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GASTROENTEROLOGY CENTER OF THE MIDSOUTH DENTAL CARE PLAN 401k Plan overview

Plan NameGASTROENTEROLOGY CENTER OF THE MIDSOUTH DENTAL CARE PLAN
Plan identification number 521

GASTROENTEROLOGY CENTER OF THE MIDSOUTH DENTAL CARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Dental
  • Temporary disability (accident and sickness)
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

GASTROENTEROLOGY CENTER OF THE MIDSOUTH, P.C. has sponsored the creation of one or more 401k plans.

Company Name:GASTROENTEROLOGY CENTER OF THE MIDSOUTH, P.C.
Employer identification number (EIN):621094933
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GASTROENTEROLOGY CENTER OF THE MIDSOUTH DENTAL CARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5212015-01-01DAVID HARANO
5212014-01-01DAVID HARANO
5212013-01-01
5212012-01-01DAVID HARANO
5212011-01-01DAVID HARANO
5212009-01-01DAVID HARANO

Plan Statistics for GASTROENTEROLOGY CENTER OF THE MIDSOUTH DENTAL CARE PLAN

401k plan membership statisitcs for GASTROENTEROLOGY CENTER OF THE MIDSOUTH DENTAL CARE PLAN

Measure Date Value
2015: GASTROENTEROLOGY CENTER OF THE MIDSOUTH DENTAL CARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01253
Number of retired or separated participants receiving benefits2015-01-01262
Total of all active and inactive participants2015-01-01262
2014: GASTROENTEROLOGY CENTER OF THE MIDSOUTH DENTAL CARE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01188
Total number of active participants reported on line 7a of the Form 55002014-01-01253
Total of all active and inactive participants2014-01-01253
2013: GASTROENTEROLOGY CENTER OF THE MIDSOUTH DENTAL CARE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01189
Total number of active participants reported on line 7a of the Form 55002013-01-01188
Total of all active and inactive participants2013-01-01188
2012: GASTROENTEROLOGY CENTER OF THE MIDSOUTH DENTAL CARE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01161
Total number of active participants reported on line 7a of the Form 55002012-01-01189
Total of all active and inactive participants2012-01-01189
2011: GASTROENTEROLOGY CENTER OF THE MIDSOUTH DENTAL CARE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01161
Total number of active participants reported on line 7a of the Form 55002011-01-01161
Total of all active and inactive participants2011-01-01161
2009: GASTROENTEROLOGY CENTER OF THE MIDSOUTH DENTAL CARE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01115
Total number of active participants reported on line 7a of the Form 55002009-01-01150
Total of all active and inactive participants2009-01-01150

Form 5500 Responses for GASTROENTEROLOGY CENTER OF THE MIDSOUTH DENTAL CARE PLAN

2015: GASTROENTEROLOGY CENTER OF THE MIDSOUTH DENTAL CARE PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: GASTROENTEROLOGY CENTER OF THE MIDSOUTH DENTAL CARE PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: GASTROENTEROLOGY CENTER OF THE MIDSOUTH DENTAL CARE PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: GASTROENTEROLOGY CENTER OF THE MIDSOUTH DENTAL CARE PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: GASTROENTEROLOGY CENTER OF THE MIDSOUTH DENTAL CARE PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: GASTROENTEROLOGY CENTER OF THE MIDSOUTH DENTAL CARE PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

DELTA DENTAL OF TENNESSEE (National Association of Insurance Commissioners NAIC id number: 54526 )
Policy contract number3014
Policy instance 1
Insurance contract or identification number3014
Number of Individuals Covered519
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $12,688
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,688
Insurance broker organization code?3
Insurance broker nameGENE MATHIS
DELTA DENTAL OF TENNESSEE (National Association of Insurance Commissioners NAIC id number: 54526 )
Policy contract number3014
Policy instance 1
Insurance contract or identification number3014
Number of Individuals Covered505
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $12,308
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,308
Insurance broker organization code?3
Insurance broker nameJAS D COLLIER & COMPANY
BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )
Policy contract number126603
Policy instance 1
Insurance contract or identification number126603
Number of Individuals Covered365
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $34,381
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,741
Insurance broker organization code?3
Insurance broker nameWILLIAM BEELER
STANDARD SECURITY LIFE (National Association of Insurance Commissioners NAIC id number: 69078 )
Policy contract number
Policy instance 2
Number of Individuals Covered174
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $3,646
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $32,814
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,646
Insurance broker organization code?3
Insurance broker nameHEALTH COST SOLUTIONS, INC
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010153978
Policy instance 3
Insurance contract or identification number000010153978
Number of Individuals Covered207
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,524
Total amount of fees paid to insurance companyUSD $283
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,159
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,524
Amount paid for insurance broker fees283
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
Insurance broker nameJAS D COLLIER AND COMPANY
BLUECROSS BLUESHIELD OF TENNESSEE, INC. (National Association of Insurance Commissioners NAIC id number: 54518 )
Policy contract number126603
Policy instance 1
Insurance contract or identification number126603
Number of Individuals Covered361
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $26,843
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,843
Insurance broker organization code?3
Insurance broker nameHENRY LINDEMAN
DELTA DENTAL OF TENNESSEE (National Association of Insurance Commissioners NAIC id number: 54526 )
Policy contract number3014
Policy instance 1
Insurance contract or identification number3014
Number of Individuals Covered381
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $4,247
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05568254
Policy instance 1
Insurance contract or identification numberKM05568254
Number of Individuals Covered0
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $187
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $-321
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $187
Insurance broker organization code?3
Insurance broker nameEDWIN W BARNETT
DELTA DENTAL OF TENNESSEE (National Association of Insurance Commissioners NAIC id number: 54526 )
Policy contract number3014
Policy instance 2
Insurance contract or identification number3014
Number of Individuals Covered311
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $3,612
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,612
Amount paid for insurance broker fees0
Insurance broker organization code?4
Insurance broker nameED BARNETT

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