401k Plan data: FAMILY DENTISTRY, INC. 401(K) PROFIT SHARING PLAN plan

FAMILY DENTISTRY, INC. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	FAMILY DENTISTRY, INC. 401(K) PROFIT SHARING PLAN
Plan identification number	001

FAMILY DENTISTRY, INC. 401(K) PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

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

Company Name: FAMILY DENTISTRY, INC.

Employer identification number (EIN): 043567750

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FAMILY DENTISTRY, INC. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2021-01-01 SANDRA COVE 2022-02-01 SANDRA COVE 2022-02-01
001 2020-01-01 SANDRA COVE 2021-04-12 SANDRA COVE 2021-04-12
001 2019-01-01 SANDRA COVE 2020-05-01 SANDRA COVE 2020-05-01
001 2018-01-01 SANDRA COVE 2019-10-11 SANDRA COVE 2019-10-11
001 2017-01-01 SANDRA COVE 2018-07-31 SANDRA COVE 2018-07-31
001 2016-01-01 SANDRA COVE 2017-06-15
001 2015-01-01 SANDRA COVE 2016-03-31 SANDRA COVE 2016-03-31
001 2014-01-01 SANDRA COVE 2015-07-21 SANDRA COVE 2015-07-21
001 2013-01-01 SANDRA COVE 2014-03-20 SANDRA COVE 2014-03-20
001 2012-01-01 SANDRA COVE 2013-07-15 SANDRA COVE 2013-07-15
001 2011-01-01 SANDRA F. COVE 2012-07-26 SANDRA F. COVE 2012-07-26
001 2010-01-01 SANDRA COVE SANDRA COVE 2011-04-26
001 2009-01-01 SANDRA COVE SANDRA COVE 2010-10-13

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2021-01-01	SANDRA COVE	2022-02-01	SANDRA COVE	2022-02-01
001	2020-01-01	SANDRA COVE	2021-04-12	SANDRA COVE	2021-04-12
001	2019-01-01	SANDRA COVE	2020-05-01	SANDRA COVE	2020-05-01
001	2018-01-01	SANDRA COVE	2019-10-11	SANDRA COVE	2019-10-11
001	2017-01-01	SANDRA COVE	2018-07-31	SANDRA COVE	2018-07-31
001	2016-01-01	SANDRA COVE	2017-06-15
001	2015-01-01	SANDRA COVE	2016-03-31	SANDRA COVE	2016-03-31
001	2014-01-01	SANDRA COVE	2015-07-21	SANDRA COVE	2015-07-21
001	2013-01-01	SANDRA COVE	2014-03-20	SANDRA COVE	2014-03-20
001	2012-01-01	SANDRA COVE	2013-07-15	SANDRA COVE	2013-07-15
001	2011-01-01	SANDRA F. COVE	2012-07-26	SANDRA F. COVE	2012-07-26
001	2010-01-01	SANDRA COVE		SANDRA COVE	2011-04-26
001	2009-01-01	SANDRA COVE		SANDRA COVE	2010-10-13

Plan Statistics for FAMILY DENTISTRY, INC. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for FAMILY DENTISTRY, INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2010: FAMILY DENTISTRY, INC. 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 11
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 11
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 3
Total of all active and inactive participants 2010-01-01 14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 14
Number of participants with account balances 2010-01-01 12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: FAMILY DENTISTRY, INC. 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 9
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 9
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 2
Total of all active and inactive participants 2009-01-01 11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 11
Number of participants with account balances 2009-01-01 11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2010: FAMILY DENTISTRY, INC. 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	11
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	11
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	3
Total of all active and inactive participants	2010-01-01	14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	14
Number of participants with account balances	2010-01-01	12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: FAMILY DENTISTRY, INC. 401(K) PROFIT SHARING PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	9
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	9
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	2
Total of all active and inactive participants	2009-01-01	11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	11
Number of participants with account balances	2009-01-01	11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on FAMILY DENTISTRY, INC. 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2010 : FAMILY DENTISTRY, INC. 401(K) PROFIT SHARING PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$73,085
Expenses. Total of all expenses incurred	2010-12-31	$11,656
Benefits paid (including direct rollovers)	2010-12-31	$11,656
Total plan assets at end of year	2010-12-31	$295,690
Total plan assets at beginning of year	2010-12-31	$234,261
Value of fidelity bond covering the plan	2010-12-31	$25,000
Total contributions received or receivable from participants	2010-12-31	$42,480
Other income received	2010-12-31	$30,605
Net income (gross income less expenses)	2010-12-31	$61,429
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$295,690
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$234,261
Assets. Value of participant loans	2010-12-31	$19,155
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0

Form 5500 Responses for FAMILY DENTISTRY, INC. 401(K) PROFIT SHARING PLAN

2010: FAMILY DENTISTRY, INC. 401(K) PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: FAMILY DENTISTRY, INC. 401(K) PROFIT SHARING PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

21517

Policy instance

Insurance contract or identification number	21517
Number of Individuals Covered	12
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No

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Company Name:	FAMILY DENTISTRY, INC.
Employer identification number (EIN):	043567750
NAIC Classification:	621210
NAIC Description:	Offices of Dentists