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FOREST RIVER, INC. DENTAL INSURANCE PLAN 401k Plan overview

Plan NameFOREST RIVER, INC. DENTAL INSURANCE PLAN
Plan identification number 505

FOREST RIVER, INC. DENTAL INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Dental

401k Sponsoring company profile

FOREST RIVER, INC. has sponsored the creation of one or more 401k plans.

Company Name:FOREST RIVER, INC.
Employer identification number (EIN):203284366
NAIC Classification:336100

Additional information about FOREST RIVER, INC.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 2005-08-18
Company Identification Number: 0800533479
Legal Registered Office Address: PO BOX 3030

ELKHART
United States of America (USA)
46515

More information about FOREST RIVER, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FOREST RIVER, INC. DENTAL INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5052015-01-01JEFF ROWE JEFF ROWE2016-07-14
5052014-01-01JEFF ROWE JEFF ROWE2016-07-14
5052013-01-01JEFF ROWE JEFF ROWE2016-07-14

Plan Statistics for FOREST RIVER, INC. DENTAL INSURANCE PLAN

401k plan membership statisitcs for FOREST RIVER, INC. DENTAL INSURANCE PLAN

Measure Date Value
2015: FOREST RIVER, INC. DENTAL INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-016,157
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: FOREST RIVER, INC. DENTAL INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-015,127
Total number of active participants reported on line 7a of the Form 55002014-01-015,914
Number of retired or separated participants receiving benefits2014-01-0120
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-015,934
2013: FOREST RIVER, INC. DENTAL INSURANCE PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-014,706
Total number of active participants reported on line 7a of the Form 55002013-01-015,097
Number of retired or separated participants receiving benefits2013-01-0130
Number of other retired or separated participants entitled to future benefits2013-01-010
Total of all active and inactive participants2013-01-015,127

Form 5500 Responses for FOREST RIVER, INC. DENTAL INSURANCE PLAN

2015: FOREST RIVER, INC. DENTAL INSURANCE PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01First time form 5500 has been submittedYes
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: FOREST RIVER, INC. 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: FOREST RIVER, INC. DENTAL INSURANCE PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01First time form 5500 has been submittedYes
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

Insurance Providers Used on plan

HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96687 )
Policy contract number379283275020
Policy instance 1
Insurance contract or identification number379283275020
Number of Individuals Covered1449
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $12,724
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $254,951
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,724
Insurance broker organization code?3
Insurance broker nameHEALY GROUP INC.
HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96687 )
Policy contract number379280325020
Policy instance 2
Insurance contract or identification number379280325020
Number of Individuals Covered11919
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $109,276
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,190,462
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $109,276
Insurance broker organization code?3
Insurance broker nameHEALY GROUP INC.
HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96687 )
Policy contract number379283275020
Policy instance 1
Insurance contract or identification number379283275020
Number of Individuals Covered1115
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $10,279
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $207,588
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,279
Insurance broker organization code?3
Insurance broker nameHEALY GROUP INC.
HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96687 )
Policy contract number379280325020
Policy instance 2
Insurance contract or identification number379280325020
Number of Individuals Covered11819
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $108,431
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $2,174,892
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $108,431
Insurance broker organization code?3
Insurance broker nameHEALY GROUP INC.
HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96687 )
Policy contract number379280325020
Policy instance 1
Insurance contract or identification number379280325020
Number of Individuals Covered10506
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $96,426
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,938,443
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $96,426
Insurance broker organization code?3
Insurance broker nameHEALY GROUP INC.
HEALTH RESOURCES INC (National Association of Insurance Commissioners NAIC id number: 96687 )
Policy contract number379283275020
Policy instance 2
Insurance contract or identification number379283275020
Number of Individuals Covered946
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $8,857
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $179,347
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,857
Insurance broker organization code?3
Insurance broker nameHEALY GROUP INC.

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