Plan Name | GROUP DENTAL INSURANCE PLAN |
Plan identification number | 502 |
401k Plan Type | Welfare Benefit |
Plan Features/Benefits |
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Company Name: | WELLSPRING FAMILY SERVICES |
Employer identification number (EIN): | 910567261 |
NAIC Classification: | 624100 |
NAIC Description: | Individual and Family Services |
Additional information about WELLSPRING FAMILY SERVICES
Jurisdiction of Incorporation: | Washington Secretary of State Corporations Division |
Incorporation Date: | 1922-04-03 |
Company Identification Number: | 600351881 |
Legal Registered Office Address: |
1450 5TH AVE STE 4200 SEATTLE United States of America (USA) 981012314 |
More information about WELLSPRING FAMILY SERVICES
Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
---|---|---|---|---|---|
502 | 2022-01-01 | ||||
502 | 2018-01-01 | BOB MENDONSA | BOB MENDONSA | 2019-05-07 | |
502 | 2017-01-01 | BOB MENDONSA | BOB MENDONSA | 2018-08-02 | |
502 | 2016-01-01 | BOB MENDONSA | BOB MENDONSA | 2017-07-27 |
Measure | Date | Value |
---|---|---|
2022: GROUP DENTAL INSURANCE PLAN 2022 401k membership | ||
Total participants, beginning-of-year | 2022-01-01 | 99 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-01-01 | 109 |
Total of all active and inactive participants | 2022-01-01 | 109 |
Total participants | 2022-01-01 | 109 |
2018: GROUP DENTAL INSURANCE PLAN 2018 401k membership | ||
Total participants, beginning-of-year | 2018-01-01 | 97 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 80 |
Number of retired or separated participants receiving benefits | 2018-01-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
Total of all active and inactive participants | 2018-01-01 | 80 |
Total participants | 2018-01-01 | 80 |
2017: GROUP DENTAL INSURANCE PLAN 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 | 97 |
Total of all active and inactive participants | 2017-01-01 | 97 |
Total participants | 2017-01-01 | 97 |
2016: GROUP DENTAL INSURANCE PLAN 2016 401k membership | ||
Total participants, beginning-of-year | 2016-01-01 | 112 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 113 |
Total of all active and inactive participants | 2016-01-01 | 113 |
Total participants | 2016-01-01 | 113 |
2022: GROUP DENTAL INSURANCE PLAN 2022 form 5500 responses | ||
---|---|---|
2022-01-01 | Type of plan entity | Single employer plan |
2022-01-01 | Submission has been amended | No |
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 benefit arrangement – Insurance | Yes |
2018: GROUP DENTAL INSURANCE PLAN 2018 form 5500 responses | ||
2018-01-01 | Type of plan entity | Single employer plan |
2018-01-01 | Submission has been amended | No |
2018-01-01 | This submission is the final filing | No |
2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2018-01-01 | Plan is a collectively bargained plan | No |
2018-01-01 | Plan funding arrangement – Insurance | Yes |
2018-01-01 | Plan benefit arrangement – Insurance | Yes |
2017: GROUP DENTAL INSURANCE PLAN 2017 form 5500 responses | ||
2017-01-01 | Type of plan entity | Single employer plan |
2017-01-01 | Submission has been amended | No |
2017-01-01 | This submission is the final filing | No |
2017-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2017-01-01 | Plan is a collectively bargained plan | No |
2017-01-01 | Plan funding arrangement – Insurance | Yes |
2017-01-01 | Plan benefit arrangement – Insurance | Yes |
2016: GROUP DENTAL INSURANCE PLAN 2016 form 5500 responses | ||
2016-01-01 | Type of plan entity | Single employer plan |
2016-01-01 | First time form 5500 has been submitted | Yes |
2016-01-01 | Submission has been amended | No |
2016-01-01 | This submission is the final filing | No |
2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-01-01 | Plan is a collectively bargained plan | No |
2016-01-01 | Plan funding arrangement – Insurance | Yes |
2016-01-01 | Plan benefit arrangement – Insurance | Yes |
DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy contract number | 07394 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
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DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy contract number | 07394 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
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DELTA DENTAL OF WASHINGTON (National Association of Insurance Commissioners NAIC id number: 74341 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy contract number | 07394 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
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