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DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN 401k Plan overview

Plan NameDELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN
Plan identification number 004

DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 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.
  • Participant-directed brokerage accounts provided as an investment option under the plan.
  • 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

DELTA DENTAL PLAN OF MICHIGAN, INC. has sponsored the creation of one or more 401k plans.

Company Name:DELTA DENTAL PLAN OF MICHIGAN, INC.
Employer identification number (EIN):381791480
NAIC Classification:524290

Additional information about DELTA DENTAL PLAN OF MICHIGAN, INC.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2003-10-03
Company Identification Number: 0800254463
Legal Registered Office Address: PO BOX 30416

LANSING
United States of America (USA)
48909

More information about DELTA DENTAL PLAN OF MICHIGAN, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0042012-01-01GORAN JURKOVIC
0042011-01-01GORAN JURKOVIC
0042010-01-01GORAN JURKOVIC
0042009-01-01GORAN JURKOVIC

Plan Statistics for DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN

401k plan membership statisitcs for DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN

Measure Date Value
2012: DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01198
Total number of active participants reported on line 7a of the Form 55002012-01-010
Number of retired or separated participants receiving benefits2012-01-010
Number of other retired or separated participants entitled to future benefits2012-01-010
Total of all active and inactive participants2012-01-010
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2012-01-010
Total participants2012-01-010
Number of participants with account balances2012-01-010
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2012-01-010
2011: DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01292
Total number of active participants reported on line 7a of the Form 55002011-01-01275
Number of retired or separated participants receiving benefits2011-01-012
Number of other retired or separated participants entitled to future benefits2011-01-0123
Total of all active and inactive participants2011-01-01300
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2011-01-010
Total participants2011-01-01300
Number of participants with account balances2011-01-01254
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2011-01-010
2010: DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01286
Total number of active participants reported on line 7a of the Form 55002010-01-01265
Number of retired or separated participants receiving benefits2010-01-012
Number of other retired or separated participants entitled to future benefits2010-01-0125
Total of all active and inactive participants2010-01-01292
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-01-010
Total participants2010-01-01292
Number of participants with account balances2010-01-01260
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2010-01-010
2009: DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01327
Total number of active participants reported on line 7a of the Form 55002009-01-01257
Number of retired or separated participants receiving benefits2009-01-012
Number of other retired or separated participants entitled to future benefits2009-01-0127
Total of all active and inactive participants2009-01-01286
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-01-010
Total participants2009-01-01286
Number of participants with account balances2009-01-01261
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2009-01-010

Financial Data on DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN

Measure Date Value
2012 : DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN 2012 401k financial data
Total transfer of assets from this plan2012-04-30$10,339,132
Total income from all sources (including contributions)2012-04-30$667,580
Total of all expenses incurred2012-04-30$335,536
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2012-04-30$333,226
Expenses. Certain deemed distributions of participant loans2012-04-30$989
Total contributions o plan (from employers,participants, others, non cash contrinutions)2012-04-30$115,850
Value of total assets at end of year2012-04-30$0
Value of total assets at beginning of year2012-04-30$10,007,088
Total of administrative expenses incurred including professional, contract, advisory and management fees2012-04-30$1,321
Total interest from all sources2012-04-30$8,160
Total dividends received (eg from common stock, registered investment company shares)2012-04-30$16,060
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2012-04-30Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan2012-04-30$0
Total dividends received from registered investment company shares (eg mutual funds)2012-04-30$16,060
Was this plan covered by a fidelity bond2012-04-30Yes
Value of fidelity bond cover2012-04-30$10,000,000
If this is an individual account plan, was there a blackout period2012-04-30No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2012-04-30$0
Were there any nonexempt tranactions with any party-in-interest2012-04-30No
Contributions received from participants2012-04-30$115,403
Participant contributions at end of year2012-04-30$0
Participant contributions at beginning of year2012-04-30$484,780
Income. Received or receivable in cash from other sources (including rollovers)2012-04-30$447
Administrative expenses (other) incurred2012-04-30$1,321
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2012-04-30No
Value of net income/loss2012-04-30$332,044
Value of net assets at end of year (total assets less liabilities)2012-04-30$0
Value of net assets at beginning of year (total assets less liabilities)2012-04-30$10,007,088
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2012-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2012-04-30No
Were any leases to which the plan was party in default or uncollectible2012-04-30No
Value of interest in registered invesment companies (eg mutual funds) at end of year2012-04-30$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2012-04-30$7,016,169
Interest on participant loans2012-04-30$8,152
Value of interest in common/collective trusts at end of year2012-04-30$0
Value of interest in common/collective trusts at beginning of year2012-04-30$2,341,147
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2012-04-30$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2012-04-30$164,992
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2012-04-30$164,992
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2012-04-30$8
Net investment gain/loss from registered investment companies (e.g. mutual funds)2012-04-30$575,114
Net investment gain or loss from common/collective trusts2012-04-30$-47,604
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2012-04-30No
Was there a failure to transmit to the plan any participant contributions2012-04-30Yes
Has the plan failed to provide any benefit when due under the plan2012-04-30No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2012-04-30$333,226
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32012-04-30No
Did the plan have assets held for investment2012-04-30Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2012-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2012-04-30Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2012-04-30Yes
Opinion of an independent qualified public accountant for this plan2012-04-30Disclaimer
Accountancy firm name2012-04-30PLANTE & MORAN
Accountancy firm EIN2012-04-30381357951
2011 : DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN 2011 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2011-12-31$0
Total income from all sources (including contributions)2011-12-31$340,755
Total of all expenses incurred2011-12-31$630,070
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2011-12-31$613,464
Expenses. Certain deemed distributions of participant loans2011-12-31$12,722
Value of total corrective distributions2011-12-31$137
Total contributions o plan (from employers,participants, others, non cash contrinutions)2011-12-31$350,336
Value of total assets at end of year2011-12-31$10,007,088
Value of total assets at beginning of year2011-12-31$10,296,403
Total of administrative expenses incurred including professional, contract, advisory and management fees2011-12-31$3,747
Total interest from all sources2011-12-31$35,050
Total dividends received (eg from common stock, registered investment company shares)2011-12-31$214,425
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2011-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2011-12-31$214,425
Was this plan covered by a fidelity bond2011-12-31Yes
Value of fidelity bond cover2011-12-31$10,000,000
If this is an individual account plan, was there a blackout period2011-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2011-12-31$0
Were there any nonexempt tranactions with any party-in-interest2011-12-31No
Contributions received from participants2011-12-31$347,902
Participant contributions at end of year2011-12-31$484,780
Participant contributions at beginning of year2011-12-31$452,141
Income. Received or receivable in cash from other sources (including rollovers)2011-12-31$2,434
Administrative expenses (other) incurred2011-12-31$3,747
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Value of net income/loss2011-12-31$-289,315
Value of net assets at end of year (total assets less liabilities)2011-12-31$10,007,088
Value of net assets at beginning of year (total assets less liabilities)2011-12-31$10,296,403
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2011-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2011-12-31No
Were any leases to which the plan was party in default or uncollectible2011-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2011-12-31$7,016,169
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2011-12-31$7,324,841
Interest on participant loans2011-12-31$35,037
Value of interest in common/collective trusts at end of year2011-12-31$2,341,147
Value of interest in common/collective trusts at beginning of year2011-12-31$2,406,655
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2011-12-31$164,992
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2011-12-31$112,766
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2011-12-31$112,766
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2011-12-31$13
Net investment gain/loss from registered investment companies (e.g. mutual funds)2011-12-31$-327,809
Net investment gain or loss from common/collective trusts2011-12-31$68,753
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2011-12-31No
Was there a failure to transmit to the plan any participant contributions2011-12-31Yes
Has the plan failed to provide any benefit when due under the plan2011-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2011-12-31$613,464
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32011-12-31No
Did the plan have assets held for investment2011-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2011-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2011-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2011-12-31Yes
Opinion of an independent qualified public accountant for this plan2011-12-31Disclaimer
Accountancy firm name2011-12-31PLANTE & MORAN, PLLC
Accountancy firm EIN2011-12-31381357951
2010 : DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN 2010 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2010-12-31$0
Total income from all sources (including contributions)2010-12-31$1,367,907
Total of all expenses incurred2010-12-31$912,862
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2010-12-31$891,095
Expenses. Certain deemed distributions of participant loans2010-12-31$18,699
Total contributions o plan (from employers,participants, others, non cash contrinutions)2010-12-31$407,377
Value of total assets at end of year2010-12-31$10,296,403
Value of total assets at beginning of year2010-12-31$9,841,358
Total of administrative expenses incurred including professional, contract, advisory and management fees2010-12-31$3,068
Total interest from all sources2010-12-31$38,719
Total dividends received (eg from common stock, registered investment company shares)2010-12-31$178,417
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2010-12-31No
Total dividends received from registered investment company shares (eg mutual funds)2010-12-31$178,417
Was this plan covered by a fidelity bond2010-12-31Yes
Value of fidelity bond cover2010-12-31$10,000,000
If this is an individual account plan, was there a blackout period2010-12-31No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2010-12-31$0
Were there any nonexempt tranactions with any party-in-interest2010-12-31No
Contributions received from participants2010-12-31$407,377
Participant contributions at end of year2010-12-31$452,141
Participant contributions at beginning of year2010-12-31$491,155
Participant contributions at end of year2010-12-31$0
Participant contributions at beginning of year2010-12-31$9,137
Administrative expenses (other) incurred2010-12-31$3,068
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Value of net income/loss2010-12-31$455,045
Value of net assets at end of year (total assets less liabilities)2010-12-31$10,296,403
Value of net assets at beginning of year (total assets less liabilities)2010-12-31$9,841,358
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2010-12-31No
Were any loans by the plan or fixed income obligations due to the plan in default2010-12-31No
Were any leases to which the plan was party in default or uncollectible2010-12-31No
Value of interest in registered invesment companies (eg mutual funds) at end of year2010-12-31$7,324,841
Value of interest in registered invesment companies (eg mutual funds) at beginning of year2010-12-31$6,624,447
Interest on participant loans2010-12-31$38,676
Value of interest in common/collective trusts at end of year2010-12-31$2,406,655
Value of interest in common/collective trusts at beginning of year2010-12-31$2,518,964
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year2010-12-31$112,766
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year2010-12-31$197,655
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year2010-12-31$197,655
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)2010-12-31$43
Net investment gain/loss from registered investment companies (e.g. mutual funds)2010-12-31$643,421
Net investment gain or loss from common/collective trusts2010-12-31$99,973
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2010-12-31No
Was there a failure to transmit to the plan any participant contributions2010-12-31Yes
Has the plan failed to provide any benefit when due under the plan2010-12-31No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers2010-12-31$891,095
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-32010-12-31No
Did the plan have assets held for investment2010-12-31Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2010-12-31No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2010-12-31No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2010-12-31Yes
Opinion of an independent qualified public accountant for this plan2010-12-31Disclaimer
Accountancy firm name2010-12-31PLANTE & MORAN, PLLC
Accountancy firm EIN2010-12-31381357951
2009 : DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2009-12-31$0

Form 5500 Responses for DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN

2012: DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingYes
2012-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2012-01-01Plan is a collectively bargained planYes
2012-01-01Plan funding arrangement – TrustYes
2012-01-01Plan benefit arrangement - TrustYes
2011: DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planYes
2011-01-01Plan funding arrangement – TrustYes
2011-01-01Plan benefit arrangement - TrustYes
2010: DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planYes
2010-01-01Plan funding arrangement – TrustYes
2010-01-01Plan benefit arrangement - TrustYes
2009: DELTA DENTAL PLAN OF MICHIGAN, INC. NON-SALARIED EMPLOYEES' 401(K) PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planYes
2009-01-01Plan funding arrangement – TrustYes
2009-01-01Plan benefit arrangement - TrustYes

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