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ROTSCHY, INC. DENTAL PLAN 401k Plan overview

Plan NameROTSCHY, INC. DENTAL PLAN
Plan identification number 503

ROTSCHY, INC. DENTAL PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Dental

401k Sponsoring company profile

ROTSCHY, INC. has sponsored the creation of one or more 401k plans.

Company Name:ROTSCHY, INC.
Employer identification number (EIN):911420205
NAIC Classification:238900

Additional information about ROTSCHY, INC.

Jurisdiction of Incorporation: Washington Secretary of State Corporations Division
Incorporation Date: 1988-07-25
Company Identification Number: 601099290
Legal Registered Office Address: 7408 NE 113TH CIR

VANCOUVER
United States of America (USA)
986622351

More information about ROTSCHY, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ROTSCHY, INC. DENTAL PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032021-04-01TOM SWOKOWSKI2023-05-30
5032019-04-01TOM SWOKOWSKI2023-05-30
5032018-04-01TOM SWOKOWSKI2023-05-30
5032017-04-01TOM SWOKOWSKI2023-05-30
5032016-04-01TOM SWOKOWSKI2023-05-30
5032015-04-01TOM SWOKOWSKI2023-05-30
5032014-04-01TOM SWOKOWSKI2023-05-30

Form 5500 Responses for ROTSCHY, INC. DENTAL PLAN

2021: ROTSCHY, INC. DENTAL PLAN 2021 form 5500 responses
2021-04-01Type of plan entitySingle employer plan
2021-04-01This submission is the final filingYes
2021-04-01Plan funding arrangement – General assets of the sponsorYes
2021-04-01Plan benefit arrangement – General assets of the sponsorYes
2019: ROTSCHY, INC. DENTAL PLAN 2019 form 5500 responses
2019-04-01Type of plan entitySingle employer plan
2019-04-01Plan funding arrangement – InsuranceYes
2019-04-01Plan benefit arrangement – InsuranceYes
2018: ROTSCHY, INC. DENTAL PLAN 2018 form 5500 responses
2018-04-01Type of plan entitySingle employer plan
2018-04-01Plan funding arrangement – InsuranceYes
2018-04-01Plan benefit arrangement – InsuranceYes
2017: ROTSCHY, INC. DENTAL PLAN 2017 form 5500 responses
2017-04-01Type of plan entitySingle employer plan
2017-04-01Plan funding arrangement – InsuranceYes
2017-04-01Plan benefit arrangement – InsuranceYes
2016: ROTSCHY, INC. DENTAL PLAN 2016 form 5500 responses
2016-04-01Type of plan entitySingle employer plan
2016-04-01Plan funding arrangement – InsuranceYes
2016-04-01Plan benefit arrangement – InsuranceYes
2015: ROTSCHY, INC. DENTAL PLAN 2015 form 5500 responses
2015-04-01Type of plan entitySingle employer plan
2015-04-01Plan funding arrangement – InsuranceYes
2015-04-01Plan benefit arrangement – InsuranceYes
2014: ROTSCHY, INC. DENTAL PLAN 2014 form 5500 responses
2014-04-01Type of plan entitySingle employer plan
2014-04-01First time form 5500 has been submittedYes
2014-04-01Plan funding arrangement – InsuranceYes
2014-04-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number914383
Policy instance 1
Insurance contract or identification number914383
Number of Individuals Covered1001
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $8,402
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $199,659
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number914383
Policy instance 1
Insurance contract or identification number914383
Number of Individuals Covered283
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5484524
Policy instance 1
Insurance contract or identification number5484524
Number of Individuals Covered283
Insurance policy start date2017-04-01
Insurance policy end date2018-03-31
Total amount of commissions paid to insurance brokerUSD $21,834
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $273,046
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )
Policy contract number1062990
Policy instance 1
Insurance contract or identification number1062990
Number of Individuals Covered632
Insurance policy start date2016-04-01
Insurance policy end date2017-03-31
Total amount of commissions paid to insurance brokerUSD $18,104
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $226,061
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 )
Policy contract numberWA300865
Policy instance 1
Insurance contract or identification numberWA300865
Number of Individuals Covered224
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Total amount of commissions paid to insurance brokerUSD $15,709
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $165,139
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number5470829
Policy instance 1
Insurance contract or identification number5470829
Number of Individuals Covered202
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Total amount of commissions paid to insurance brokerUSD $4,801
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $201,275
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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