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| Plan Name | ST. ANDREWS EPISCOPAL SCHOOL DENTAL PLAN |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | ST. ANDREWS EPISCOPAL SCHOOL |
| Employer identification number (EIN): | 521107876 |
| NAIC Classification: | 611000 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2022-01-01 | MARK MCKINGHT | 2023-07-25 | ||
| 502 | 2021-01-01 | DEBORAH HAYES | 2022-07-27 |
| Measure | Date | Value |
|---|---|---|
| 2022: ST. ANDREWS EPISCOPAL SCHOOL DENTAL PLAN 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-01-01 | 112 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 118 |
| Number of retired or separated participants receiving benefits | 2022-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2022-01-01 | 0 |
| Total of all active and inactive participants | 2022-01-01 | 118 |
| Number of employers contributing to the scheme | 2022-01-01 | 0 |
| 2021: ST. ANDREWS EPISCOPAL SCHOOL DENTAL PLAN 2021 401k membership | ||
| Total participants, beginning-of-year | 2021-01-01 | 107 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 111 |
| Number of retired or separated participants receiving benefits | 2021-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2021-01-01 | 0 |
| Total of all active and inactive participants | 2021-01-01 | 111 |
| Number of employers contributing to the scheme | 2021-01-01 | 0 |
| 2022: ST. ANDREWS EPISCOPAL SCHOOL 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: ST. ANDREWS EPISCOPAL SCHOOL 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 |
| GHMSI (National Association of Insurance Commissioners NAIC id number: 53007 ) | |||||||||||||||||||||||||||||||
| Policy contract number | 1G3B | ||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||
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| CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 ) | |||||||||||||||||||||||||||||||
| Policy contract number | 1G3B | ||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||
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