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BLACKFORD DENTAL MANAGEMENT HOLDINGS 401k Plan overview

Plan NameBLACKFORD DENTAL MANAGEMENT HOLDINGS
Plan identification number 501

BLACKFORD DENTAL MANAGEMENT HOLDINGS Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover

401k Sponsoring company profile

BLACKFORD DENTAL MANAGEMENT HOLDINGS, LLC has sponsored the creation of one or more 401k plans.

Company Name:BLACKFORD DENTAL MANAGEMENT HOLDINGS, LLC
Employer identification number (EIN):473427799
NAIC Classification:621210
NAIC Description:Offices of Dentists

Additional information about BLACKFORD DENTAL MANAGEMENT HOLDINGS, LLC

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 5705923

More information about BLACKFORD DENTAL MANAGEMENT HOLDINGS, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BLACKFORD DENTAL MANAGEMENT HOLDINGS

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012017-01-01ARMANDO YANEZ
5012016-01-01ARMANDO YANEZ

Plan Statistics for BLACKFORD DENTAL MANAGEMENT HOLDINGS

401k plan membership statisitcs for BLACKFORD DENTAL MANAGEMENT HOLDINGS

Measure Date Value
2017: BLACKFORD DENTAL MANAGEMENT HOLDINGS 2017 401k membership
Total participants, beginning-of-year2017-01-01473
Total number of active participants reported on line 7a of the Form 55002017-01-01228
Number of retired or separated participants receiving benefits2017-01-013
Total of all active and inactive participants2017-01-01231
Total participants2017-01-01231
2016: BLACKFORD DENTAL MANAGEMENT HOLDINGS 2016 401k membership
Total participants, beginning-of-year2016-01-01168
Total number of active participants reported on line 7a of the Form 55002016-01-01175
Number of retired or separated participants receiving benefits2016-01-016
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-01181
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2016-01-010
Total participants2016-01-01181

Form 5500 Responses for BLACKFORD DENTAL MANAGEMENT HOLDINGS

2017: BLACKFORD DENTAL MANAGEMENT HOLDINGS 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Submission has been amendedNo
2017-01-01This submission is the final filingNo
2017-01-01This return/report is a short plan year return/report (less than 12 months)No
2017-01-01Plan is a collectively bargained planNo
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: BLACKFORD DENTAL MANAGEMENT HOLDINGS 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01First time form 5500 has been submittedYes
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number906975
Policy instance 1
Insurance contract or identification number906975
Number of Individuals Covered224
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $36,248
Total amount of fees paid to insurance companyUSD $83,095
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $1,479,315
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $36,248
Amount paid for insurance broker fees83095
Insurance broker organization code?3
Insurance broker nameROBERT FABRIZIO
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1052204
Policy instance 2
Insurance contract or identification number1052204
Number of Individuals Covered182
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $10,750
Total amount of fees paid to insurance companyUSD $1,108
Are there contracts with allocated funds for individual policies?0
Are there contracts with allocated funds for group deferred annuity?No
Are there contracts with allocated funds for types other than group deferred annuity or individual?No
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
Are there contracts with unallocated funds for contracts of type guaranteed investment?No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $77,496
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $5,375
Amount paid for insurance broker fees554
Additional information about fees paid to insurance brokerBONUS, AGENT EXPENSE ALLOWANCE
Insurance broker organization code?3
Insurance broker nameWILLIAM MANNIX

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