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COMMUNITY INTEGRATED SERVICES GROUP DENTAL PLAN 401k Plan overview

Plan NameCOMMUNITY INTEGRATED SERVICES GROUP DENTAL PLAN
Plan identification number 503

COMMUNITY INTEGRATED SERVICES GROUP DENTAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Dental

401k Sponsoring company profile

COMMUNITY INTEGRATED SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name:COMMUNITY INTEGRATED SERVICES, INC.
Employer identification number (EIN):200006353
NAIC Classification:623000
NAIC Description: Nursing and Residential Care Facilities

Additional information about COMMUNITY INTEGRATED SERVICES, INC.

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 3378077

More information about COMMUNITY INTEGRATED SERVICES, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COMMUNITY INTEGRATED SERVICES GROUP DENTAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032021-08-01CHARLES MORTON2023-02-16
5032021-08-01CHARLES MORTON2024-04-23

Plan Statistics for COMMUNITY INTEGRATED SERVICES GROUP DENTAL PLAN

401k plan membership statisitcs for COMMUNITY INTEGRATED SERVICES GROUP DENTAL PLAN

Measure Date Value
2021: COMMUNITY INTEGRATED SERVICES GROUP DENTAL PLAN 2021 401k membership
Total participants, beginning-of-year2021-08-01100
Total number of active participants reported on line 7a of the Form 55002021-08-01111
Number of retired or separated participants receiving benefits2021-08-010
Number of other retired or separated participants entitled to future benefits2021-08-010
Total of all active and inactive participants2021-08-01111
Number of employers contributing to the scheme2021-08-010

Form 5500 Responses for COMMUNITY INTEGRATED SERVICES GROUP DENTAL PLAN

2021: COMMUNITY INTEGRATED SERVICES GROUP DENTAL PLAN 2021 form 5500 responses
2021-08-01Type of plan entitySingle employer plan
2021-08-01First time form 5500 has been submittedYes
2021-08-01Submission has been amendedYes
2021-08-01This submission is the final filingYes
2021-08-01Plan funding arrangement – InsuranceYes
2021-08-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1143240
Policy instance 1
Insurance contract or identification number1143240
Number of Individuals Covered124
Insurance policy start date2021-08-01
Insurance policy end date2022-07-31
Total amount of commissions paid to insurance brokerUSD $3,594
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $72,708
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,594
Amount paid for insurance broker fees0
Insurance broker organization code?3

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