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GROUP DENTAL INSURANCE PLAN 401k Plan overview

Plan NameGROUP DENTAL INSURANCE PLAN
Plan identification number 508

GROUP DENTAL INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Dental

401k Sponsoring company profile

DEAD RIVER COMPANY has sponsored the creation of one or more 401k plans.

Company Name:DEAD RIVER COMPANY
Employer identification number (EIN):010385895
NAIC Classification:424700

Additional information about DEAD RIVER COMPANY

Jurisdiction of Incorporation: Vermont Secretary of State Corporations Division
Incorporation Date: 1993-07-19
Company Identification Number: 64198
Legal Registered Office Address: 1154 Route 30

Townshend
United States of America (USA)
05353

More information about DEAD RIVER COMPANY

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP DENTAL INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5082015-01-01GRANT DELAWARE
5082014-01-01GRANT E DELAWARE
5082013-01-01CRAIG BOYD CHRISTOPHER HERSEY2014-07-29
5082012-01-01CRAIG BOYD CHRISTOPHER HERSEY2013-10-08
5082011-01-01CRAIG BOYD
5082009-01-01CRAIG BOYD CHRISTOPHER HERSEY2010-10-14

Plan Statistics for GROUP DENTAL INSURANCE PLAN

401k plan membership statisitcs for GROUP DENTAL INSURANCE PLAN

Measure Date Value
2015: GROUP DENTAL INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01620
Total number of active participants reported on line 7a of the Form 55002015-01-010
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-010
2014: GROUP DENTAL INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01575
Total number of active participants reported on line 7a of the Form 55002014-01-01595
Number of retired or separated participants receiving benefits2014-01-0125
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01620
2013: GROUP DENTAL INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01584
Total number of active participants reported on line 7a of the Form 55002013-01-01547
Number of retired or separated participants receiving benefits2013-01-019
Total of all active and inactive participants2013-01-01556
Total participants2013-01-01556
2012: GROUP DENTAL INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01535
Total number of active participants reported on line 7a of the Form 55002012-01-01558
Number of retired or separated participants receiving benefits2012-01-0126
Total of all active and inactive participants2012-01-01584
Total participants2012-01-01584
2011: GROUP DENTAL INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01530
Total number of active participants reported on line 7a of the Form 55002011-01-01506
Number of retired or separated participants receiving benefits2011-01-0124
Number of other retired or separated participants entitled to future benefits2011-01-015
Total of all active and inactive participants2011-01-01535
Total participants2011-01-01535
2009: GROUP DENTAL INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01467
Total number of active participants reported on line 7a of the Form 55002009-01-01497
Number of retired or separated participants receiving benefits2009-01-012
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01499
Total participants2009-01-01499

Form 5500 Responses for GROUP DENTAL INSURANCE PLAN

2015: GROUP DENTAL INSURANCE PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingYes
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: GROUP DENTAL INSURANCE PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – InsuranceYes
2013: GROUP DENTAL INSURANCE PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – InsuranceYes
2012: GROUP DENTAL INSURANCE PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – InsuranceYes
2011: GROUP DENTAL INSURANCE PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – InsuranceYes
2009: GROUP DENTAL INSURANCE PLAN 2009 form 5500 responses
2009-01-01Type of plan entityMulitple employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 )
Policy contract number6223
Policy instance 1
Insurance contract or identification number6223
Number of Individuals Covered627
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $10,238
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $488,314
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,238
Insurance broker organization code?3
Insurance broker nameUSI INSURANCE SERVICES, LLC
DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 )
Policy contract number6223
Policy instance 1
Insurance contract or identification number6223
Number of Individuals Covered1296
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $9,693
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $452,089
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,693
Insurance broker organization code?3
Insurance broker nameUSI INSURANCE SERVICES, LLC
DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 )
Policy contract number000006223
Policy instance 1
Insurance contract or identification number000006223
Number of Individuals Covered1161
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $11,989
Are there contracts with allocated funds for individual policies?No
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $404,746
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,989
Insurance broker organization code?3
Insurance broker nameUSI INSURANCE SERVICES LLC
DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 )
Policy contract number000006223
Policy instance 1
Insurance contract or identification number000006223
Number of Individuals Covered1211
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $12,082
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $409,530
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,082
Insurance broker organization code?3
Insurance broker nameTD INSURANCE INC
DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 )
Policy contract number000006223
Policy instance 1
Insurance contract or identification number000006223
Number of Individuals Covered991
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $10,617
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $346,988
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
DELTA DENTAL PLAN OF MAINE (National Association of Insurance Commissioners NAIC id number: 14369 )
Policy contract number000006223
Policy instance 1
Insurance contract or identification number000006223
Number of Individuals Covered968
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $8,635
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $333,310
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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