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| Plan Name | CORRECTIONAL DENTAL PROVIDER NETWORK HEALTH AND WELFARE BENEFIT PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | CORRECTIONAL DENTAL PROVIDER NETWORK, PLLC |
| Employer identification number (EIN): | 814720135 |
| NAIC Classification: | 621420 |
| NAIC Description: | Outpatient Mental Health and Substance Abuse Centers |
Additional information about CORRECTIONAL DENTAL PROVIDER NETWORK, PLLC
| Jurisdiction of Incorporation: | Florida Department of State Division of Corporations |
| Incorporation Date: | 2016-12-12 |
| Company Identification Number: | L16000224322 |
| Legal Registered Office Address: |
8253 MULLIGAN CIRCLE PORT ST. LUCIE 34986 |
More information about CORRECTIONAL DENTAL PROVIDER NETWORK, PLLC
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2019-01-01 | MICHAEL ADU-TUTU | 2020-08-17 | ||
| 501 | 2018-01-01 | ||||
| 501 | 2017-04-01 |
| Measure | Date | Value |
|---|---|---|
| 2019: CORRECTIONAL DENTAL PROVIDER NETWORK HEALTH AND WELFARE BENEFIT PLAN 2019 401k membership | ||
| Total participants, beginning-of-year | 2019-01-01 | 107 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 53 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 2 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 55 |
| Number of employers contributing to the scheme | 2019-01-01 | 0 |
| 2018: CORRECTIONAL DENTAL PROVIDER NETWORK HEALTH AND WELFARE BENEFIT PLAN 2018 401k membership | ||
| Total participants, beginning-of-year | 2018-01-01 | 210 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 102 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 4 |
| Total of all active and inactive participants | 2018-01-01 | 107 |
| Number of employers contributing to the scheme | 2018-01-01 | 0 |
| 2017: CORRECTIONAL DENTAL PROVIDER NETWORK HEALTH AND WELFARE BENEFIT PLAN 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-04-01 | 210 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-04-01 | 0 |
| Number of retired or separated participants receiving benefits | 2017-04-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2017-04-01 | 0 |
| Total of all active and inactive participants | 2017-04-01 | 0 |
| 2019: CORRECTIONAL DENTAL PROVIDER NETWORK HEALTH AND WELFARE BENEFIT PLAN 2019 form 5500 responses | ||
|---|---|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2018: CORRECTIONAL DENTAL PROVIDER NETWORK HEALTH AND WELFARE BENEFIT PLAN 2018 form 5500 responses | ||
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2017: CORRECTIONAL DENTAL PROVIDER NETWORK HEALTH AND WELFARE BENEFIT PLAN 2017 form 5500 responses | ||
| 2017-04-01 | Type of plan entity | Single employer plan |
| 2017-04-01 | First time form 5500 has been submitted | Yes |
| 2017-04-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2017-04-01 | Plan funding arrangement – Insurance | Yes |
| 2017-04-01 | Plan benefit arrangement – Insurance | Yes |
| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |||||||||||||||||||||||||||||||||||||
| Policy contract number | 101772 | ||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||
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| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |||||||||||||||||||||||||||||||||||||
| Policy contract number | 101772 | ||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||
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| AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 ) | |||||||||||||||||||||||||||||||||||||
| Policy contract number | 101772 | ||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||
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