| Plan Name | DENTAL ACQUISITION GROUP CAFETERIA PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | DENTAL ACQUISITION GROUP |
| Employer identification number (EIN): | 812932094 |
| NAIC Classification: | 621210 |
| NAIC Description: | Offices of Dentists |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2022-02-01 | OPAL ANDERSON | 2023-12-14 | ||
| 501 | 2021-02-01 | DR. ROHIT REDDY | 2022-11-02 | ||
| 501 | 2020-02-01 | DR. ROHIT REDDY | 2021-11-08 | ||
| 501 | 2019-02-01 | DR. ROHIT REDDY | 2020-08-27 |
| 2022: DENTAL ACQUISITION GROUP CAFETERIA PLAN 2022 form 5500 responses | ||
|---|---|---|
| 2022-02-01 | Type of plan entity | Single employer plan |
| 2022-02-01 | Submission has been amended | Yes |
| 2022-02-01 | This submission is the final filing | Yes |
| 2022-02-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2022-02-01 | Plan funding arrangement – Insurance | Yes |
| 2022-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: DENTAL ACQUISITION GROUP CAFETERIA PLAN 2021 form 5500 responses | ||
| 2021-02-01 | Type of plan entity | Single employer plan |
| 2021-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2021-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2021-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2020: DENTAL ACQUISITION GROUP CAFETERIA PLAN 2020 form 5500 responses | ||
| 2020-02-01 | Type of plan entity | Single employer plan |
| 2020-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2020-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2019: DENTAL ACQUISITION GROUP CAFETERIA PLAN 2019 form 5500 responses | ||
| 2019-02-01 | Type of plan entity | Single employer plan |
| 2019-02-01 | First time form 5500 has been submitted | Yes |
| 2019-02-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-02-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-02-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) | |
| Policy contract number | 284277 |
| Policy instance | 1 |
| QBE INSURANCE (National Association of Insurance Commissioners NAIC id number: 10219 ) | |
| Policy contract number | LGS02436-20 |
| Policy instance | 1 |
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) | |
| Policy contract number | 284277 |
| Policy instance | 1 |
| QBE A&H (National Association of Insurance Commissioners NAIC id number: 10219 ) | |
| Policy contract number | LGS02436-20 |
| Policy instance | 2 |
| BLUE CROSS BLUE SHIELD OF MICHIGAN (National Association of Insurance Commissioners NAIC id number: 54291 ) | |
| Policy contract number | 284277 |
| Policy instance | 1 |