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| Plan Name | DR. JEFFREY A SALADIN DENTAL CORPORATION DEFINED BENEFIT TRUST |
| Plan identification number | 001 |
| 401k Plan Type | Defined Benefit Pension |
| Plan Features/Benefits |
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| Company Name: | DR. JEFFREY A. SALADIN, DENTAL CORPORATION |
| Employer identification number (EIN): | 900217702 |
| 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 |
|---|---|---|---|---|---|
| 001 | 2015-01-01 | ||||
| 001 | 2014-01-01 | ||||
| 001 | 2013-01-01 | ||||
| 001 | 2012-01-01 | DIANE HEBERT | |||
| 001 | 2011-01-01 | DIANE HEBERT |
| 2012: DR. JEFFREY A SALADIN DENTAL CORPORATION DEFINED BENEFIT TRUST 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 – Section 412(e)(3) insurance Contracts | Yes |
| 2012-01-01 | Plan benefit arrangement – Section 412(e)(3) insurance Contracts | Yes |
| 2011: DR. JEFFREY A SALADIN DENTAL CORPORATION DEFINED BENEFIT TRUST 2011 form 5500 responses | ||
| 2011-01-01 | Type of plan entity | Single employer plan |
| 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 – Section 412(e)(3) insurance Contracts | Yes |
| 2011-01-01 | Plan benefit arrangement – Section 412(e)(3) insurance Contracts | Yes |
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) | |
| Policy contract number | 61228 |
| Policy instance | 1 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 ) | |
| Policy contract number | 61228 |
| Policy instance | 2 |
| JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 ) | |
| Policy contract number | 61228 |
| Policy instance | 1 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 ) | |
| Policy contract number | 61228 |
| Policy instance | 2 |
| JOHN HANCOCK LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65099 ) | |
| Policy contract number | 61228 |
| Policy instance | 1 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 61228 |
| Policy instance | 2 |
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