BURNETT MEDICAL CENTER has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER
401k plan membership statisitcs for GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER
| Measure | Date | Value |
|---|
| 2023: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2023 401k membership |
|---|
| Total participants, beginning-of-year | 2023-01-01 | 104 |
| Total number of active participants reported on line 7a of the Form 5500 | 2023-01-01 | 109 |
| Number of retired or separated participants receiving benefits | 2023-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2023-01-01 | 0 |
| Total of all active and inactive participants | 2023-01-01 | 109 |
| Total participants | 2023-01-01 | 109 |
| 2022: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2022 401k membership |
|---|
| Total participants, beginning-of-year | 2022-01-01 | 108 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 104 |
| Total of all active and inactive participants | 2022-01-01 | 104 |
| Total participants | 2022-01-01 | 104 |
| 2021: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2021 401k membership |
|---|
| Total participants, beginning-of-year | 2021-01-01 | 115 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-01-01 | 108 |
| Total of all active and inactive participants | 2021-01-01 | 108 |
| Total participants | 2021-01-01 | 108 |
| 2020: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2020 401k membership |
|---|
| Total participants, beginning-of-year | 2020-01-01 | 110 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-01-01 | 115 |
| Total of all active and inactive participants | 2020-01-01 | 115 |
| Total participants | 2020-01-01 | 115 |
| 2019: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2019 401k membership |
|---|
| Total participants, beginning-of-year | 2019-01-01 | 127 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 110 |
| Total of all active and inactive participants | 2019-01-01 | 110 |
| Total participants | 2019-01-01 | 110 |
| 2018: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2018 401k membership |
|---|
| Total participants, beginning-of-year | 2018-01-01 | 118 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 127 |
| Total of all active and inactive participants | 2018-01-01 | 127 |
| Total participants | 2018-01-01 | 127 |
| 2017: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2017 401k membership |
|---|
| Total participants, beginning-of-year | 2017-01-01 | 112 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-01-01 | 118 |
| Total of all active and inactive participants | 2017-01-01 | 118 |
| Total participants | 2017-01-01 | 118 |
| 2016: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2016 401k membership |
|---|
| Total participants, beginning-of-year | 2016-01-01 | 120 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 112 |
| Total of all active and inactive participants | 2016-01-01 | 112 |
| Total participants | 2016-01-01 | 112 |
| 2015: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2015 401k membership |
|---|
| Total participants, beginning-of-year | 2015-01-01 | 110 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-01-01 | 120 |
| Total of all active and inactive participants | 2015-01-01 | 120 |
| Total participants | 2015-01-01 | 120 |
| 2014: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2014 401k membership |
|---|
| Total participants, beginning-of-year | 2014-01-01 | 109 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-01-01 | 110 |
| Total of all active and inactive participants | 2014-01-01 | 110 |
| Total participants | 2014-01-01 | 110 |
| 2013: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2013 401k membership |
|---|
| Total participants, beginning-of-year | 2013-01-01 | 107 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-01-01 | 109 |
| Total of all active and inactive participants | 2013-01-01 | 109 |
| Total participants | 2013-01-01 | 109 |
| 2012: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2012 401k membership |
|---|
| Total participants, beginning-of-year | 2012-01-01 | 111 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-01-01 | 107 |
| Total of all active and inactive participants | 2012-01-01 | 107 |
| Total participants | 2012-01-01 | 107 |
| 2011: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2011 401k membership |
|---|
| Total participants, beginning-of-year | 2011-01-01 | 111 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 111 |
| Total of all active and inactive participants | 2011-01-01 | 111 |
| Total participants | 2011-01-01 | 111 |
| 2010: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2010 401k membership |
|---|
| Total participants, beginning-of-year | 2010-01-01 | 111 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-01-01 | 111 |
| Total of all active and inactive participants | 2010-01-01 | 111 |
| Total participants | 2010-01-01 | 111 |
| 2023: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2023 form 5500 responses |
|---|
| 2023-01-01 | Type of plan entity | Single employer plan |
| 2023-01-01 | Plan funding arrangement – Insurance | Yes |
| 2023-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2022 form 5500 responses |
|---|
| 2022-01-01 | Type of plan entity | Single employer plan |
| 2022-01-01 | Plan funding arrangement – Insurance | Yes |
| 2022-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2021 form 5500 responses |
|---|
| 2021-01-01 | Type of plan entity | Single employer plan |
| 2021-01-01 | Plan funding arrangement – Insurance | Yes |
| 2021-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 2020-01-01 | Plan funding arrangement – Insurance | Yes |
| 2020-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2018 form 5500 responses |
|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2017 form 5500 responses |
|---|
| 2017-01-01 | Type of plan entity | Single employer plan |
| 2017-01-01 | Plan funding arrangement – Insurance | Yes |
| 2017-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2016 form 5500 responses |
|---|
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | Plan funding arrangement – Insurance | Yes |
| 2016-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2015: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2015 form 5500 responses |
|---|
| 2015-01-01 | Type of plan entity | Single employer plan |
| 2015-01-01 | Plan funding arrangement – Insurance | Yes |
| 2015-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2014: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2014 form 5500 responses |
|---|
| 2014-01-01 | Type of plan entity | Single employer plan |
| 2014-01-01 | Plan funding arrangement – Insurance | Yes |
| 2014-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2013: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2013 form 5500 responses |
|---|
| 2013-01-01 | Type of plan entity | Single employer plan |
| 2013-01-01 | Plan funding arrangement – Insurance | Yes |
| 2013-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2012: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2012 form 5500 responses |
|---|
| 2012-01-01 | Type of plan entity | Single employer plan |
| 2012-01-01 | Plan funding arrangement – Insurance | Yes |
| 2012-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2011 form 5500 responses |
|---|
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2010: GROUP DENTAL INSURANCE BENEFITS FOR EMPLOYEES OF BURNETT MEDICAL CENTER 2010 form 5500 responses |
|---|
| 2010-01-01 | Type of plan entity | Single employer plan |
| 2010-01-01 | First time form 5500 has been submitted | Yes |
| 2010-01-01 | Plan funding arrangement – Insurance | Yes |
| 2010-01-01 | Plan benefit arrangement – Insurance | Yes |
| BLUE CROSS BLUE SHIELD OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54003 ) |
| Policy contract number | DD1118 |
| Policy instance | 1 |
| Insurance contract or identification number | DD1118 | | Number of Individuals Covered | 188 | | Insurance policy start date | 2023-01-01 | | Insurance policy end date | 2023-12-31 | | Total amount of commissions paid to insurance broker | USD $9,290 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $93,949 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54003 ) |
| Policy contract number | DD1118 |
| Policy instance | 1 |
| Insurance contract or identification number | DD1118 | | Number of Individuals Covered | 183 | | Insurance policy start date | 2022-01-01 | | Insurance policy end date | 2022-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $82,614 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54003 ) |
| Policy contract number | 123088 |
| Policy instance | 1 |
| Insurance contract or identification number | 123088 | | Number of Individuals Covered | 191 | | Insurance policy start date | 2021-01-01 | | Insurance policy end date | 2021-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $81,739 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54003 ) |
| Policy contract number | 123088 |
| Policy instance | 1 |
| Insurance contract or identification number | 123088 | | Number of Individuals Covered | 224 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $79,313 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| BLUE CROSS BLUE SHIELD OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54003 ) |
| Policy contract number | 123088 |
| Policy instance | 1 |
| Insurance contract or identification number | 123088 | | Number of Individuals Covered | 110 | | Insurance policy start date | 2019-01-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $13,252 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $88,347 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $13,252 | | Insurance broker organization code? | 3 |
|
| BLUE CROSS BLUE SHIELD OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54003 ) |
| Policy contract number | 123088 |
| Policy instance | 1 |
| Insurance contract or identification number | 123088 | | Number of Individuals Covered | 127 | | Insurance policy start date | 2018-01-01 | | Insurance policy end date | 2018-12-31 | | Total amount of commissions paid to insurance broker | USD $14,003 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $93,351 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $14,003 | | Insurance broker organization code? | 3 |
|
| AMERITAS LIFE INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | 010-044461 |
| Policy instance | 1 |
| Insurance contract or identification number | 010-044461 | | Number of Individuals Covered | 259 | | Insurance policy start date | 2017-01-01 | | Insurance policy end date | 2017-12-31 | | Total amount of commissions paid to insurance broker | USD $7,806 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $78,061 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,806 | | Insurance broker organization code? | 3 | | Insurance broker name | LAMAIR MULOCK CONDON CO |
|
| DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 ) |
| Policy contract number | 3615 |
| Policy instance | 1 |
| Insurance contract or identification number | 3615 | | Number of Individuals Covered | 120 | | Insurance policy start date | 2015-01-01 | | Insurance policy end date | 2015-12-31 | | Total amount of commissions paid to insurance broker | USD $8,215 | | Dental Insurance Welfare Benefit | Yes | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $8,215 | | Insurance broker organization code? | 3 | | Insurance broker name | ISG ADVISORS LLC |
|
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 51014 |
| Policy instance | 2 |
| Insurance contract or identification number | 51014 | | Number of Individuals Covered | 198 | | Insurance policy start date | 2016-01-01 | | Insurance policy end date | 2016-12-31 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $14,358 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
|
| NATIONAL GUARDIAN LIFE (National Association of Insurance Commissioners NAIC id number: 66583 ) |
| Policy contract number | 51014 |
| Policy instance | 2 |
| Insurance contract or identification number | 51014 | | Number of Individuals Covered | 90 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $171 | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $13,037 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $171 | | Insurance broker organization code? | 3 | | Insurance broker name | ISG ADVISORS LLC |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00482067 |
| Policy instance | 1 |
| Insurance contract or identification number | 00482067 | | Number of Individuals Covered | 110 | | Insurance policy start date | 2014-01-01 | | Insurance policy end date | 2014-12-31 | | Total amount of commissions paid to insurance broker | USD $7,597 | | Dental Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $75,975 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,597 | | Insurance broker organization code? | 3 | | Insurance broker name | ISG ADVISORS LLC |
|
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) |
| Policy contract number | 00482067 |
| Policy instance | 1 |
| Insurance contract or identification number | 00482067 | | Number of Individuals Covered | 109 | | Insurance policy start date | 2013-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $7,499 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $74,992 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,499 | | Insurance broker organization code? | 3 | | Insurance broker name | ISG ADVISORS LLC |
|
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | 010-034796 |
| Policy instance | 1 |
| Insurance contract or identification number | 010-034796 | | Number of Individuals Covered | 107 | | Insurance policy start date | 2012-01-01 | | Insurance policy end date | 2013-12-31 | | Total amount of commissions paid to insurance broker | USD $7,632 | | Total amount of fees paid to insurance company | USD $562 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $76,322 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $7,632 | | Amount paid for insurance broker fees | 562 | | Additional information about fees paid to insurance broker | FEES | | Insurance broker organization code? | 3 | | Insurance broker name | ISG ADVISORS LLC |
|
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | 010-034796 |
| Policy instance | 1 |
| Insurance contract or identification number | 010-034796 | | Number of Individuals Covered | 111 | | Insurance policy start date | 2011-01-01 | | Insurance policy end date | 2011-12-31 | | Total amount of commissions paid to insurance broker | USD $7,285 | | Total amount of fees paid to insurance company | USD $718 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $72,848 |
|
| AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 ) |
| Policy contract number | 010-034796 |
| Policy instance | 1 |
| Insurance contract or identification number | 010-034796 | | Number of Individuals Covered | 111 | | Insurance policy start date | 2010-01-01 | | Insurance policy end date | 2010-12-31 | | Total amount of commissions paid to insurance broker | USD $7,691 | | Dental Insurance Welfare Benefit | Yes | | Vision Insurance Welfare Benefit | Yes | | Welfare Benefit Premiums Paid to Carrier | USD $69,053 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $1,169 | | Insurance broker organization code? | 3 | | Insurance broker name | ISG ADVISORS LLC |
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