401k Plan data: JWSC DENTAL VISION plan

JWSC DENTAL VISION 401k Plan overview

Plan Name	JWSC DENTAL VISION
Plan identification number	503

JWSC DENTAL VISION Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Long-term disability cover

401k Sponsoring company profile

BRUNSWICK-GLYNN COUNTY JOINT WATER & SEWER COMMISSION has sponsored the creation of one or more 401k plans.

Company Name: BRUNSWICK-GLYNN COUNTY JOINT WATER & SEWER COMMISSION

Employer identification number (EIN): 743229050

NAIC Classification: 221300

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JWSC DENTAL VISION

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2020-03-01
503 2015-03-01 DAPHNE GABLE DAPHNE GABLE 2016-09-30
503 2014-01-01 DAPHNE GABLE DAPHNE GABLE 2015-06-30
503 2013-01-01 DAPHNE GABLE DAPHNE GABLE 2014-06-02
503 2012-01-01 DAPHNE GABLE DAPHNE GABLE 2013-06-28
503 2011-01-01 DAPHNE GABLE

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
503	2020-03-01
503	2015-03-01	DAPHNE GABLE	DAPHNE GABLE	2016-09-30
503	2014-01-01	DAPHNE GABLE	DAPHNE GABLE	2015-06-30
503	2013-01-01	DAPHNE GABLE	DAPHNE GABLE	2014-06-02
503	2012-01-01	DAPHNE GABLE	DAPHNE GABLE	2013-06-28
503	2011-01-01	DAPHNE GABLE

Plan Statistics for JWSC DENTAL VISION

401k plan membership statisitcs for JWSC DENTAL VISION

Measure Date Value
2020: JWSC DENTAL VISION 2020 401k membership
Total participants, beginning-of-year 2020-03-01 99
Total number of active participants reported on line 7a of the Form 5500 2020-03-01 128
Total of all active and inactive participants 2020-03-01 128
Total participants 2020-03-01 128
2015: JWSC DENTAL VISION 2015 401k membership
Total participants, beginning-of-year 2015-03-01 95
Total of all active and inactive participants 2015-03-01 0
Total participants 2015-03-01 0
2014: JWSC DENTAL VISION 2014 401k membership
Total participants, beginning-of-year 2014-01-01 113
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 110
Total of all active and inactive participants 2014-01-01 110
Total participants 2014-01-01 110
2013: JWSC DENTAL VISION 2013 401k membership
Total participants, beginning-of-year 2013-01-01 113
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 113
Total of all active and inactive participants 2013-01-01 113
Total participants 2013-01-01 113
2012: JWSC DENTAL VISION 2012 401k membership
Total participants, beginning-of-year 2012-01-01 100
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 113
Total of all active and inactive participants 2012-01-01 113
Total participants 2012-01-01 113
2011: JWSC DENTAL VISION 2011 401k membership
Total participants, beginning-of-year 2011-01-01 99
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 100
Total of all active and inactive participants 2011-01-01 100
Total participants 2011-01-01 100

Measure	Date	Value
2020: JWSC DENTAL VISION 2020 401k membership
Total participants, beginning-of-year	2020-03-01	99
Total number of active participants reported on line 7a of the Form 5500	2020-03-01	128
Total of all active and inactive participants	2020-03-01	128
Total participants	2020-03-01	128
2015: JWSC DENTAL VISION 2015 401k membership
Total participants, beginning-of-year	2015-03-01	95
Total of all active and inactive participants	2015-03-01	0
Total participants	2015-03-01	0
2014: JWSC DENTAL VISION 2014 401k membership
Total participants, beginning-of-year	2014-01-01	113
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	110
Total of all active and inactive participants	2014-01-01	110
Total participants	2014-01-01	110
2013: JWSC DENTAL VISION 2013 401k membership
Total participants, beginning-of-year	2013-01-01	113
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	113
Total of all active and inactive participants	2013-01-01	113
Total participants	2013-01-01	113
2012: JWSC DENTAL VISION 2012 401k membership
Total participants, beginning-of-year	2012-01-01	100
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	113
Total of all active and inactive participants	2012-01-01	113
Total participants	2012-01-01	113
2011: JWSC DENTAL VISION 2011 401k membership
Total participants, beginning-of-year	2011-01-01	99
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	100
Total of all active and inactive participants	2011-01-01	100
Total participants	2011-01-01	100

Form 5500 Responses for JWSC DENTAL VISION

2020: JWSC DENTAL VISION 2020 form 5500 responses
2020-03-01	Type of plan entity	Single employer plan
2020-03-01	First time form 5500 has been submitted	Yes
2020-03-01	Submission has been amended	No
2020-03-01	This submission is the final filing	No
2020-03-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2020-03-01	Plan is a collectively bargained plan	No
2020-03-01	Plan funding arrangement – Insurance	Yes
2020-03-01	Plan benefit arrangement – Insurance	Yes
2015: JWSC DENTAL VISION 2015 form 5500 responses
2015-03-01	Type of plan entity	Single employer plan
2015-03-01	Submission has been amended	No
2015-03-01	This submission is the final filing	No
2015-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-03-01	Plan is a collectively bargained plan	No
2015-03-01	Plan funding arrangement – Insurance	Yes
2015-03-01	Plan benefit arrangement – Insurance	Yes
2014: JWSC DENTAL VISION 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2013: JWSC DENTAL VISION 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2012: JWSC DENTAL VISION 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2011: JWSC DENTAL VISION 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	First time form 5500 has been submitted	Yes
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )

Policy contract number

GA6777

Policy instance

Insurance contract or identification number	GA6777
Number of Individuals Covered	128
Insurance policy start date	2020-03-01
Insurance policy end date	2020-07-31
Total amount of commissions paid to insurance broker	USD $1,768
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $43,245
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,768
Additional information about fees paid to insurance broker	COMMISSION
Insurance broker organization code?	3

BLUE CROSS BLUE SHIELD OF GEORGIA INC. (G0386) (National Association of Insurance Commissioners NAIC id number: 96962 )

Policy contract number

9122658500

Policy instance

Insurance contract or identification number	9122658500
Number of Individuals Covered	99
Insurance policy start date	2015-03-01
Insurance policy end date	2016-02-29
Total amount of commissions paid to insurance broker	USD $16,490
Are there contracts with allocated funds for individual policies?	No
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $285,602
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $16,490
Additional information about fees paid to insurance broker	COMMISSION
Insurance broker organization code?	3
Insurance broker name	FIRST COAST BENEFITS SOLUTIONS

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLTD0461K

Policy instance

Insurance contract or identification number	GLTD0461K
Number of Individuals Covered	110
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $1,666
Are there contracts with allocated funds for individual policies?	No
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $3,610
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $1,666
Additional information about fees paid to insurance broker	COMMISSIONS
Insurance broker organization code?	3
Insurance broker name	FIRST COAST BENEFITS SOLUTIONS

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLTD0461K

Policy instance

Insurance contract or identification number	GLTD0461K
Number of Individuals Covered	113
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $1,593
Are there contracts with allocated funds for individual policies?	No
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $15,926
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,593
Additional information about fees paid to insurance broker	COMMISSIONS
Insurance broker organization code?	3
Insurance broker name	FIRST COAST BEN SOLUTIONS INC

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLTD0461K

Policy instance

Insurance contract or identification number	GLTD0461K
Number of Individuals Covered	113
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $16,030
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $113
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $16,030
Additional information about fees paid to insurance broker	COMMISSIONS
Insurance broker organization code?	3
Insurance broker name	FIRST COAST BENEFIS SOLUTIONS

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLTD0461K

Policy instance

Insurance contract or identification number	GLTD0461K
Number of Individuals Covered	100
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $1,391
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $13,907
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	BRUNSWICK-GLYNN COUNTY JOINT WATER & SEWER COMMISSION
Employer identification number (EIN):	743229050
NAIC Classification:	221300