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GEMINI MOUNTAIN MEDICAL DENTAL PLAN 401k Plan overview

Plan NameGEMINI MOUNTAIN MEDICAL DENTAL PLAN
Plan identification number 503

GEMINI MOUNTAIN MEDICAL DENTAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Dental

401k Sponsoring company profile

GEMINI MOUNTAIN MEDICAL, LLC has sponsored the creation of one or more 401k plans.

Company Name:GEMINI MOUNTAIN MEDICAL, LLC
Employer identification number (EIN):810875076
NAIC Classification:423400

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GEMINI MOUNTAIN MEDICAL DENTAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032023-01-01MICHAEL F. LYONS2024-07-22

Plan Statistics for GEMINI MOUNTAIN MEDICAL DENTAL PLAN

401k plan membership statisitcs for GEMINI MOUNTAIN MEDICAL DENTAL PLAN

Measure Date Value
2023: GEMINI MOUNTAIN MEDICAL DENTAL PLAN 2023 401k membership
Total participants, beginning-of-year2023-01-01100
Total number of active participants reported on line 7a of the Form 55002023-01-01127
Number of retired or separated participants receiving benefits2023-01-010
Number of other retired or separated participants entitled to future benefits2023-01-010
Total of all active and inactive participants2023-01-01127
Number of employers contributing to the scheme2023-01-010

Form 5500 Responses for GEMINI MOUNTAIN MEDICAL DENTAL PLAN

2023: GEMINI MOUNTAIN MEDICAL DENTAL PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01First time form 5500 has been submittedYes
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

DELTA DENTAL OF COLORADO (National Association of Insurance Commissioners NAIC id number: 55875 )
Policy contract numberDD000000665
Policy instance 1
Insurance contract or identification numberDD000000665
Number of Individuals Covered200
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $2,612
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $52,232
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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