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FISHERS PEDIATRIC DENTISTRY LLC 401k Plan overview

Plan NameFISHERS PEDIATRIC DENTISTRY LLC
Plan identification number 501

FISHERS PEDIATRIC DENTISTRY LLC Benefits

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

401k Sponsoring company profile

FISHERS PEDIATRIC DENTISTRY, LLC has sponsored the creation of one or more 401k plans.

Company Name:FISHERS PEDIATRIC DENTISTRY, LLC
Employer identification number (EIN):812793684
NAIC Classification:621210
NAIC Description:Offices of Dentists

Additional information about FISHERS PEDIATRIC DENTISTRY, LLC

Jurisdiction of Incorporation: Indiana Secretary of State
Incorporation Date:
Company Identification Number: 607011143457

More information about FISHERS PEDIATRIC DENTISTRY, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FISHERS PEDIATRIC DENTISTRY LLC

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-01-01
5012021-01-01
5012020-01-01
5012019-01-01
5012018-01-01ANA VAZQUEZ ANA VAZQUEZ2019-07-22
5012017-01-01ANA VAZQUEZ-ACREE ANA VAZQUEZ-ACREE2018-07-22

Plan Statistics for FISHERS PEDIATRIC DENTISTRY LLC

401k plan membership statisitcs for FISHERS PEDIATRIC DENTISTRY LLC

Measure Date Value
2022: FISHERS PEDIATRIC DENTISTRY LLC 2022 401k membership
Total participants, beginning-of-year2022-01-0125
Total number of active participants reported on line 7a of the Form 55002022-01-0127
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-0127
2021: FISHERS PEDIATRIC DENTISTRY LLC 2021 401k membership
Total participants, beginning-of-year2021-01-0128
Total number of active participants reported on line 7a of the Form 55002021-01-0125
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-0125
2020: FISHERS PEDIATRIC DENTISTRY LLC 2020 401k membership
Total participants, beginning-of-year2020-01-0133
Total number of active participants reported on line 7a of the Form 55002020-01-0128
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-0128
2019: FISHERS PEDIATRIC DENTISTRY LLC 2019 401k membership
Total participants, beginning-of-year2019-01-0131
Total number of active participants reported on line 7a of the Form 55002019-01-0133
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-0133
2018: FISHERS PEDIATRIC DENTISTRY LLC 2018 401k membership
Total participants, beginning-of-year2018-01-0130
Total number of active participants reported on line 7a of the Form 55002018-01-0131
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-0131
2017: FISHERS PEDIATRIC DENTISTRY LLC 2017 401k membership
Total participants, beginning-of-year2017-01-0129
Total number of active participants reported on line 7a of the Form 55002017-01-0130
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-0130

Form 5500 Responses for FISHERS PEDIATRIC DENTISTRY LLC

2022: FISHERS PEDIATRIC DENTISTRY LLC 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: FISHERS PEDIATRIC DENTISTRY LLC 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: FISHERS PEDIATRIC DENTISTRY LLC 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: FISHERS PEDIATRIC DENTISTRY LLC 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: FISHERS PEDIATRIC DENTISTRY LLC 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: FISHERS PEDIATRIC DENTISTRY LLC 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01First time form 5500 has been submittedYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number1684
Policy instance 1
Insurance contract or identification number1684
Number of Individuals Covered25
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $8,897
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,482
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,897
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number1684
Policy instance 1
Insurance contract or identification number1684
Number of Individuals Covered25
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $9,713
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $20,585
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,713
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number1684
Policy instance 1
Insurance contract or identification number1684
Number of Individuals Covered35
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $11,248
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $23,868
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,248
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number1684
Policy instance 1
Insurance contract or identification number1684
Number of Individuals Covered35
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $11,916
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $27,607
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,916
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number1684
Policy instance 1
Insurance contract or identification number1684
Number of Individuals Covered31
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $10,476
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,061
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,476
EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 )
Policy contract number1684
Policy instance 1
Insurance contract or identification number1684
Number of Individuals Covered30
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $10,390
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $24,897
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,390
Insurance broker nameHOFFMAN BENEFIT SERVICES INC

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