DELTA DENTAL PLAN OF PUERTO RICO INC 401k Plan overview

DELTA DENTAL PLAN OF PUERTO RICO INC Benefits

401k Sponsoring company profile

Company Name:	DELTA DENTAL OF PUERTO RIRCO, INC.
Employer identification number (EIN):	680652604
NAIC Classification:	524150

Form 5500 Filing Information

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
502	2023-03-01

Plan Statistics for DELTA DENTAL PLAN OF PUERTO RICO INC

Measure	Date	Value
2023: DELTA DENTAL PLAN OF PUERTO RICO INC 2023 401k membership
Total participants, beginning-of-year	2023-03-01	105
Total number of active participants reported on line 7a of the Form 5500	2023-03-01	105
Total of all active and inactive participants	2023-03-01	105
Total participants	2023-03-01	105

Form 5500 Responses for DELTA DENTAL PLAN OF PUERTO RICO INC

Insurance Providers Used on plan

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• DELTA DENTAL PLAN OF MICHIGAN, INC. RETIREMENT INCOME PLAN [EIN = 381791480]
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• DELTA DENTAL [EIN = 311421130]
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