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WEST RIVER HEALTH SERVICES HEALTH, VISION AND DENTAL BENEFITS 401k Plan overview

Plan NameWEST RIVER HEALTH SERVICES HEALTH, VISION AND DENTAL BENEFITS
Plan identification number 501

WEST RIVER HEALTH SERVICES HEALTH, VISION AND DENTAL BENEFITS Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental
  • Vision

401k Sponsoring company profile

WEST RIVER HEALTH SERVICES has sponsored the creation of one or more 401k plans.

Company Name:WEST RIVER HEALTH SERVICES
Employer identification number (EIN):450340688
NAIC Classification:622000
NAIC Description: Hospitals

Additional information about WEST RIVER HEALTH SERVICES

Jurisdiction of Incorporation: South Dakota Secretary of State
Incorporation Date:
Company Identification Number: FN010284

More information about WEST RIVER HEALTH SERVICES

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WEST RIVER HEALTH SERVICES HEALTH, VISION AND DENTAL BENEFITS

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01NATHAN STADHEIM2023-06-26
5012021-01-01NATHAN STADHEIM2022-04-11
5012020-01-01NATHAN STADHEIM2021-07-28
5012019-01-01NATHAN STADHEIM 2020-07-06
5012018-01-01NATHAN STADHEIM2019-07-29
5012017-01-01
5012016-01-01NATHAN STADHEIM2019-05-03
5012015-01-01NATHAN STADHEIM2019-05-02
5012014-01-01

Plan Statistics for WEST RIVER HEALTH SERVICES HEALTH, VISION AND DENTAL BENEFITS

401k plan membership statisitcs for WEST RIVER HEALTH SERVICES HEALTH, VISION AND DENTAL BENEFITS

Measure Date Value
2022: WEST RIVER HEALTH SERVICES HEALTH, VISION AND DENTAL BENEFITS 2022 401k membership
Total participants, beginning-of-year2022-01-01139
Total number of active participants reported on line 7a of the Form 55002022-01-01127
Number of retired or separated participants receiving benefits2022-01-013
Total of all active and inactive participants2022-01-01130
2021: WEST RIVER HEALTH SERVICES HEALTH, VISION AND DENTAL BENEFITS 2021 401k membership
Total participants, beginning-of-year2021-01-01193
Total number of active participants reported on line 7a of the Form 55002021-01-01149
Number of retired or separated participants receiving benefits2021-01-013
Total of all active and inactive participants2021-01-01152
2020: WEST RIVER HEALTH SERVICES HEALTH, VISION AND DENTAL BENEFITS 2020 401k membership
Total participants, beginning-of-year2020-01-01165
Total number of active participants reported on line 7a of the Form 55002020-01-01152
Number of retired or separated participants receiving benefits2020-01-011
Total of all active and inactive participants2020-01-01153
2019: WEST RIVER HEALTH SERVICES HEALTH, VISION AND DENTAL BENEFITS 2019 401k membership
Total participants, beginning-of-year2019-01-01197
Total number of active participants reported on line 7a of the Form 55002019-01-01194
Number of retired or separated participants receiving benefits2019-01-013
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01197
2018: WEST RIVER HEALTH SERVICES HEALTH, VISION AND DENTAL BENEFITS 2018 401k membership
Total participants, beginning-of-year2018-01-01196
Total number of active participants reported on line 7a of the Form 55002018-01-01200
Number of retired or separated participants receiving benefits2018-01-016
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-01206
2017: WEST RIVER HEALTH SERVICES HEALTH, VISION AND DENTAL BENEFITS 2017 401k membership
Total participants, beginning-of-year2017-01-01224
Total number of active participants reported on line 7a of the Form 55002017-01-01225
Number of retired or separated participants receiving benefits2017-01-013
Total of all active and inactive participants2017-01-01228
2016: WEST RIVER HEALTH SERVICES HEALTH, VISION AND DENTAL BENEFITS 2016 401k membership
Total participants, beginning-of-year2016-01-01202
Total number of active participants reported on line 7a of the Form 55002016-01-01224
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01224
2015: WEST RIVER HEALTH SERVICES HEALTH, VISION AND DENTAL BENEFITS 2015 401k membership
Total participants, beginning-of-year2015-01-01201
Total number of active participants reported on line 7a of the Form 55002015-01-01204
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 participants2015-01-01204
2014: WEST RIVER HEALTH SERVICES HEALTH, VISION AND DENTAL BENEFITS 2014 401k membership
Total participants, beginning-of-year2014-01-01197
Total number of active participants reported on line 7a of the Form 55002014-01-01206
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01206

Form 5500 Responses for WEST RIVER HEALTH SERVICES HEALTH, VISION AND DENTAL BENEFITS

2022: WEST RIVER HEALTH SERVICES HEALTH, VISION AND DENTAL BENEFITS 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – General assets of the sponsorYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – General assets of the sponsorYes
2021: WEST RIVER HEALTH SERVICES HEALTH, VISION AND DENTAL BENEFITS 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – General assets of the sponsorYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – General assets of the sponsorYes
2020: WEST RIVER HEALTH SERVICES HEALTH, VISION AND DENTAL BENEFITS 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – General assets of the sponsorYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – General assets of the sponsorYes
2019: WEST RIVER HEALTH SERVICES HEALTH, VISION AND DENTAL BENEFITS 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – General assets of the sponsorYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: WEST RIVER HEALTH SERVICES HEALTH, VISION AND DENTAL BENEFITS 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – General assets of the sponsorYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: WEST RIVER HEALTH SERVICES HEALTH, VISION AND DENTAL BENEFITS 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: WEST RIVER HEALTH SERVICES HEALTH, VISION AND DENTAL BENEFITS 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: WEST RIVER HEALTH SERVICES HEALTH, VISION AND DENTAL BENEFITS 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 filingNo
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 – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: WEST RIVER HEALTH SERVICES HEALTH, VISION AND DENTAL BENEFITS 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01First time form 5500 has been submittedYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberVNX NDTDD551752
Policy instance 2
Insurance contract or identification numberVNX NDTDD551752
Number of Individuals Covered27
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $2,091
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,894
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,394
Insurance broker organization code?3
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberVNW NDTDD551751
Policy instance 1
Insurance contract or identification numberVNW NDTDD551751
Number of Individuals Covered185
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $12,052
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $78,391
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,035
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )
Policy contract number250955
Policy instance 2
Insurance contract or identification number250955
Number of Individuals Covered245
Insurance policy start date2021-01-01
Insurance policy end date2021-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,238,890
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberVNW NDTDD551751
Policy instance 1
Insurance contract or identification numberVNW NDTDD551751
Number of Individuals Covered221
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $13,488
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $91,412
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,992
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )
Policy contract number250955
Policy instance 2
Insurance contract or identification number250955
Number of Individuals Covered248
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,755,211
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberVNW NDTDD551751
Policy instance 1
Insurance contract or identification numberVNW NDTDD551751
Number of Individuals Covered205
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $12,654
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $84,515
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,436
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )
Policy contract number250955
Policy instance 3
Insurance contract or identification number250955
Number of Individuals Covered237
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $28,028
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )
Policy contract number250955
Policy instance 2
Insurance contract or identification number250955
Number of Individuals Covered278
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,797,821
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberVNW NDTDD551751
Policy instance 1
Insurance contract or identification numberVNW NDTDD551751
Number of Individuals Covered197
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $12,775
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $117,361
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,242
Insurance broker organization code?3
BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )
Policy contract number78427
Policy instance 3
Insurance contract or identification number78427
Number of Individuals Covered259
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,306
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )
Policy contract number78427
Policy instance 2
Insurance contract or identification number78427
Number of Individuals Covered291
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberVNW NDTDD551751
Policy instance 1
Insurance contract or identification numberVNW NDTDD551751
Number of Individuals Covered210
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $12,202
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $81,376
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,872
Insurance broker organization code?3
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberVNW NDTDD551751
Policy instance 3
Insurance contract or identification numberVNW NDTDD551751
Number of Individuals Covered206
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $11,512
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $76,034
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $7,426
Insurance broker organization code?3
Insurance broker nameDENTAL MGMT CONSULTANTS
BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )
Policy contract number78427
Policy instance 2
Insurance contract or identification number78427
Number of Individuals Covered278
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $31,854
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (National Association of Insurance Commissioners NAIC id number: 55891 )
Policy contract number78427
Policy instance 1
Insurance contract or identification number78427
Number of Individuals Covered303
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SANFORD HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 95683 )
Policy contract numberHP040051
Policy instance 2
Insurance contract or identification numberHP040051
Number of Individuals Covered300
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $23,523
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,617,318
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $23,523
Insurance broker organization code?3
COMPANION LIFE (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract numberVNW NDTDD551751
Policy instance 1
Insurance contract or identification numberVNW NDTDD551751
Number of Individuals Covered180
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $9,251
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $64,611
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,341
Insurance broker organization code?3

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