benefits | 2015-12-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2015-12-01 | 0 |
Total of all active and inactive participants | 2015-12-01 | 184 |
Form 5500 Responses for ACCESS DENTAL SERVICES, LLC WELFARE PLAN
2017: ACCESS DENTAL SERVICES, LLC WELFARE PLAN 2017 form 5500 responses |
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2017-12-01 | Type of plan entity | Single employer plan |
2017-12-01 | This submission is the final filing | Yes |
2017-12-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
2017-12-01 | Plan funding arrangement – Insurance | Yes |
2017-12-01 | Plan benefit arrangement – Insurance | Yes |
2016: ACCESS DENTAL SERVICES, LLC WELFARE PLAN 2016 form 5500 responses |
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2016-12-01 | Type of plan entity | Single employer plan |
2016-12-01 | Plan funding arrangement – Insurance | Yes |
2016-12-01 | Plan benefit arrangement – Insurance | Yes |
2015: ACCESS DENTAL SERVICES, LLC WELFARE PLAN 2015 form 5500 responses |
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2015-12-01 | Type of plan entity | Single employer plan |
2015-12-01 | First time form 5500 has been submitted | Yes |
2015-12-01 | Submission has been amended | No |
2015-12-01 | This submission is the final filing | No |
2015-12-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-12-01 | Plan is a collectively bargained plan | No |
2015-12-01 | Plan funding arrangement – Insurance | Yes |
2015-12-01 | Plan benefit arrangement – Insurance | Yes |
Insurance Providers Used on plan
GERBER LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70939 ) |
Policy contract number | 390-007 |
Policy instance | 1 |
Insurance contract or identification number | 390-007 | Number of Individuals Covered | 85 | Insurance policy start date | 2017-12-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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PREMIER ACCESS INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60237 ) |
Policy contract number | 16000 |
Policy instance | 2 |
Insurance contract or identification number | 16000 | Number of Individuals Covered | 71 | Insurance policy start date | 2017-12-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $938 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 0000 ) |
Policy contract number | 649396 |
Policy instance | 3 |
Insurance contract or identification number | 649396 | Number of Individuals Covered | 0 | Insurance policy start date | 2017-12-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $0 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | Yes |
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THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
Policy contract number | 522612 |
Policy instance | 4 |
Insurance contract or identification number | 522612 | Number of Individuals Covered | 254 | Insurance policy start date | 2017-12-01 | Insurance policy end date | 2017-12-31 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Life Insurance Welfare Benefit | Yes | Long Term Disability Insurance Welfare Benefit | Yes | Other welfare benefits provided | ACCIDENTAL DEATH AND DISMEMBERMENT | Welfare Benefit Premiums Paid to Carrier | USD $3,903 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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