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| Plan Name | EAST RIDGE RETIREMENT VILLAGE DENTAL PLAN |
| Plan identification number | 512 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | EAST RIDGE RETIREMENT VILLAGE |
| Employer identification number (EIN): | 590903331 |
| NAIC Classification: | 623000 |
| NAIC Description: | Nursing and Residential Care Facilities |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 512 | 2018-01-01 | CHRISTINE SHIPLEY | CHRISTINE SHIPLEY | 2019-05-13 | |
| 512 | 2017-01-01 | CATHERINE AYERS | CATHERINE AYERS | 2018-07-30 |
| Measure | Date | Value |
|---|---|---|
| 2018: EAST RIDGE RETIREMENT VILLAGE DENTAL PLAN 2018 401k membership | ||
| Total participants, beginning-of-year | 2018-01-01 | 123 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 0 |
| Total participants | 2018-01-01 | 0 |
| 2017: EAST RIDGE RETIREMENT VILLAGE DENTAL PLAN 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-01-01 | 116 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 123 |
| Total of all active and inactive participants | 2017-01-01 | 123 |
| Total participants | 2017-01-01 | 123 |
| 2018: EAST RIDGE RETIREMENT VILLAGE DENTAL PLAN 2018 form 5500 responses | ||
|---|---|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Submission has been amended | No |
| 2018-01-01 | This submission is the final filing | Yes |
| 2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-01-01 | Plan is a collectively bargained plan | No |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: EAST RIDGE RETIREMENT VILLAGE DENTAL PLAN 2017 form 5500 responses | ||
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | First time form 5500 has been submitted | Yes |
| 2017-01-01 | Submission has been amended | No |
| 2017-01-01 | This submission is the final filing | No |
| 2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-01-01 | Plan is a collectively bargained plan | No |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) | |
| Policy contract number | 756754 |
| Policy instance | 1 |
| STANDARD INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 69019 ) | |
| Policy contract number | 756754 |
| Policy instance | 1 |
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