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| Plan Name | DEXTER SOUTHFIELD INC. HEALTH PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | DEXTER SOUTHFIELD INC. |
| Employer identification number (EIN): | 422104152 |
| NAIC Classification: | 611000 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2017-07-01 | CARLA GATES |
| Measure | Date | Value |
|---|---|---|
| 2017: DEXTER SOUTHFIELD INC. HEALTH PLAN 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-07-01 | 148 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-07-01 | 0 |
| Number of retired or separated participants receiving benefits | 2017-07-01 | 0 |
| Total of all active and inactive participants | 2017-07-01 | 0 |
| 2017: DEXTER SOUTHFIELD INC. HEALTH 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 | Yes |
| 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 – Insurance | Yes |
| 2017-07-01 | Plan benefit arrangement – Insurance | Yes |
| HARVARD PILGRIM HEALTH CARE, INC. (National Association of Insurance Commissioners NAIC id number: 96911 ) | |
| Policy contract number | 089465 |
| Policy instance | 1 |
| HPHC INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 18975 ) | |
| Policy contract number | 089466 |
| Policy instance | 2 |
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