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| Plan Name | DENTAL PLAN |
| Plan identification number | 503 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | BROCKWAY-SMITH COMPANY |
| Employer identification number (EIN): | 041123740 |
| NAIC Classification: | 423300 |
Additional information about BROCKWAY-SMITH COMPANY
| Jurisdiction of Incorporation: | Vermont Secretary of State Corporations Division |
| Incorporation Date: | 1994-01-24 |
| Company Identification Number: | 64628 |
| Legal Registered Office Address: |
17 G W Tatro Dr Jeffersonville United States of America (USA) 05464 |
More information about BROCKWAY-SMITH COMPANY
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 503 | 2022-07-01 | LINDA LYONS | 2024-01-09 | ||
| 503 | 2021-07-01 | ||||
| 503 | 2021-07-01 | LINDA LYONS | |||
| 503 | 2020-07-01 | ||||
| 503 | 2019-07-01 | ||||
| 503 | 2018-07-01 | ||||
| 503 | 2017-07-01 | LINDA LYONS | LINDA LYONS | 2019-01-29 | |
| 503 | 2016-07-01 | LINDA LYONS | LINDA LYONS | 2018-01-24 | |
| 503 | 2015-07-01 | LINDA LYONS | LINDA LYONS | 2017-01-26 | |
| 503 | 2014-07-01 | LINDA LYONS | |||
| 503 | 2013-07-01 | LINDA LYONS | |||
| 503 | 2012-07-01 | LINDA LYONS | LINDA LYONS | 2014-04-01 | |
| 503 | 2011-07-01 | LINDA LYONS | |||
| 503 | 2009-07-01 | LINDA EDDY |
| Measure | Date | Value |
|---|---|---|
| 2022: DENTAL PLAN 2022 401k membership | ||
| Total participants, beginning-of-year | 2022-07-01 | 353 |
| Total number of active participants reported on line 7a of the Form 5500 | 2022-07-01 | 343 |
| Number of retired or separated participants receiving benefits | 2022-07-01 | 8 |
| Number of other retired or separated participants entitled to future benefits | 2022-07-01 | 0 |
| Total of all active and inactive participants | 2022-07-01 | 351 |
| Number of employers contributing to the scheme | 2022-07-01 | 0 |
| 2021: DENTAL PLAN 2021 401k membership | ||
| Total participants, beginning-of-year | 2021-07-01 | 336 |
| Total number of active participants reported on line 7a of the Form 5500 | 2021-07-01 | 344 |
| Number of retired or separated participants receiving benefits | 2021-07-01 | 9 |
| Number of other retired or separated participants entitled to future benefits | 2021-07-01 | 0 |
| Total of all active and inactive participants | 2021-07-01 | 353 |
| 2020: DENTAL PLAN 2020 401k membership | ||
| Total participants, beginning-of-year | 2020-07-01 | 345 |
| Total number of active participants reported on line 7a of the Form 5500 | 2020-07-01 | 336 |
| Number of retired or separated participants receiving benefits | 2020-07-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2020-07-01 | 0 |
| Total of all active and inactive participants | 2020-07-01 | 336 |
| 2019: DENTAL PLAN 2019 401k membership | ||
| Total participants, beginning-of-year | 2019-07-01 | 317 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-07-01 | 336 |
| Number of retired or separated participants receiving benefits | 2019-07-01 | 9 |
| Number of other retired or separated participants entitled to future benefits | 2019-07-01 | 0 |
| Total of all active and inactive participants | 2019-07-01 | 345 |
| 2018: DENTAL PLAN 2018 401k membership | ||
| Total participants, beginning-of-year | 2018-07-01 | 299 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-07-01 | 305 |
| Number of retired or separated participants receiving benefits | 2018-07-01 | 12 |
| Total of all active and inactive participants | 2018-07-01 | 317 |
| Total participants | 2018-07-01 | 317 |
| 2017: DENTAL PLAN 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-07-01 | 278 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-07-01 | 287 |
| Number of retired or separated participants receiving benefits | 2017-07-01 | 12 |
| Total of all active and inactive participants | 2017-07-01 | 299 |
| Total participants | 2017-07-01 | 299 |
| 2016: DENTAL PLAN 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-07-01 | 269 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-07-01 | 268 |
| Number of retired or separated participants receiving benefits | 2016-07-01 | 10 |
| Total of all active and inactive participants | 2016-07-01 | 278 |
| Total participants | 2016-07-01 | 278 |
| 2015: DENTAL PLAN 2015 401k membership | ||
| Total participants, beginning-of-year | 2015-07-01 | 271 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-07-01 | 269 |
| Number of retired or separated participants receiving benefits | 2015-07-01 | 0 |
| Total of all active and inactive participants | 2015-07-01 | 269 |
| Total participants | 2015-07-01 | 269 |
| 2014: DENTAL PLAN 2014 401k membership | ||
| Total participants, beginning-of-year | 2014-07-01 | 274 |
| Total number of active participants reported on line 7a of the Form 5500 | 2014-07-01 | 271 |
| Total of all active and inactive participants | 2014-07-01 | 271 |
| Total participants | 2014-07-01 | 271 |
| 2013: DENTAL PLAN 2013 401k membership | ||
| Total participants, beginning-of-year | 2013-07-01 | 247 |
| Total number of active participants reported on line 7a of the Form 5500 | 2013-07-01 | 274 |
| Total of all active and inactive participants | 2013-07-01 | 274 |
| Total participants | 2013-07-01 | 274 |
| 2012: DENTAL PLAN 2012 401k membership | ||
| Total participants, beginning-of-year | 2012-07-01 | 325 |
| Total number of active participants reported on line 7a of the Form 5500 | 2012-07-01 | 247 |
| Total of all active and inactive participants | 2012-07-01 | 247 |
| Total participants | 2012-07-01 | 247 |
| 2011: DENTAL PLAN 2011 401k membership | ||
| Total participants, beginning-of-year | 2011-07-01 | 351 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-07-01 | 325 |
| Total of all active and inactive participants | 2011-07-01 | 325 |
| Total participants | 2011-07-01 | 325 |
| 2009: DENTAL PLAN 2009 401k membership | ||
| Total participants, beginning-of-year | 2009-07-01 | 490 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-07-01 | 440 |
| Total of all active and inactive participants | 2009-07-01 | 440 |
| Total participants | 2009-07-01 | 440 |
| 2022: DENTAL PLAN 2022 form 5500 responses | ||
|---|---|---|
| 2022-07-01 | Type of plan entity | Single employer plan |
| 2022-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2022-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2021: DENTAL PLAN 2021 form 5500 responses | ||
| 2021-07-01 | Type of plan entity | Single employer plan |
| 2021-07-01 | Submission has been amended | No |
| 2021-07-01 | This submission is the final filing | No |
| 2021-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2021-07-01 | Plan is a collectively bargained plan | No |
| 2021-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: DENTAL PLAN 2020 form 5500 responses | ||
| 2020-07-01 | Type of plan entity | Single employer plan |
| 2020-07-01 | Submission has been amended | No |
| 2020-07-01 | This submission is the final filing | No |
| 2020-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2020-07-01 | Plan is a collectively bargained plan | No |
| 2020-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: DENTAL PLAN 2019 form 5500 responses | ||
| 2019-07-01 | Type of plan entity | Single employer plan |
| 2019-07-01 | Submission has been amended | No |
| 2019-07-01 | This submission is the final filing | No |
| 2019-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-07-01 | Plan is a collectively bargained plan | No |
| 2019-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: DENTAL PLAN 2018 form 5500 responses | ||
| 2018-07-01 | Type of plan entity | Single employer plan |
| 2018-07-01 | Submission has been amended | No |
| 2018-07-01 | This submission is the final filing | No |
| 2018-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-07-01 | Plan is a collectively bargained plan | No |
| 2018-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: DENTAL PLAN 2017 form 5500 responses | ||
| 2017-07-01 | Type of plan entity | Single employer plan |
| 2017-07-01 | Submission has been amended | No |
| 2017-07-01 | This submission is the final filing | No |
| 2017-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-07-01 | Plan is a collectively bargained plan | No |
| 2017-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2017-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: DENTAL PLAN 2016 form 5500 responses | ||
| 2016-07-01 | Type of plan entity | Single employer plan |
| 2016-07-01 | Submission has been amended | No |
| 2016-07-01 | This submission is the final filing | No |
| 2016-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-07-01 | Plan is a collectively bargained plan | No |
| 2016-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: DENTAL PLAN 2015 form 5500 responses | ||
| 2015-07-01 | Type of plan entity | Single employer plan |
| 2015-07-01 | Submission has been amended | No |
| 2015-07-01 | This submission is the final filing | No |
| 2015-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2015-07-01 | Plan is a collectively bargained plan | No |
| 2015-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2014: DENTAL PLAN 2014 form 5500 responses | ||
| 2014-07-01 | Type of plan entity | Single employer plan |
| 2014-07-01 | Submission has been amended | No |
| 2014-07-01 | This submission is the final filing | No |
| 2014-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2014-07-01 | Plan is a collectively bargained plan | No |
| 2014-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2014-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2013: DENTAL PLAN 2013 form 5500 responses | ||
| 2013-07-01 | Type of plan entity | Single employer plan |
| 2013-07-01 | Submission has been amended | No |
| 2013-07-01 | This submission is the final filing | No |
| 2013-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2013-07-01 | Plan is a collectively bargained plan | No |
| 2013-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2013-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2012: DENTAL PLAN 2012 form 5500 responses | ||
| 2012-07-01 | Type of plan entity | Single employer plan |
| 2012-07-01 | Submission has been amended | No |
| 2012-07-01 | This submission is the final filing | No |
| 2012-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2012-07-01 | Plan is a collectively bargained plan | No |
| 2012-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2012-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2011: DENTAL PLAN 2011 form 5500 responses | ||
| 2011-07-01 | Type of plan entity | Single employer plan |
| 2011-07-01 | Submission has been amended | No |
| 2011-07-01 | This submission is the final filing | No |
| 2011-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-07-01 | Plan is a collectively bargained plan | No |
| 2011-07-01 | Plan funding arrangement – Insurance | Yes |
| 2011-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2011-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2011-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2009: DENTAL PLAN 2009 form 5500 responses | ||
| 2009-07-01 | Type of plan entity | Single employer plan |
| 2009-07-01 | Submission has been amended | No |
| 2009-07-01 | This submission is the final filing | No |
| 2009-07-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-07-01 | Plan is a collectively bargained plan | No |
| 2009-07-01 | Plan funding arrangement – Insurance | Yes |
| 2009-07-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2009-07-01 | Plan benefit arrangement – Insurance | Yes |
| 2009-07-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 ) | |
| Policy contract number | 001007 |
| Policy instance | 1 |
| DELTA DENTAL OF MASSACHUSETTS (National Association of Insurance Commissioners NAIC id number: 52060 ) | |
| Policy contract number | 001007 |
| Policy instance | 1 |