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Plan Name | DENTAL PLAN |
Plan identification number | 502 |
401k Plan Type | Welfare Benefit |
Plan Features/Benefits |
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Company Name: | PARK DUVALLE COMMUNITY HEALTH CENTER |
Employer identification number (EIN): | 610666209 |
NAIC Classification: | 621491 |
NAIC Description: | HMO Medical Centers |
Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
---|---|---|---|---|---|
502 | 2019-08-01 | ELIZABETH ANN HAGAN-GRIGSBY | 2021-05-17 |
Measure | Date | Value |
---|---|---|
2019: DENTAL PLAN 2019 401k membership | ||
Total participants, beginning-of-year | 2019-08-01 | 100 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-08-01 | 0 |
Number of retired or separated participants receiving benefits | 2019-08-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2019-08-01 | 0 |
Total of all active and inactive participants | 2019-08-01 | 0 |
Number of employers contributing to the scheme | 2019-08-01 | 0 |
2019: DENTAL PLAN 2019 form 5500 responses | ||
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2019-08-01 | Type of plan entity | Single employer plan |
2019-08-01 | First time form 5500 has been submitted | Yes |
2019-08-01 | This submission is the final filing | Yes |
2019-08-01 | Plan funding arrangement – Insurance | Yes |
2019-08-01 | Plan benefit arrangement – Insurance | Yes |
ANTHEM HEALTH PLAN OF KENTUCKY D.B.A. ANTHEM BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 95120 ) | |||||||||||||||||||||||||||
Policy contract number | KY2259 | ||||||||||||||||||||||||||
Policy instance | 1 | ||||||||||||||||||||||||||
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