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Original filing (PDF)20230918120629NAL0019703859001
ARIZONA DENTAL INSURANCE SERVICE, INC.
Form 5500
FILING_RECEIVED
DELTA DENTAL OF ARIZONA 401(K) PLAN
401(k) retirement plan
Active participants
0
Accounts w/ balance
0
Plan assets (EOY)
$10.6M
Net assets (EOY)
$0
How this plan invests
This plan
37 collective trusts
Schedule D
Individual securities
on each trust's filing
This plan doesn't hold securities directly — it invests through trusts. Click a trust below to drill into its securities.
Plan health score (directional)
86
/ 100
Grade A
Top-tier plan health
Directional indicator computed from public Form 5500 data — compliance, concentration, cost, vendor stack and participation. Not a fiduciary tool.
Compliance & disclosures
100
Concentration risk
75
Total plan cost
65
Vendor stack
100
Participation health
100
Knocking points off
- 60 bps in Schedule C fees — 107% above peer band of 29 bps.
Helping the score
- Concentration not scored — Schedule of Assets PDF not yet parsed for this plan.
Decision-maker contacts
CFO / Head of HR / Benefits Manager — verified email + LinkedIn for ARIZONA DENTAL INSURANCE SERVICE, INC..
Plan sponsor
Name
ARIZONA DENTAL INSURANCE SERVICE, INC.
EIN
86-0274899
Address
5656 W TALAVI BOULEVARD · GLENDALE, AZ · 85306
Phone
(602) 938-3131
Industry
Finance & Insurancesee all
Plan administrator
Name
MERCER INVESTMENTS LLC
EIN
30-0282430
City
BOSTON, MA
Phone
(617) 747-9500
Plan characteristics
Plan number
001
Plan year
2022
Plan year begin
2022-01-01
Tax period
2022-12-31
Filed
2023-09-18
Pension benefit codes
2E · Profit-sharing
2F · ERISA section 404(c)
2G · Total participant-directed accounts
2J · 401(k) feature
2K · 401(m) arrangement
2S · Automatic enrollment
2T · Default investment account (QDIA)
3D · Pre-approved plan (master / prototype / VS)
Audit & trust (Schedule H)
Auditor
CLIFTONLARSONALLEN LLP
Trustee / custodian
—
Trustee phone
—
Service providers (Schedule C)
3 rowsRecordkeeper
1| Name | EIN | Location | Relation | Direct comp | Indirect comp |
|---|---|---|---|---|---|
| EMPOWER ANNUITY INSURANCE COMPANY | — | GREENWOOD VILLAGE, CO | RECORDKEEPER | $4K | — |
Other
2| Name | EIN | Location | Relation | Direct comp | Indirect comp |
|---|---|---|---|---|---|
| MERCER (US) INC MERCER INVESTMENTS | — | CHICAGO, IL | OTHER | $60K | — |
| EMPOWER ADVISORY GROUP, LLC | — | GREENWOOD VILLAGE, CO | INVESTMENT MGMT | $11 | — |
Investments
37 pooled funds· $10.4M(98% of reported assets)
Rows tagged as a trust or pooled fund hold many underlying securities. Click one to drill into its own Schedule of Assets — where the individual funds, shares, and CUSIPs live.
| Investment | Type | Current value | % of plan |
|---|---|---|---|
| STATE ST TARGET RET 2035 SL CL IV STATE STREET GLOBAL ADVISORS COLLECTIVE TRUSTS · EIN 32-6528132 / PN 024 | Common Collective Trust | $2.4M | 22.4% |
| STATE ST TARGET RET 2030 SL CL IV STATE STREET GLOBAL ADVISORS COLLECTIVE TRUSTS · EIN 32-6528132 / PN 023 | Common Collective Trust | $1.2M | 11.7% |
| STATE STREET S&P 500(R) INDEX SL C1 STATE STREET GLOBAL ADVISORS COLLECTIVE TRUSTS · EIN 04-0025081 / PN 006 | Common Collective Trust | $1.0M | 9.5% |
| INVESCO STABLE VALUE TRUST CL B1 INVESCO FUNDS · EIN 84-1142974 / PN 001 | Common Collective Trust | $919K | 8.6% |
| STATE ST TARGET RET 2025 SL CL IV STATE STREET GLOBAL ADVISORS COLLECTIVE TRUSTS · EIN 32-6528132 / PN 022 | Common Collective Trust | $848K | 8.0% |
| STATE ST TARGET RET 2020 SL CL IV STATE STREET GLOBAL ADVISORS COLLECTIVE TRUSTS · EIN 32-6528132 / PN 021 | Common Collective Trust | $641K | 6.0% |
| STATE STREET RUSSELL SMALL/MID CAP STATE STREET GLOBAL ADVISORS COLLECTIVE TRUSTS · EIN 04-0025081 / PN 009 | Common Collective Trust | $558K | 5.2% |
| STATE ST TARGET RET 2055 SL CL IV STATE STREET GLOBAL ADVISORS COLLECTIVE TRUSTS · EIN 32-6528132 / PN 028 | Common Collective Trust | $459K | 4.3% |
| STATE ST TARGET RET 2040 SL CL IV STATE STREET GLOBAL ADVISORS COLLECTIVE TRUSTS · EIN 32-6528132 / PN 025 | Common Collective Trust | $443K | 4.2% |
| STATE ST TARGET RET 2050 SL CL IV STATE STREET GLOBAL ADVISORS COLLECTIVE TRUSTS · EIN 32-6528132 / PN 027 | Common Collective Trust | $436K | 4.1% |
| STATE ST TARGET RET 2045 SL CL IV STATE STREET GLOBAL ADVISORS COLLECTIVE TRUSTS · EIN 32-6528132 / PN 026 | Common Collective Trust | $425K | 4.0% |
| STATE STREET GLOBAL ALL CAP EQUITY STATE STREET GLOBAL ADVISORS COLLECTIVE TRUSTS · EIN 90-0337987 / PN 282 | Common Collective Trust | $315K | 3.0% |
| MERCER SMALL/MID CAP STOCK FUND MERCER FUNDS · EIN 81-3183567 / PN 011 | Common Collective Trust | $283K | 2.7% |
| STATE STREET U.S. BOND INDEX SL C1 STATE STREET GLOBAL ADVISORS COLLECTIVE TRUSTS · EIN 04-0025081 / PN 071 | Common Collective Trust | $145K | 1.4% |
| MERCER LARGE CAP STOCK MERCER FUNDS · EIN 81-3153346 / PN 012 | Common Collective Trust | $135K | 1.3% |
| STATE ST TARGET RET 2060 SL CL IV STATE STREET GLOBAL ADVISORS COLLECTIVE TRUSTS · EIN 32-6528132 / PN 029 | Common Collective Trust | $67K | 0.6% |
| MERCER INTERNATIONAL STOCK MERCER FUNDS · EIN 81-3158100 / PN 010 | Common Collective Trust | $59K | 0.6% |
| STATE ST TARGET RET 2065 SL CL IV STATE STREET GLOBAL ADVISORS COLLECTIVE TRUSTS · EIN 32-6528132 / PN 045 | Common Collective Trust | $7K | <0.1% |
| MERCER DIVERSIFIED BOND MERCER FUNDS · EIN 81-3188218 / PN 009 | Common Collective Trust | $5K | <0.1% |
| BLACKROCK STRATEGIC COMPLETION NL M BLACKROCK UNITIZED CIT · EIN 46-3525011 / PN 001 | Common Collective Trust | $3K | <0.1% |
| STATE ST TARGET RET INCOME SL CL IV STATE STREET GLOBAL ADVISORS COLLECTIVE TRUSTS · EIN 32-6528132 / PN 030 | Common Collective Trust | $158 | <0.1% |
| MERCER SMALLMID CAP STOCK MERCER FUNDS · EIN 81-3153346 / PN 012 | Common Collective Trust | $0 | <0.1% |
| MERCER LARGE CAP STOCK MERCER · EIN 81-3183567 / PN 011 | Common Collective Trust | $0 | <0.1% |
| STATE STREET GL ALL CAP EQ IDX NL A STATE STREET · EIN 90-0337987 / PN 299 | Common Collective Trust | $0 | <0.1% |
| STATE STREET RUSSEL SMMD IDX NL A STATE STREET · EIN 04-0025081 / PN 453 | Common Collective Trust | $0 | <0.1% |
| STATE STREET S&P 500 INDEX NL A STATE STREET · EIN 04-0025081 / PN 097 | Common Collective Trust | $0 | <0.1% |
| STATE STRETE TRGT RTMNT 2020 INC NL STATE STREET · EIN 90-0337987 / PN 193 | Common Collective Trust | $0 | <0.1% |
| STATE STREET TRGT RTMNT 2025 INC NL STATE STREET · EIN 90-0337987 / PN 193 | Common Collective Trust | $0 | <0.1% |
| STATE STREET TRGT RTMNT 2030 INC NL STATE STREET · EIN 90-0337987 / PN 195 | Common Collective Trust | $0 | <0.1% |
| STATE STREET TRGT RTMNT 2035 INC NL STATE STREET · EIN 90-0337987 / PN 197 | Common Collective Trust | $0 | <0.1% |
| STATE STREET TRGT RTMNT 2040 INC NL STATE STREET · EIN 90-0337987 / PN 199 | Common Collective Trust | $0 | <0.1% |
| STATE STREET TRGT RTMNT 2045 INC NL STATE STREET · EIN 90-0337987 / PN 201 | Common Collective Trust | $0 | <0.1% |
| STATE STREET TRGT RTMNT 2050 INC NL STATE STREET · EIN 90-0337987 / PN 203 | Common Collective Trust | $0 | <0.1% |
| STATE SRETE TRGT RTMNT 2055 INC NL MERCER FUNDS · EIN 90-0337987 / PN 321 | Common Collective Trust | $0 | <0.1% |
| STATE STREET TRGT RTMNT 2060 INC NL STATE STREET · EIN 90-0337987 / PN 418 | Common Collective Trust | $0 | <0.1% |
| STATE STREET TRGT RTMNT 2065 NL CL STATE STREET · EIN 04-0025081 / PN 000 | Common Collective Trust | $0 | <0.1% |
| STATE STREET US BOND INDEX NL A STATE STREET · EIN 90-0337987 / PN 177 | Common Collective Trust | $0 | <0.1% |