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INTERDENT SERVICE CORPORATION 401(K) PLAN 401k Plan overview

Plan NameINTERDENT SERVICE CORPORATION 401(K) PLAN
Plan identification number 001

INTERDENT SERVICE CORPORATION 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Profit-sharing
  • ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
  • Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
  • Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
  • Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
  • Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

INTERDENT SERVICE CORPORATION AND IT'S SUPPORTED DENTAL PRACTICES has sponsored the creation of one or more 401k plans.

Company Name:INTERDENT SERVICE CORPORATION AND IT'S SUPPORTED DENTAL PRACTICES
Employer identification number (EIN):911577891
NAIC Classification:621210
NAIC Description:Offices of Dentists

Additional information about INTERDENT SERVICE CORPORATION AND IT'S SUPPORTED DENTAL PRACTICES

Jurisdiction of Incorporation: Washington Secretary of State Corporations Division
Incorporation Date: 1992-12-04
Company Identification Number: 601429911
Legal Registered Office Address: 711 CAPITOL WAY S STE 204

OLYMPIA
United States of America (USA)
985011267

More information about INTERDENT SERVICE CORPORATION AND IT'S SUPPORTED DENTAL PRACTICES

Form 5500 Filing Information

Submission information for form 5500 for 401k plan INTERDENT SERVICE CORPORATION 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012022-01-01MARK SHORTT2023-10-13
0012021-01-01DIANE STERN2022-10-14 DIANE STERN2022-10-14
0012020-01-01DIANE STERN2021-09-08
0012019-01-01DIANE STERN2020-08-26
0012018-01-01DIANE STERN2019-09-26
0012017-01-01

Plan Statistics for INTERDENT SERVICE CORPORATION 401(K) PLAN

401k plan membership statisitcs for INTERDENT SERVICE CORPORATION 401(K) PLAN

Measure Date Value
2022: INTERDENT SERVICE CORPORATION 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-012,092
Total number of active participants reported on line 7a of the Form 55002022-01-011,875
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-01932
Total of all active and inactive participants2022-01-012,807
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-012,807
Number of participants with account balances2022-01-012,464
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: INTERDENT SERVICE CORPORATION 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-012,606
Total number of active participants reported on line 7a of the Form 55002021-01-011,866
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-011,116
Total of all active and inactive participants2021-01-012,982
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-012,982
Number of participants with account balances2021-01-012,364
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-011
2020: INTERDENT SERVICE CORPORATION 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-012,631
Total number of active participants reported on line 7a of the Form 55002020-01-011,928
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-01678
Total of all active and inactive participants2020-01-012,606
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-012,606
Number of participants with account balances2020-01-012,368
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: INTERDENT SERVICE CORPORATION 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-012,639
Total number of active participants reported on line 7a of the Form 55002019-01-012,059
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-01572
Total of all active and inactive participants2019-01-012,631
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-012,631
Number of participants with account balances2019-01-012,429
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-016
2018: INTERDENT SERVICE CORPORATION 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-012,482
Total number of active participants reported on line 7a of the Form 55002018-01-012,105
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-01532
Total of all active and inactive participants2018-01-012,637
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-012
Total participants2018-01-012,639
Number of participants with account balances2018-01-012,393
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010
2017: INTERDENT SERVICE CORPORATION 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-013,220
Total number of active participants reported on line 7a of the Form 55002017-01-012,042
Number of retired or separated participants receiving benefits2017-01-01440
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-012,482
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2017-01-010
Total participants2017-01-012,482
Number of participants with account balances2017-01-012,472
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2017-01-010

Financial Data on INTERDENT SERVICE CORPORATION 401(K) PLAN

Measure Date Value
2022 : INTERDENT SERVICE CORPORATION 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets2022-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2022-12-31$0
Total income from all sources (including contributions)2022-12-31$-4,214,077
Total loss/gain on sale of assets2022-12-31$0
Total of all expenses incurred2022-12-31$7,022,702
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2022-12-31$6,762,307
Total contributions o plan (from employers,participants, others, non cash contrinutions)2022-12-31$9,380,834
Value of total assets at end of year2022-12-31$73,611,459
Value of total assets at beginning of year2022-12-31$84,848,238
Total of administrative expenses incurred including professional, contract, advisory and management fees2022-12-31$260,395
Total interest from all sources2022-12-31$51,689
Total dividends received (eg from common stock, registered investment company shares)2022-12-31$206,812
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2022-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2022-12-31$206,812
Administrative expenses professional fees incurred2022-12-31$13,000
Was this plan covered by a fidelity bond2022-12-31Yes
Value of fidelity bond cover2022-12-31$500,000
If this is an individual account plan, was there a blackout period2022-12-31No
Were there any nonexempt tranactions with any party-in-interest2022-12-31No
Contributions received from participants2022-12-31$7,931,619
Participant contributions at end of year2022-12-31$1,059,277
Participant contributions at beginning of year2022-12-31$1,176,241
Participant contributions at end of year2022-12-31$0
Participant contributions at beginning of year2022-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2022-12-31$198,115
Administrative expenses (other) incurred2022-12-31$3,581
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Value of net income/loss2022-12-31$-11,236,779
Value of net assets at end of year (total assets less liabilities)2022-12-31$73,611,459
Value of net assets at beginning of year (total assets less liabilities)2022-12-31$84,848,238
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2022-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2022-12-31No
Were any leases to which the plan was party in default or uncollectible2022-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2022-12-31$10,162,441
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2022-12-31$11,123,026
Value of interest in pooled separate accounts at end of year2022-12-31$4,449,315
Value of interest in pooled separate accounts at beginning of year2022-12-31$5,361,693
Interest on participant loans2022-12-31$51,689
Value of interest in common/collective trusts at end of year2022-12-31$54,036,057
Value of interest in common/collective trusts at beginning of year2022-12-31$63,680,221
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2022-12-31$2,653,269
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2022-12-31$2,497,074
Net investment gain/loss from registered investment companies (e.g. mutual funds)2022-12-31$-1,925,924
Net investment gain/loss from pooled separate accounts2022-12-31$-919,851
Net investment gain or loss from common/collective trusts2022-12-31$-11,007,637
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2022-12-31No
Was there a failure to transmit to the plan any participant contributions2022-12-31Yes
Has the plan failed to provide any benefit when due under the plan2022-12-31No
Contributions received in cash from employer2022-12-31$1,251,100
Employer contributions (assets) at end of year2022-12-31$1,251,100
Employer contributions (assets) at beginning of year2022-12-31$1,009,983
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2022-12-31$6,762,307
Contract administrator fees2022-12-31$243,814
Liabilities. Value of benefit claims payable at end of year2022-12-31$0
Liabilities. Value of benefit claims payable at beginning of year2022-12-31$0
Did the plan have assets held for investment2022-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2022-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2022-12-31No
Opinion of an independent qualified public accountant for this plan2022-12-31Unqualified
Accountancy firm name2022-12-31MILLER KAPLAN ARASE LLP
Accountancy firm EIN2022-12-31952036255
2021 : INTERDENT SERVICE CORPORATION 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-12-31$2,609
Total income from all sources (including contributions)2021-12-31$20,353,556
Total loss/gain on sale of assets2021-12-31$0
Total of all expenses incurred2021-12-31$8,687,932
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-12-31$8,198,806
Expenses. Certain deemed distributions of participant loans2021-12-31$190,225
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-12-31$9,138,094
Value of total assets at end of year2021-12-31$84,848,238
Value of total assets at beginning of year2021-12-31$73,185,223
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-12-31$298,901
Total interest from all sources2021-12-31$696,726
Total dividends received (eg from common stock, registered investment company shares)2021-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-12-31No
Was this plan covered by a fidelity bond2021-12-31Yes
Value of fidelity bond cover2021-12-31$500,000
If this is an individual account plan, was there a blackout period2021-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
Were there any nonexempt tranactions with any party-in-interest2021-12-31No
Contributions received from participants2021-12-31$7,576,113
Participant contributions at end of year2021-12-31$1,176,241
Participant contributions at beginning of year2021-12-31$1,332,417
Participant contributions at end of year2021-12-31$0
Participant contributions at beginning of year2021-12-31$1,026
Income. Received or receivable in cash from other sources (including rollovers)2021-12-31$551,998
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2021-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2021-12-31$2,609
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Value of net income/loss2021-12-31$11,665,624
Value of net assets at end of year (total assets less liabilities)2021-12-31$84,848,238
Value of net assets at beginning of year (total assets less liabilities)2021-12-31$73,182,614
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2021-12-31No
Were any leases to which the plan was party in default or uncollectible2021-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2021-12-31$11,123,026
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2021-12-31$8,193,627
Value of interest in pooled separate accounts at end of year2021-12-31$5,361,693
Value of interest in pooled separate accounts at beginning of year2021-12-31$3,272,882
Interest on participant loans2021-12-31$60,041
Interest earned on other investments2021-12-31$636,685
Value of interest in common/collective trusts at end of year2021-12-31$63,680,221
Value of interest in common/collective trusts at beginning of year2021-12-31$56,787,224
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2021-12-31$2,497,074
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2021-12-31$3,598,047
Net investment gain/loss from registered investment companies (e.g. mutual funds)2021-12-31$8,179,582
Net investment gain/loss from pooled separate accounts2021-12-31$84,438
Net investment gain or loss from common/collective trusts2021-12-31$2,254,716
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-12-31No
Was there a failure to transmit to the plan any participant contributions2021-12-31Yes
Has the plan failed to provide any benefit when due under the plan2021-12-31No
Contributions received in cash from employer2021-12-31$1,009,983
Employer contributions (assets) at end of year2021-12-31$1,009,983
Employer contributions (assets) at beginning of year2021-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2021-12-31$8,198,806
Contract administrator fees2021-12-31$298,901
Did the plan have assets held for investment2021-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-12-31No
Opinion of an independent qualified public accountant for this plan2021-12-31Unqualified
Accountancy firm name2021-12-31MILLER KAPLAN ARASE LLP
Accountancy firm EIN2021-12-31952036255
2020 : INTERDENT SERVICE CORPORATION 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$2,609
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-12-31$919
Total income from all sources (including contributions)2020-12-31$15,203,627
Total loss/gain on sale of assets2020-12-31$0
Total of all expenses incurred2020-12-31$8,476,348
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-12-31$8,045,053
Expenses. Certain deemed distributions of participant loans2020-12-31$172,242
Value of total corrective distributions2020-12-31$1,691
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-12-31$6,517,292
Value of total assets at end of year2020-12-31$73,185,223
Value of total assets at beginning of year2020-12-31$66,456,254
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-12-31$257,362
Total interest from all sources2020-12-31$431,785
Total dividends received (eg from common stock, registered investment company shares)2020-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-12-31No
Was this plan covered by a fidelity bond2020-12-31Yes
Value of fidelity bond cover2020-12-31$500,000
If this is an individual account plan, was there a blackout period2020-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
Were there any nonexempt tranactions with any party-in-interest2020-12-31No
Contributions received from participants2020-12-31$6,246,202
Participant contributions at end of year2020-12-31$1,332,417
Participant contributions at beginning of year2020-12-31$1,275,203
Participant contributions at end of year2020-12-31$1,026
Participant contributions at beginning of year2020-12-31$298
Income. Received or receivable in cash from other sources (including rollovers)2020-12-31$271,090
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2020-12-31$281
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2020-12-31$2,609
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2020-12-31$919
Other income not declared elsewhere2020-12-31$413,354
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Value of net income/loss2020-12-31$6,727,279
Value of net assets at end of year (total assets less liabilities)2020-12-31$73,182,614
Value of net assets at beginning of year (total assets less liabilities)2020-12-31$66,455,335
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2020-12-31No
Were any leases to which the plan was party in default or uncollectible2020-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2020-12-31$8,193,627
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2020-12-31$5,672,765
Value of interest in pooled separate accounts at end of year2020-12-31$3,272,882
Value of interest in pooled separate accounts at beginning of year2020-12-31$3,438,753
Interest on participant loans2020-12-31$62,082
Interest earned on other investments2020-12-31$369,703
Value of interest in common/collective trusts at end of year2020-12-31$56,787,224
Value of interest in common/collective trusts at beginning of year2020-12-31$52,735,111
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2020-12-31$3,598,047
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2020-12-31$3,334,124
Net investment gain/loss from registered investment companies (e.g. mutual funds)2020-12-31$563,181
Net investment gain/loss from pooled separate accounts2020-12-31$375,999
Net investment gain or loss from common/collective trusts2020-12-31$6,902,016
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-12-31No
Was there a failure to transmit to the plan any participant contributions2020-12-31Yes
Has the plan failed to provide any benefit when due under the plan2020-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2020-12-31$8,044,772
Contract administrator fees2020-12-31$257,362
Did the plan have assets held for investment2020-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-12-31No
Opinion of an independent qualified public accountant for this plan2020-12-31Disclaimer
Accountancy firm name2020-12-31MILLER KAPLAN ARASE LLP
Accountancy firm EIN2020-12-31952036255
2019 : INTERDENT SERVICE CORPORATION 401(K) PLAN 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total unrealized appreciation/depreciation of assets2019-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$919
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$919
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-12-31$12,588
Total income from all sources (including contributions)2019-12-31$18,870,909
Total income from all sources (including contributions)2019-12-31$18,870,909
Total loss/gain on sale of assets2019-12-31$0
Total loss/gain on sale of assets2019-12-31$0
Total of all expenses incurred2019-12-31$6,651,637
Total of all expenses incurred2019-12-31$6,651,637
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$6,361,816
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-12-31$6,361,816
Value of total corrective distributions2019-12-31$9,829
Value of total corrective distributions2019-12-31$9,829
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-12-31$7,600,053
Value of total assets at end of year2019-12-31$66,456,254
Value of total assets at end of year2019-12-31$66,456,254
Value of total assets at beginning of year2019-12-31$54,248,651
Value of total assets at beginning of year2019-12-31$54,248,651
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$279,992
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-12-31$279,992
Total interest from all sources2019-12-31$182,359
Total interest from all sources2019-12-31$182,359
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Total dividends received (eg from common stock, registered investment company shares)2019-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-12-31No
Was this plan covered by a fidelity bond2019-12-31Yes
Was this plan covered by a fidelity bond2019-12-31Yes
Value of fidelity bond cover2019-12-31$3,000,000
Value of fidelity bond cover2019-12-31$3,000,000
If this is an individual account plan, was there a blackout period2019-12-31No
If this is an individual account plan, was there a blackout period2019-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Were there any nonexempt tranactions with any party-in-interest2019-12-31No
Contributions received from participants2019-12-31$7,355,388
Contributions received from participants2019-12-31$7,355,388
Participant contributions at end of year2019-12-31$1,275,203
Participant contributions at end of year2019-12-31$1,275,203
Participant contributions at beginning of year2019-12-31$1,269,417
Participant contributions at beginning of year2019-12-31$1,269,417
Participant contributions at end of year2019-12-31$298
Participant contributions at end of year2019-12-31$298
Participant contributions at beginning of year2019-12-31$1,289
Participant contributions at beginning of year2019-12-31$1,289
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$244,665
Income. Received or receivable in cash from other sources (including rollovers)2019-12-31$244,665
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-12-31$1,237
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2019-12-31$1,237
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$919
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2019-12-31$919
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$12,588
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2019-12-31$12,588
Other income not declared elsewhere2019-12-31$5,959
Other income not declared elsewhere2019-12-31$5,959
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Value of net income/loss2019-12-31$12,219,272
Value of net income/loss2019-12-31$12,219,272
Value of net assets at end of year (total assets less liabilities)2019-12-31$66,455,335
Value of net assets at end of year (total assets less liabilities)2019-12-31$66,455,335
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$54,236,063
Value of net assets at beginning of year (total assets less liabilities)2019-12-31$54,236,063
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Were any leases to which the plan was party in default or uncollectible2019-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$5,672,765
Value of interest in registered invesment companies (eg mutual funds) at end of year2019-12-31$5,672,765
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$4,632,609
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2019-12-31$4,632,609
Value of interest in pooled separate accounts at end of year2019-12-31$3,438,753
Value of interest in pooled separate accounts at end of year2019-12-31$3,438,753
Value of interest in pooled separate accounts at beginning of year2019-12-31$2,449,648
Value of interest in pooled separate accounts at beginning of year2019-12-31$2,449,648
Interest on participant loans2019-12-31$70,087
Interest on participant loans2019-12-31$70,087
Interest earned on other investments2019-12-31$112,272
Interest earned on other investments2019-12-31$112,272
Value of interest in common/collective trusts at end of year2019-12-31$52,735,111
Value of interest in common/collective trusts at end of year2019-12-31$52,735,111
Value of interest in common/collective trusts at beginning of year2019-12-31$42,893,981
Value of interest in common/collective trusts at beginning of year2019-12-31$42,893,981
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$3,334,124
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2019-12-31$3,334,124
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$3,001,707
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2019-12-31$3,001,707
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$1,874,378
Net investment gain/loss from registered investment companies (e.g. mutual funds)2019-12-31$1,874,378
Net investment gain/loss from pooled separate accounts2019-12-31$430,384
Net investment gain/loss from pooled separate accounts2019-12-31$430,384
Net investment gain or loss from common/collective trusts2019-12-31$8,777,776
Net investment gain or loss from common/collective trusts2019-12-31$8,777,776
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-12-31No
Was there a failure to transmit to the plan any participant contributions2019-12-31Yes
Was there a failure to transmit to the plan any participant contributions2019-12-31Yes
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Has the plan failed to provide any benefit when due under the plan2019-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$6,360,579
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2019-12-31$6,360,579
Contract administrator fees2019-12-31$279,992
Contract administrator fees2019-12-31$279,992
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-12-31No
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32019-12-31No
Did the plan have assets held for investment2019-12-31Yes
Did the plan have assets held for investment2019-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-12-31Yes
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Opinion of an independent qualified public accountant for this plan2019-12-31Disclaimer
Accountancy firm name2019-12-31MILLER KAPLAN ARASE LLP
Accountancy firm name2019-12-31MILLER KAPLAN ARASE LLP
Accountancy firm EIN2019-12-31952036255
Accountancy firm EIN2019-12-31952036255
2018 : INTERDENT SERVICE CORPORATION 401(K) PLAN 2018 401k financial data
Unrealized appreciation/depreciation of real estate assets2018-12-31$0
Unrealized appreciation/depreciation of other (non real estate) assets2018-12-31$0
Total unrealized appreciation/depreciation of assets2018-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$12,588
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-12-31$0
Total income from all sources (including contributions)2018-12-31$3,252,051
Total loss/gain on sale of assets2018-12-31$0
Total of all expenses incurred2018-12-31$5,604,360
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-12-31$5,323,944
Expenses. Certain deemed distributions of participant loans2018-12-31$2,772
Value of total corrective distributions2018-12-31$13,375
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-12-31$7,382,597
Value of total assets at end of year2018-12-31$54,248,651
Value of total assets at beginning of year2018-12-31$56,588,372
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-12-31$264,269
Total income from rents2018-12-31$0
Total interest from all sources2018-12-31$55,320
Total dividends received (eg from common stock, registered investment company shares)2018-12-31$81,974
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2018-12-31$81,974
Administrative expenses professional fees incurred2018-12-31$0
Was this plan covered by a fidelity bond2018-12-31Yes
Value of fidelity bond cover2018-12-31$500,000
If this is an individual account plan, was there a blackout period2018-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2018-12-31$0
Were there any nonexempt tranactions with any party-in-interest2018-12-31No
Contributions received from participants2018-12-31$6,959,681
Participant contributions at end of year2018-12-31$1,269,417
Participant contributions at beginning of year2018-12-31$1,136,780
Participant contributions at end of year2018-12-31$1,289
Participant contributions at beginning of year2018-12-31$0
Income. Received or receivable in cash from other sources (including rollovers)2018-12-31$422,916
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)2018-12-31$3,378
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2018-12-31$12,588
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2018-12-31$0
Other income not declared elsewhere2018-12-31$2,882
Administrative expenses (other) incurred2018-12-31$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Income. Non cash contributions2018-12-31$0
Value of net income/loss2018-12-31$-2,352,309
Value of net assets at end of year (total assets less liabilities)2018-12-31$54,236,063
Value of net assets at beginning of year (total assets less liabilities)2018-12-31$56,588,372
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2018-12-31No
Were any leases to which the plan was party in default or uncollectible2018-12-31No
Investment advisory and management fees2018-12-31$0
Value of interest in registered invesment companies (eg mutual funds) at end of year2018-12-31$4,632,609
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2018-12-31$3,093,442
Value of interest in pooled separate accounts at end of year2018-12-31$2,449,648
Value of interest in pooled separate accounts at beginning of year2018-12-31$1,991,526
Interest on participant loans2018-12-31$55,320
Income. Interest from loans (other than to participants)2018-12-31$0
Interest earned on other investments2018-12-31$0
Income. Interest from US Government securities2018-12-31$0
Income. Interest from corporate debt instruments2018-12-31$0
Value of interest in common/collective trusts at end of year2018-12-31$42,893,981
Value of interest in common/collective trusts at beginning of year2018-12-31$48,928,321
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2018-12-31$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2018-12-31$3,001,707
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2018-12-31$1,438,303
Expenses. Payments to insurance carriers foe the provision of benefits2018-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2018-12-31$-642,051
Net investment gain/loss from pooled separate accounts2018-12-31$-188,661
Net investment gain or loss from common/collective trusts2018-12-31$-3,440,010
Net gain/loss from 103.12 investment entities2018-12-31$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-12-31No
Was there a failure to transmit to the plan any participant contributions2018-12-31Yes
Has the plan failed to provide any benefit when due under the plan2018-12-31No
Contributions received in cash from employer2018-12-31$0
Income. Dividends from preferred stock2018-12-31$0
Income. Dividends from common stock2018-12-31$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2018-12-31$5,320,566
Contract administrator fees2018-12-31$264,269
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32018-12-31Yes
Did the plan have assets held for investment2018-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-12-31No
Aggregate proceeds on sale of assets2018-12-31$0
Aggregate carrying amount (costs) on sale of assets2018-12-31$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-12-31Yes
Opinion of an independent qualified public accountant for this plan2018-12-31Disclaimer
Accountancy firm name2018-12-31MILLER KAPLAN ARASE LLP
Accountancy firm EIN2018-12-31952036255
2017 : INTERDENT SERVICE CORPORATION 401(K) PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets2017-12-31$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2017-12-31$894
Total income from all sources (including contributions)2017-12-31$13,740,503
Total loss/gain on sale of assets2017-12-31$0
Total of all expenses incurred2017-12-31$9,189,331
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2017-12-31$9,006,141
Total contributions o plan (from employers,participants, others, non cash contrinutions)2017-12-31$7,113,774
Value of total assets at end of year2017-12-31$56,588,372
Value of total assets at beginning of year2017-12-31$52,038,094
Total of administrative expenses incurred including professional, contract, advisory and management fees2017-12-31$183,190
Total interest from all sources2017-12-31$400,970
Total dividends received (eg from common stock, registered investment company shares)2017-12-31$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2017-12-31No
Was this plan covered by a fidelity bond2017-12-31Yes
Value of fidelity bond cover2017-12-31$3,000,000
If this is an individual account plan, was there a blackout period2017-12-31Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2017-12-31$0
Were there any nonexempt tranactions with any party-in-interest2017-12-31No
Contributions received from participants2017-12-31$6,764,913
Participant contributions at end of year2017-12-31$1,136,780
Participant contributions at beginning of year2017-12-31$1,228,019
Income. Received or receivable in cash from other sources (including rollovers)2017-12-31$348,861
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year2017-12-31$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year2017-12-31$894
Total non interest bearing cash at end of year2017-12-31$0
Total non interest bearing cash at beginning of year2017-12-31$700
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Value of net income/loss2017-12-31$4,551,172
Value of net assets at end of year (total assets less liabilities)2017-12-31$56,588,372
Value of net assets at beginning of year (total assets less liabilities)2017-12-31$52,037,200
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2017-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2017-12-31No
Were any leases to which the plan was party in default or uncollectible2017-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2017-12-31$3,093,442
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2017-12-31$45,592,019
Value of interest in pooled separate accounts at end of year2017-12-31$1,991,526
Value of interest in pooled separate accounts at beginning of year2017-12-31$0
Interest on participant loans2017-12-31$51,745
Value of interest in common/collective trusts at end of year2017-12-31$48,928,321
Value of interest in common/collective trusts at beginning of year2017-12-31$5,215,990
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2017-12-31$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2017-12-31$1,366
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2017-12-31$1,366
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2017-12-31$349,225
Value of funds held in insurance company general accounts (unallocated contracts) at end of year2017-12-31$1,438,303
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year2017-12-31$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)2017-12-31$6,225,759
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2017-12-31No
Was there a failure to transmit to the plan any participant contributions2017-12-31No
Has the plan failed to provide any benefit when due under the plan2017-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2017-12-31$9,006,141
Contract administrator fees2017-12-31$183,190
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32017-12-31Yes
Did the plan have assets held for investment2017-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2017-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2017-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2017-12-31Yes
Opinion of an independent qualified public accountant for this plan2017-12-31Disclaimer
Accountancy firm name2017-12-31MILLER KAPLAN ARASE LLP
Accountancy firm EIN2017-12-31952036255

Form 5500 Responses for INTERDENT SERVICE CORPORATION 401(K) PLAN

2022: INTERDENT SERVICE CORPORATION 401(K) PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: INTERDENT SERVICE CORPORATION 401(K) PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: INTERDENT SERVICE CORPORATION 401(K) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: INTERDENT SERVICE CORPORATION 401(K) PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: INTERDENT SERVICE CORPORATION 401(K) PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes
2017: INTERDENT SERVICE CORPORATION 401(K) PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – TrustYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 1
Insurance contract or identification number613953
Number of Individuals Covered2666
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $845
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees845
Additional information about fees paid to insurance brokerREFERRAL/SERVICE FEE
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 1
Insurance contract or identification number613953
Number of Individuals Covered2657
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $1,033
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees1033
Additional information about fees paid to insurance brokerREFERRAL/SERVICE FEE
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 1
Insurance contract or identification number613953
Number of Individuals Covered2622
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $2,880
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees2880
Additional information about fees paid to insurance brokerREFERRAL/SERVICE FEE
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 1
Insurance contract or identification number613953
Number of Individuals Covered2600
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $2,578
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees1416
Additional information about fees paid to insurance brokerREFERRAL/SERVICE FEE
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 1
Insurance contract or identification number613953
Number of Individuals Covered2645
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $738
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees738
Additional information about fees paid to insurance brokerREFERRAL/SERVICE FEE
Insurance broker organization code?3
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number613953
Policy instance 1
Insurance contract or identification number613953
Number of Individuals Covered2696
Insurance policy start date2017-07-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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