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GOODWILL INDUSTRIES OF SOUTH CENTRAL WISCONSIN INC. DENTAL PLAN 401k Plan overview

Plan NameGOODWILL INDUSTRIES OF SOUTH CENTRAL WISCONSIN INC. DENTAL PLAN
Plan identification number 504

GOODWILL INDUSTRIES OF SOUTH CENTRAL WISCONSIN INC. DENTAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Dental
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

GOODWILL INDUSTRIES OF SOUTH CENTRAL WISCONSIN, INC. has sponsored the creation of one or more 401k plans.

Company Name:GOODWILL INDUSTRIES OF SOUTH CENTRAL WISCONSIN, INC.
Employer identification number (EIN):391147571
NAIC Classification:813000
NAIC Description: Religious, Grantmaking, Civic, Professional, and Similar Organizations

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GOODWILL INDUSTRIES OF SOUTH CENTRAL WISCONSIN INC. DENTAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042015-01-01MICHELA COBB
5042014-01-01MICHELA COBB
5042013-01-01MICHELA COBB
5042012-01-01MICHELA COBB

Plan Statistics for GOODWILL INDUSTRIES OF SOUTH CENTRAL WISCONSIN INC. DENTAL PLAN

401k plan membership statisitcs for GOODWILL INDUSTRIES OF SOUTH CENTRAL WISCONSIN INC. DENTAL PLAN

Measure Date Value
2015: GOODWILL INDUSTRIES OF SOUTH CENTRAL WISCONSIN INC. DENTAL PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01110
Total number of active participants reported on line 7a of the Form 55002015-01-010
Total of all active and inactive participants2015-01-010
2014: GOODWILL INDUSTRIES OF SOUTH CENTRAL WISCONSIN INC. DENTAL PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01104
Total number of active participants reported on line 7a of the Form 55002014-01-01105
Number of retired or separated participants receiving benefits2014-01-012
Total of all active and inactive participants2014-01-01107
2013: GOODWILL INDUSTRIES OF SOUTH CENTRAL WISCONSIN INC. DENTAL PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-01117
Total number of active participants reported on line 7a of the Form 55002013-01-01114
Total of all active and inactive participants2013-01-01114
2012: GOODWILL INDUSTRIES OF SOUTH CENTRAL WISCONSIN INC. DENTAL PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-01105
Total number of active participants reported on line 7a of the Form 55002012-01-01115
Total of all active and inactive participants2012-01-01115

Form 5500 Responses for GOODWILL INDUSTRIES OF SOUTH CENTRAL WISCONSIN INC. DENTAL PLAN

2015: GOODWILL INDUSTRIES OF SOUTH CENTRAL WISCONSIN INC. DENTAL 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)Yes
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: GOODWILL INDUSTRIES OF SOUTH CENTRAL WISCONSIN INC. DENTAL 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: GOODWILL INDUSTRIES OF SOUTH CENTRAL WISCONSIN INC. DENTAL 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: GOODWILL INDUSTRIES OF SOUTH CENTRAL WISCONSIN INC. DENTAL 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

Insurance Providers Used on plan

DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number01202
Policy instance 1
Insurance contract or identification number01202
Number of Individuals Covered0
Insurance policy start date2015-01-01
Insurance policy end date2015-01-31
Total amount of commissions paid to insurance brokerUSD $630
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $630
Insurance broker organization code?3
Insurance broker nameM3 INSURANCE SOLUTIONS, INC.
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number01202
Policy instance 1
Insurance contract or identification number01202
Number of Individuals Covered120
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $6,820
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,820
Insurance broker organization code?3
Insurance broker nameM3 INSURANCE SOLUTIONS, INC.
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number01202
Policy instance 1
Insurance contract or identification number01202
Number of Individuals Covered116
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $6,324
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,324
Insurance broker organization code?3
Insurance broker nameM3 INSURANCE SOLUTIONS, INC.
DELTA DENTAL OF WISCONSIN (National Association of Insurance Commissioners NAIC id number: 54046 )
Policy contract number01202
Policy instance 1
Insurance contract or identification number01202
Number of Individuals Covered115
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $5,263
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,263
Insurance broker organization code?3
Insurance broker nameM3 INSURANCE SOLUTIONS, INC.

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