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  5. Dental Benefit Plans of Minnesota

Dental Benefit Plans of Minnesota

Company Details

Name: Dental Benefit Plans of Minnesota
Jurisdiction: Minnesota
Legal type: Assumed Name
Status: Active / In Good Standing
Date formed: 24 Jul 2015 (10 years ago)
Company Number: a791d7ff-2132-e511-b14d-001ec94ffe7f
File Number: 834331500027
Principal Place of Business Address: 500 Washington Avenue South, Minneapolis, MN 55415, USA
ZIP code: 55415
County: Hennepin County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DENTAL BENEFIT PLANS OF MINNESOTA 2014 411852523 2015-08-12 DENTAL BENEFIT PLANS OF MINNESOTA 86
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2009-05-09
Business code 524140
Sponsor’s telephone number 6122243274
Plan sponsor’s address 500 WASHINGTON AVE SOUTH, SUITE 2060, MINNEAPOLIS, MN, 55415

Signature of
Role Plan administrator
Date 2015-08-12
Name of individual signing JUDY PETERSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-08-12
Name of individual signing DENTAL BENEFIT PLANS OF MN
Valid signature Filed with authorized/valid electronic signature
DENTAL BENEFIT PLANS OF MINNESOTA 2013 411852523 2014-08-07 DENTAL BENEFIT PLANS OF MINNESOTA 55
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2009-05-09
Business code 524140
Sponsor’s telephone number 6122243274
Plan sponsor’s address 500 WASHINGTON AVE SOUTH, SUITE 2060, MINNEAPOLIS, MN, 55415

Signature of
Role Plan administrator
Date 2014-08-07
Name of individual signing JUDY PETERSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-08-07
Name of individual signing JUDY PETERSON
Valid signature Filed with authorized/valid electronic signature
DENTAL BENEFIT PLANS OF MINNESOTA 2012 411852523 2013-09-18 DENTAL BENEFIT PLANS OF MINNESOTA 41
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2009-05-09
Business code 524140
Sponsor’s telephone number 6122243274
Plan sponsor’s address 500 WASHINGTON AVE SOUTH, SUITE 2060, MINNEAPOLIS, MN, 55415

Signature of
Role Plan administrator
Date 2013-09-18
Name of individual signing JUDY PETERSON
Valid signature Filed with authorized/valid electronic signature
DENTAL BENEFIT PLANS OF MINNESOTA 2011 411852523 2012-10-11 DENTAL BENEFIT PLANS OF MINNESOTA 36
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2009-05-09
Business code 524140
Sponsor’s telephone number 6519945274
Plan sponsor’s address 3560 DELTA DENTAL DRIVE, EAGAN, MN, 55122

Plan administrator’s name and address
Administrator’s EIN 411852523
Plan administrator’s name DENTAL BENEFIT PLANS OF MINNESOTA
Plan administrator’s address 3560 DELTA DENTAL DRIVE, EAGAN, MN, 55122
Administrator’s telephone number 6519945274

Signature of
Role Plan administrator
Date 2012-10-11
Name of individual signing JUDY PETERSON
Valid signature Filed with authorized/valid electronic signature
DENTAL BENEFIT PLANS OF MINNESOTA 2010 411852523 2011-10-07 DENTAL BENEFIT PLANS OF MINNESOTA 34
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2009-01-01
Business code 524140
Sponsor’s telephone number 6519945274
Plan sponsor’s address 3560 DELTA DENTAL DRIVE, EAGAN, MN, 55122

Plan administrator’s name and address
Administrator’s EIN 411852523
Plan administrator’s name DENTAL BENEFIT PLANS OF MINNESOTA
Plan administrator’s address 3560 DELTA DENTAL DRIVE, EAGAN, MN, 55122
Administrator’s telephone number 6519945274

Signature of
Role Plan administrator
Date 2011-10-07
Name of individual signing JUDY PETERSON
Valid signature Filed with authorized/valid electronic signature

Aplicant

Name Role Address
Stratacor Aplicant 500 Washington Avenue South, Minneapolis, MN 55415

Filing

Filing Name Filing date
Original Filing - Assumed Name (Business Name: Dental Benefit Plans of Minnesota) 2015-07-24

Related by officers

No related officers

Related by address

500 Washington Avenue South, Minneapolis, MN 55415, USA

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Date of last update: 09 Jan 2025

Sources: Minnesota's Official State Website

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