401k Plan data: DELTA DENTAL OF COLORADO SAVINGS AND RETIREMENT PLAN plan

DELTA DENTAL OF COLORADO SAVINGS AND RETIREMENT PLAN 401k Plan overview

Plan Name	DELTA DENTAL OF COLORADO SAVINGS AND RETIREMENT PLAN
Plan identification number	002

DELTA DENTAL OF COLORADO SAVINGS AND RETIREMENT PLAN Benefits

401k Plan Type

Defined 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.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
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 OF COLORADO has sponsored the creation of one or more 401k plans.

Company Name: DELTA DENTAL OF COLORADO

Employer identification number (EIN): 834416613

NAIC Classification: 524140

Additional information about DELTA DENTAL OF COLORADO

Jurisdiction of Incorporation: Colorado Department of State

Incorporation Date: 2019-04-12

Company Identification Number: 20191317942

Legal Registered Office Address: 4528 S. Ulster Street
Suite 800
Denver
United States of America (USA)
80237

More information about DELTA DENTAL OF COLORADO

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DELTA DENTAL OF COLORADO SAVINGS AND RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2023-01-01
002 2022-01-01
002 2021-01-01
002 2020-01-01

Plan Statistics for DELTA DENTAL OF COLORADO SAVINGS AND RETIREMENT PLAN

401k plan membership statisitcs for DELTA DENTAL OF COLORADO SAVINGS AND RETIREMENT PLAN

Measure Date Value
2023: DELTA DENTAL OF COLORADO SAVINGS AND RETIREMENT PLAN 2023 401k membership
Total participants, beginning-of-year 2023-01-01 301
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 233
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 65
Total of all active and inactive participants 2023-01-01 298
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2023-01-01 0
Total participants 2023-01-01 298
Number of participants with account balances 2023-01-01 294
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2023-01-01 0
2022: DELTA DENTAL OF COLORADO SAVINGS AND RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 274
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 235
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 62
Total of all active and inactive participants 2022-01-01 297
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 297
Number of participants with account balances 2022-01-01 294
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: DELTA DENTAL OF COLORADO SAVINGS AND RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 257
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 214
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 56
Total of all active and inactive participants 2021-01-01 270
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 270
Number of participants with account balances 2021-01-01 264
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: DELTA DENTAL OF COLORADO SAVINGS AND RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 234
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 207
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 48
Total of all active and inactive participants 2020-01-01 255
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 255
Number of participants with account balances 2020-01-01 253
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0

Measure	Date	Value
2023: DELTA DENTAL OF COLORADO SAVINGS AND RETIREMENT PLAN 2023 401k membership
Total participants, beginning-of-year	2023-01-01	301
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	233
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	65
Total of all active and inactive participants	2023-01-01	298
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2023-01-01	0
Total participants	2023-01-01	298
Number of participants with account balances	2023-01-01	294
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2023-01-01	0
2022: DELTA DENTAL OF COLORADO SAVINGS AND RETIREMENT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	274
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	235
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	62
Total of all active and inactive participants	2022-01-01	297
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	297
Number of participants with account balances	2022-01-01	294
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: DELTA DENTAL OF COLORADO SAVINGS AND RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	257
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	214
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	56
Total of all active and inactive participants	2021-01-01	270
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	270
Number of participants with account balances	2021-01-01	264
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: DELTA DENTAL OF COLORADO SAVINGS AND RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	234
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	207
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	48
Total of all active and inactive participants	2020-01-01	255
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	255
Number of participants with account balances	2020-01-01	253
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0

Financial Data on DELTA DENTAL OF COLORADO SAVINGS AND RETIREMENT PLAN

Measure	Date	Value
2022 : DELTA DENTAL OF COLORADO SAVINGS AND RETIREMENT PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$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	$-1,491,778
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$2,546,735
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$2,476,760
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$3,253,280
Value of total assets at end of year	2022-12-31	$23,187,170
Value of total assets at beginning of year	2022-12-31	$27,225,683
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$69,975
Total interest from all sources	2022-12-31	$12,506
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$123,442
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2022-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2022-12-31	$123,442
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$1,500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$1,642,594
Participant contributions at end of year	2022-12-31	$259,541
Participant contributions at beginning of year	2022-12-31	$255,500
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$211,028
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Value of net income/loss	2022-12-31	$-4,038,513
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$23,187,170
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$27,225,683
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Investment advisory and management fees	2022-12-31	$39,994
Value of interest in registered invesment companies (eg mutual funds) at end of year	2022-12-31	$8,466,380
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2022-12-31	$10,065,862
Interest on participant loans	2022-12-31	$12,506
Value of interest in common/collective trusts at end of year	2022-12-31	$14,461,249
Value of interest in common/collective trusts at beginning of year	2022-12-31	$16,904,321
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-1,891,817
Net investment gain or loss from common/collective trusts	2022-12-31	$-2,989,189
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$1,399,658
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$2,476,760
Contract administrator fees	2022-12-31	$29,981
Did the plan have assets held for investment	2022-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	PLANTE & MORAN, PLLC
Accountancy firm EIN	2022-12-31	381357951
2021 : DELTA DENTAL OF COLORADO SAVINGS AND RETIREMENT PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$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	$0
Total income from all sources (including contributions)	2021-12-31	$6,512,662
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$1,842,053
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$1,773,787
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$3,095,430
Value of total assets at end of year	2021-12-31	$27,225,683
Value of total assets at beginning of year	2021-12-31	$22,555,074
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$68,266
Total interest from all sources	2021-12-31	$12,722
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$121,336
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2021-12-31	$121,336
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$1,500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$1,462,864
Participant contributions at end of year	2021-12-31	$255,500
Participant contributions at beginning of year	2021-12-31	$198,873
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$340,192
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$4,670,609
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$27,225,683
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$22,555,074
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Investment advisory and management fees	2021-12-31	$39,994
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$10,065,862
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$8,262,826
Interest on participant loans	2021-12-31	$12,722
Value of interest in common/collective trusts at end of year	2021-12-31	$16,904,321
Value of interest in common/collective trusts at beginning of year	2021-12-31	$14,093,375
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$1,255,968
Net investment gain or loss from common/collective trusts	2021-12-31	$2,027,206
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$1,292,374
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$1,773,787
Contract administrator fees	2021-12-31	$28,272
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	PLANTE & MORAN, PLLC
Accountancy firm EIN	2021-12-31	381357951
2020 : DELTA DENTAL OF COLORADO SAVINGS AND RETIREMENT PLAN 2020 401k financial data
Unrealized appreciation/depreciation of real estate assets	2020-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2020-12-31	$0
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total transfer of assets to this plan	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$5,453,770
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$2,016,181
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$1,954,526
Expenses. Certain deemed distributions of participant loans	2020-12-31	$0
Value of total corrective distributions	2020-12-31	$105
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$2,510,653
Value of total assets at end of year	2020-12-31	$22,555,074
Value of total assets at beginning of year	2020-12-31	$19,117,485
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$61,550
Total income from rents	2020-12-31	$0
Total interest from all sources	2020-12-31	$12,371
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$91,307
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2020-12-31	$91,307
Administrative expenses professional fees incurred	2020-12-31	$0
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$1,500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Amount of non-exempt transactions with any party-in-interest	2020-12-31	$0
Contributions received from participants	2020-12-31	$1,285,381
Participant contributions at end of year	2020-12-31	$198,873
Participant contributions at beginning of year	2020-12-31	$207,388
Participant contributions at end of year	2020-12-31	$0
Participant contributions at beginning of year	2020-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$86,190
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2020-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2020-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2020-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-12-31	$0
Other income not declared elsewhere	2020-12-31	$165
Administrative expenses (other) incurred	2020-12-31	$0
Liabilities. Value of operating payables at beginning of year	2020-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$3,437,589
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$22,555,074
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$19,117,485
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Amount of loans by the plan or fixed income obligations due to the plan which were in default/classified-as-uncollectible as of the close of the plan year	2020-12-31	$0
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Amount of leases to which the plan was a party which were in default/classified-as-uncollectible during the year	2020-12-31	$0
Investment advisory and management fees	2020-12-31	$39,995
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$8,262,826
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$6,636,191
Interest on participant loans	2020-12-31	$12,371
Income. Interest from loans (other than to participants)	2020-12-31	$0
Interest earned on other investments	2020-12-31	$0
Income. Interest from US Government securities	2020-12-31	$0
Income. Interest from corporate debt instruments	2020-12-31	$0
Value of interest in common/collective trusts at end of year	2020-12-31	$14,093,375
Value of interest in common/collective trusts at beginning of year	2020-12-31	$12,273,906
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2020-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2020-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$1,023,060
Net investment gain/loss from pooled separate accounts	2020-12-31	$0
Net investment gain or loss from common/collective trusts	2020-12-31	$1,816,214
Net gain/loss from 103.12 investment entities	2020-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$1,139,082
Employer contributions (assets) at end of year	2020-12-31	$0
Employer contributions (assets) at beginning of year	2020-12-31	$0
Income. Dividends from preferred stock	2020-12-31	$0
Income. Dividends from common stock	2020-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$1,954,526
Contract administrator fees	2020-12-31	$21,555
Liabilities. Value of benefit claims payable at beginning of year	2020-12-31	$0
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Aggregate proceeds on sale of assets	2020-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2020-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2020-12-31	$0
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	PLANTE & MORAN, PLLC
Accountancy firm EIN	2020-12-31	381357951

Form 5500 Responses for DELTA DENTAL OF COLORADO SAVINGS AND RETIREMENT PLAN

2023: DELTA DENTAL OF COLORADO SAVINGS AND RETIREMENT PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	This submission is the final filing	No
2023-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2023-01-01	Plan is a collectively bargained plan	No
2023-01-01	Plan funding arrangement – Insurance	Yes
2023-01-01	Plan funding arrangement – Trust	Yes
2023-01-01	Plan benefit arrangement – Insurance	Yes
2023-01-01	Plan benefit arrangement - Trust	Yes
2022: DELTA DENTAL OF COLORADO SAVINGS AND RETIREMENT PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: DELTA DENTAL OF COLORADO SAVINGS AND RETIREMENT PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: DELTA DENTAL OF COLORADO SAVINGS AND RETIREMENT PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

370508

Policy instance

Insurance contract or identification number	370508
Number of Individuals Covered	298
Insurance policy start date	2023-01-01
Insurance policy end date	2023-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

370508

Policy instance

Insurance contract or identification number	370508
Number of Individuals Covered	297
Insurance policy start date	2022-01-01
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

370508

Policy instance

Insurance contract or identification number	370508
Number of Individuals Covered	270
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

370508

Policy instance

Insurance contract or identification number	370508
Number of Individuals Covered	255
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

Potentially related plans

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Company Name:	DELTA DENTAL OF COLORADO
Employer identification number (EIN):	834416613
NAIC Classification:	524140

Jurisdiction of Incorporation:	Colorado Department of State
Incorporation Date:	2019-04-12
Company Identification Number:	20191317942
Legal Registered Office Address:	4528 S. Ulster Street Suite 800 Denver United States of America (USA) 80237