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ORTHOPAEDIC & FRACTURE CLINIC HEALTH INSURANCE PLA 401k Plan overview

Plan NameORTHOPAEDIC & FRACTURE CLINIC HEALTH INSURANCE PLA
Plan identification number 502

ORTHOPAEDIC & FRACTURE CLINIC HEALTH INSURANCE PLA Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

THE ORTHOPAEDIC AND FRACTURE CLINIC, P.A. has sponsored the creation of one or more 401k plans.

Company Name:THE ORTHOPAEDIC AND FRACTURE CLINIC, P.A.
Employer identification number (EIN):410940705
NAIC Classification:621111
NAIC Description:Offices of Physicians (except Mental Health Specialists)

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ORTHOPAEDIC & FRACTURE CLINIC HEALTH INSURANCE PLA

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022018-01-01
5022017-01-01RICHARD E MENDEN RICHARD E MENDEN2018-06-29
5022016-01-01RICHARD E MENDEN RICHARD E MENDEN2017-05-31
5022015-01-01RICHARD E MENDEN RICHARD E MENDEN2016-07-26
5022014-08-01RICHARD E MENDEN RICHARD E MENDEN2015-07-29
5022013-08-01RICHARD E MENDEN RICHARD E MENDEN2015-01-21
5022012-08-01RICHARD E MENDEN RICHARD E MENDEN2014-02-26
5022011-08-01RICHARD E MENDEN
5022009-08-01RICHARD E MENDEN

Plan Statistics for ORTHOPAEDIC & FRACTURE CLINIC HEALTH INSURANCE PLA

401k plan membership statisitcs for ORTHOPAEDIC & FRACTURE CLINIC HEALTH INSURANCE PLA

Measure Date Value
2018: ORTHOPAEDIC & FRACTURE CLINIC HEALTH INSURANCE PLA 2018 401k membership
Total participants, beginning-of-year2018-01-0191
Total number of active participants reported on line 7a of the Form 55002018-01-0186
Number of retired or separated participants receiving benefits2018-01-012
Number of other retired or separated participants entitled to future benefits2018-01-012
Total of all active and inactive participants2018-01-0190
2017: ORTHOPAEDIC & FRACTURE CLINIC HEALTH INSURANCE PLA 2017 401k membership
Total participants, beginning-of-year2017-01-01116
Total number of active participants reported on line 7a of the Form 55002017-01-0191
Number of retired or separated participants receiving benefits2017-01-011
Number of other retired or separated participants entitled to future benefits2017-01-011
Total of all active and inactive participants2017-01-0193
2016: ORTHOPAEDIC & FRACTURE CLINIC HEALTH INSURANCE PLA 2016 401k membership
Total participants, beginning-of-year2016-01-01110
Total number of active participants reported on line 7a of the Form 55002016-01-01116
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01116
2015: ORTHOPAEDIC & FRACTURE CLINIC HEALTH INSURANCE PLA 2015 401k membership
Total participants, beginning-of-year2015-01-01109
Total number of active participants reported on line 7a of the Form 55002015-01-01110
Total of all active and inactive participants2015-01-01110
2014: ORTHOPAEDIC & FRACTURE CLINIC HEALTH INSURANCE PLA 2014 401k membership
Total participants, beginning-of-year2014-08-01106
Total number of active participants reported on line 7a of the Form 55002014-08-01109
Total of all active and inactive participants2014-08-01109
2013: ORTHOPAEDIC & FRACTURE CLINIC HEALTH INSURANCE PLA 2013 401k membership
Total participants, beginning-of-year2013-08-01104
Total number of active participants reported on line 7a of the Form 55002013-08-01106
Total of all active and inactive participants2013-08-01106
2012: ORTHOPAEDIC & FRACTURE CLINIC HEALTH INSURANCE PLA 2012 401k membership
Total participants, beginning-of-year2012-08-01106
Total number of active participants reported on line 7a of the Form 55002012-08-01104
Total of all active and inactive participants2012-08-01104
2011: ORTHOPAEDIC & FRACTURE CLINIC HEALTH INSURANCE PLA 2011 401k membership
Total participants, beginning-of-year2011-08-01111
Total number of active participants reported on line 7a of the Form 55002011-08-01106
Number of retired or separated participants receiving benefits2011-08-011
Total of all active and inactive participants2011-08-01107
2009: ORTHOPAEDIC & FRACTURE CLINIC HEALTH INSURANCE PLA 2009 401k membership
Total participants, beginning-of-year2009-08-01109
Total number of active participants reported on line 7a of the Form 55002009-08-01110
Number of retired or separated participants receiving benefits2009-08-011
Number of other retired or separated participants entitled to future benefits2009-08-013
Total of all active and inactive participants2009-08-01114

Form 5500 Responses for ORTHOPAEDIC & FRACTURE CLINIC HEALTH INSURANCE PLA

2018: ORTHOPAEDIC & FRACTURE CLINIC HEALTH INSURANCE PLA 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – General assets of the sponsorYes
2017: ORTHOPAEDIC & FRACTURE CLINIC HEALTH INSURANCE PLA 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: ORTHOPAEDIC & FRACTURE CLINIC HEALTH INSURANCE PLA 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: ORTHOPAEDIC & FRACTURE CLINIC HEALTH INSURANCE PLA 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: ORTHOPAEDIC & FRACTURE CLINIC HEALTH INSURANCE PLA 2014 form 5500 responses
2014-08-01Type of plan entitySingle employer plan
2014-08-01This return/report is a short plan year return/report (less than 12 months)Yes
2014-08-01Plan funding arrangement – InsuranceYes
2014-08-01Plan funding arrangement – General assets of the sponsorYes
2014-08-01Plan benefit arrangement – InsuranceYes
2014-08-01Plan benefit arrangement – General assets of the sponsorYes
2013: ORTHOPAEDIC & FRACTURE CLINIC HEALTH INSURANCE PLA 2013 form 5500 responses
2013-08-01Type of plan entitySingle employer plan
2013-08-01Plan funding arrangement – InsuranceYes
2013-08-01Plan funding arrangement – General assets of the sponsorYes
2013-08-01Plan benefit arrangement – InsuranceYes
2013-08-01Plan benefit arrangement – General assets of the sponsorYes
2012: ORTHOPAEDIC & FRACTURE CLINIC HEALTH INSURANCE PLA 2012 form 5500 responses
2012-08-01Type of plan entitySingle employer plan
2012-08-01Plan funding arrangement – InsuranceYes
2012-08-01Plan benefit arrangement – InsuranceYes
2011: ORTHOPAEDIC & FRACTURE CLINIC HEALTH INSURANCE PLA 2011 form 5500 responses
2011-08-01Type of plan entitySingle employer plan
2011-08-01Plan funding arrangement – InsuranceYes
2011-08-01Plan benefit arrangement – InsuranceYes
2009: ORTHOPAEDIC & FRACTURE CLINIC HEALTH INSURANCE PLA 2009 form 5500 responses
2009-08-01Type of plan entitySingle employer plan
2009-08-01This submission is the final filingNo
2009-08-01Plan funding arrangement – InsuranceYes
2009-08-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

DELTA DENTAL OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 )
Policy contract number0000006767
Policy instance 2
Insurance contract or identification number0000006767
Number of Individuals Covered163
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $5,370
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $58,988
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,370
Insurance broker organization code?3
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract numberEP829
Policy instance 1
Insurance contract or identification numberEP829
Number of Individuals Covered197
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $23,672
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $371,777
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,672
Insurance broker organization code?3
DELTA DENTAL OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55034 )
Policy contract number0000006767
Policy instance 2
Insurance contract or identification number0000006767
Number of Individuals Covered151
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $6,284
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $62,843
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,284
Insurance broker organization code?3
Insurance broker nameNORTH RISK PARTNERS LLC
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract numberEP829
Policy instance 1
Insurance contract or identification numberEP829
Number of Individuals Covered194
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $25,894
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $347,976
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,894
Insurance broker organization code?3
Insurance broker nameNORTH RISK PARTNERS LLC DBA JOHNSON
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract numberEP829
Policy instance 1
Insurance contract or identification numberEP829
Number of Individuals Covered291
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $31,044
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $492,843
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $31,044
Insurance broker organization code?3
Insurance broker nameNORTH RISK PARTNERS LLC DBA JOHNSON
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract numberEP829
Policy instance 1
Insurance contract or identification numberEP829
Number of Individuals Covered109
Insurance policy start date2014-08-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $11,235
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $203,047
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,235
Insurance broker organization code?3
Insurance broker nameNORTH RISK PARTNERS LLC DBA JOHNSON
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract numberEP829
Policy instance 1
Insurance contract or identification numberEP829
Number of Individuals Covered106
Insurance policy start date2013-08-01
Insurance policy end date2014-07-31
Total amount of commissions paid to insurance brokerUSD $26,901
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $556,622
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,901
Insurance broker organization code?3
Insurance broker nameNORTH RISK PARTNERS LLC DBA JOHNSON
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract numberEP829
Policy instance 1
Insurance contract or identification numberEP829
Number of Individuals Covered104
Insurance policy start date2012-08-01
Insurance policy end date2013-07-31
Total amount of commissions paid to insurance brokerUSD $26,785
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $423,457
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,785
Insurance broker organization code?3
Insurance broker nameJOHNSON MCCANN BENEFITS LLC
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract numberEP829
Policy instance 1
Insurance contract or identification numberEP829
Number of Individuals Covered106
Insurance policy start date2011-08-01
Insurance policy end date2012-07-31
Total amount of commissions paid to insurance brokerUSD $27,532
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $401,473
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA (National Association of Insurance Commissioners NAIC id number: 55026 )
Policy contract numberEP829
Policy instance 1
Insurance contract or identification numberEP829
Number of Individuals Covered110
Insurance policy start date2010-08-01
Insurance policy end date2011-07-31
Total amount of commissions paid to insurance brokerUSD $28,077
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $360,338
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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