401k Plan data: JEROME HERNANDEZ OD INC 401 K PROFIT SHARING PLAN TRUST plan

JEROME HERNANDEZ OD INC 401 K PROFIT SHARING PLAN TRUST 401k Plan overview

Plan Name	JEROME HERNANDEZ OD INC 401 K PROFIT SHARING PLAN TRUST
Plan identification number	001

JEROME HERNANDEZ OD INC 401 K PROFIT SHARING PLAN TRUST Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
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.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Plan provides for automatic enrollment in plan that has employee contributions deducted from payroll.
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

JEROME HERNANDEZ, OD, INC. has sponsored the creation of one or more 401k plans.

Company Name: JEROME HERNANDEZ, OD, INC.

Employer identification number (EIN): 271333007

NAIC Classification: 621320
NAIC Description: Offices of Optometrists

Additional information about JEROME HERNANDEZ, OD, INC.

Jurisdiction of Incorporation: Florida Department of State Division of Corporations

Incorporation Date: 2009-11-17

Company Identification Number: P09000094219

Legal Registered Office Address: 8231 S DIXIE HIGHWAY

MIAMI

33143

More information about JEROME HERNANDEZ, OD, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JEROME HERNANDEZ OD INC 401 K PROFIT SHARING PLAN TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 JEROME HERNANDEZ 2023-07-10
001 2021-01-01 JEROME HERNANDEZ 2022-09-04
001 2020-01-01 JEROME HERNANDEZ 2021-06-08
001 2019-01-01 JEROME HERNANDEZ 2020-07-10
001 2018-01-01 JEROME HERNANDEZ 2019-05-20
001 2017-01-01 JEROME HERNANDEZ 2018-10-04
001 2016-01-01 JEROME HERNANDEZ 2017-07-07
001 2014-10-01 JEROME HERNANDEZ
001 2013-10-01 JEROME HERNANDEZ
001 2012-10-01 JEROME HERNANDEZ
001 2011-10-01 JEROME HERNANDEZ

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01	JEROME HERNANDEZ	2023-07-10
001	2021-01-01	JEROME HERNANDEZ	2022-09-04
001	2020-01-01	JEROME HERNANDEZ	2021-06-08
001	2019-01-01	JEROME HERNANDEZ	2020-07-10
001	2018-01-01	JEROME HERNANDEZ	2019-05-20
001	2017-01-01	JEROME HERNANDEZ	2018-10-04
001	2016-01-01	JEROME HERNANDEZ	2017-07-07
001	2014-10-01	JEROME HERNANDEZ
001	2013-10-01	JEROME HERNANDEZ
001	2012-10-01	JEROME HERNANDEZ
001	2011-10-01	JEROME HERNANDEZ

Plan Statistics for JEROME HERNANDEZ OD INC 401 K PROFIT SHARING PLAN TRUST

401k plan membership statisitcs for JEROME HERNANDEZ OD INC 401 K PROFIT SHARING PLAN TRUST

Measure Date Value
2014: JEROME HERNANDEZ OD INC 401 K PROFIT SHARING PLAN TRUST 2014 401k membership
Total participants, beginning-of-year 2014-10-01 1
Total number of active participants reported on line 7a of the Form 5500 2014-10-01 1
Number of retired or separated participants receiving benefits 2014-10-01 0
Number of other retired or separated participants entitled to future benefits 2014-10-01 0
Total of all active and inactive participants 2014-10-01 1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-10-01 0
Total participants 2014-10-01 1
Number of participants with account balances 2014-10-01 1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-10-01 0
2013: JEROME HERNANDEZ OD INC 401 K PROFIT SHARING PLAN TRUST 2013 401k membership
Total participants, beginning-of-year 2013-10-01 1
Total number of active participants reported on line 7a of the Form 5500 2013-10-01 1
Number of retired or separated participants receiving benefits 2013-10-01 0
Number of other retired or separated participants entitled to future benefits 2013-10-01 0
Total of all active and inactive participants 2013-10-01 1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-10-01 0
Total participants 2013-10-01 1
Number of participants with account balances 2013-10-01 1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-10-01 0
2012: JEROME HERNANDEZ OD INC 401 K PROFIT SHARING PLAN TRUST 2012 401k membership
Total participants, beginning-of-year 2012-10-01 1
Total number of active participants reported on line 7a of the Form 5500 2012-10-01 1
Number of retired or separated participants receiving benefits 2012-10-01 0
Number of other retired or separated participants entitled to future benefits 2012-10-01 0
Total of all active and inactive participants 2012-10-01 1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-10-01 0
Total participants 2012-10-01 1
Number of participants with account balances 2012-10-01 1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-10-01 0
2011: JEROME HERNANDEZ OD INC 401 K PROFIT SHARING PLAN TRUST 2011 401k membership
Total participants, beginning-of-year 2011-10-01 1
Total number of active participants reported on line 7a of the Form 5500 2011-10-01 1
Number of retired or separated participants receiving benefits 2011-10-01 0
Number of other retired or separated participants entitled to future benefits 2011-10-01 0
Total of all active and inactive participants 2011-10-01 1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-10-01 0
Total participants 2011-10-01 1
Number of participants with account balances 2011-10-01 1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-10-01 0

Measure	Date	Value
2014: JEROME HERNANDEZ OD INC 401 K PROFIT SHARING PLAN TRUST 2014 401k membership
Total participants, beginning-of-year	2014-10-01	1
Total number of active participants reported on line 7a of the Form 5500	2014-10-01	1
Number of retired or separated participants receiving benefits	2014-10-01	0
Number of other retired or separated participants entitled to future benefits	2014-10-01	0
Total of all active and inactive participants	2014-10-01	1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-10-01	0
Total participants	2014-10-01	1
Number of participants with account balances	2014-10-01	1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-10-01	0
2013: JEROME HERNANDEZ OD INC 401 K PROFIT SHARING PLAN TRUST 2013 401k membership
Total participants, beginning-of-year	2013-10-01	1
Total number of active participants reported on line 7a of the Form 5500	2013-10-01	1
Number of retired or separated participants receiving benefits	2013-10-01	0
Number of other retired or separated participants entitled to future benefits	2013-10-01	0
Total of all active and inactive participants	2013-10-01	1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-10-01	0
Total participants	2013-10-01	1
Number of participants with account balances	2013-10-01	1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-10-01	0
2012: JEROME HERNANDEZ OD INC 401 K PROFIT SHARING PLAN TRUST 2012 401k membership
Total participants, beginning-of-year	2012-10-01	1
Total number of active participants reported on line 7a of the Form 5500	2012-10-01	1
Number of retired or separated participants receiving benefits	2012-10-01	0
Number of other retired or separated participants entitled to future benefits	2012-10-01	0
Total of all active and inactive participants	2012-10-01	1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-10-01	0
Total participants	2012-10-01	1
Number of participants with account balances	2012-10-01	1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-10-01	0
2011: JEROME HERNANDEZ OD INC 401 K PROFIT SHARING PLAN TRUST 2011 401k membership
Total participants, beginning-of-year	2011-10-01	1
Total number of active participants reported on line 7a of the Form 5500	2011-10-01	1
Number of retired or separated participants receiving benefits	2011-10-01	0
Number of other retired or separated participants entitled to future benefits	2011-10-01	0
Total of all active and inactive participants	2011-10-01	1
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-10-01	0
Total participants	2011-10-01	1
Number of participants with account balances	2011-10-01	1
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-10-01	0

Financial Data on JEROME HERNANDEZ OD INC 401 K PROFIT SHARING PLAN TRUST

Measure	Date	Value
2015 : JEROME HERNANDEZ OD INC 401 K PROFIT SHARING PLAN TRUST 2015 401k financial data
Total income from all sources	2015-09-30	$14,854
Expenses. Total of all expenses incurred	2015-09-30	$0
Benefits paid (including direct rollovers)	2015-09-30	$0
Total plan assets at end of year	2015-09-30	$509,977
Total plan assets at beginning of year	2015-09-30	$495,123
Total contributions received or receivable from participants	2015-09-30	$0
Contributions received from other sources (not participants or employers)	2015-09-30	$0
Other income received	2015-09-30	$14,854
Net income (gross income less expenses)	2015-09-30	$14,854
Net plan assets at end of year (total assets less liabilities)	2015-09-30	$509,977
Net plan assets at beginning of year (total assets less liabilities)	2015-09-30	$495,123
Assets. Value of employer securities	2015-09-30	$509,977
Total contributions received or receivable from employer(s)	2015-09-30	$0
Value of certain deemed distributions of participant loans	2015-09-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2015-09-30	$0
2014 : JEROME HERNANDEZ OD INC 401 K PROFIT SHARING PLAN TRUST 2014 401k financial data
Total income from all sources	2014-09-30	$75,123
Expenses. Total of all expenses incurred	2014-09-30	$0
Benefits paid (including direct rollovers)	2014-09-30	$0
Total plan assets at end of year	2014-09-30	$495,123
Total plan assets at beginning of year	2014-09-30	$420,000
Total contributions received or receivable from participants	2014-09-30	$0
Contributions received from other sources (not participants or employers)	2014-09-30	$0
Other income received	2014-09-30	$75,123
Net income (gross income less expenses)	2014-09-30	$75,123
Net plan assets at end of year (total assets less liabilities)	2014-09-30	$495,123
Net plan assets at beginning of year (total assets less liabilities)	2014-09-30	$420,000
Assets. Value of employer securities	2014-09-30	$495,123
Total contributions received or receivable from employer(s)	2014-09-30	$0
Value of certain deemed distributions of participant loans	2014-09-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-09-30	$0
2013 : JEROME HERNANDEZ OD INC 401 K PROFIT SHARING PLAN TRUST 2013 401k financial data
Total income from all sources	2013-09-30	$20,000
Expenses. Total of all expenses incurred	2013-09-30	$0
Benefits paid (including direct rollovers)	2013-09-30	$0
Total plan assets at end of year	2013-09-30	$420,000
Total plan assets at beginning of year	2013-09-30	$400,000
Total contributions received or receivable from participants	2013-09-30	$0
Contributions received from other sources (not participants or employers)	2013-09-30	$0
Other income received	2013-09-30	$20,000
Net income (gross income less expenses)	2013-09-30	$20,000
Net plan assets at end of year (total assets less liabilities)	2013-09-30	$420,000
Net plan assets at beginning of year (total assets less liabilities)	2013-09-30	$400,000
Assets. Value of employer securities	2013-09-30	$420,000
Total contributions received or receivable from employer(s)	2013-09-30	$0
Value of certain deemed distributions of participant loans	2013-09-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2013-09-30	$0
2012 : JEROME HERNANDEZ OD INC 401 K PROFIT SHARING PLAN TRUST 2012 401k financial data
Total income from all sources	2012-09-30	$225,164
Expenses. Total of all expenses incurred	2012-09-30	$0
Benefits paid (including direct rollovers)	2012-09-30	$0
Total plan assets at end of year	2012-09-30	$400,000
Total plan assets at beginning of year	2012-09-30	$174,836
Total contributions received or receivable from participants	2012-09-30	$0
Contributions received from other sources (not participants or employers)	2012-09-30	$0
Other income received	2012-09-30	$225,164
Net income (gross income less expenses)	2012-09-30	$225,164
Net plan assets at end of year (total assets less liabilities)	2012-09-30	$400,000
Net plan assets at beginning of year (total assets less liabilities)	2012-09-30	$174,836
Assets. Value of employer securities	2012-09-30	$400,000
Total contributions received or receivable from employer(s)	2012-09-30	$0
Value of certain deemed distributions of participant loans	2012-09-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2012-09-30	$0
2011 : JEROME HERNANDEZ OD INC 401 K PROFIT SHARING PLAN TRUST 2011 401k financial data
Total income from all sources	2011-09-30	$122,291
Expenses. Total of all expenses incurred	2011-09-30	$0
Benefits paid (including direct rollovers)	2011-09-30	$0
Total plan assets at end of year	2011-09-30	$174,836
Total plan assets at beginning of year	2011-09-30	$52,545
Total contributions received or receivable from participants	2011-09-30	$0
Contributions received from other sources (not participants or employers)	2011-09-30	$0
Other income received	2011-09-30	$122,291
Net income (gross income less expenses)	2011-09-30	$122,291
Net plan assets at end of year (total assets less liabilities)	2011-09-30	$174,836
Net plan assets at beginning of year (total assets less liabilities)	2011-09-30	$52,545
Assets. Value of employer securities	2011-09-30	$174,836
Total contributions received or receivable from employer(s)	2011-09-30	$0
Value of certain deemed distributions of participant loans	2011-09-30	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2011-09-30	$0

Form 5500 Responses for JEROME HERNANDEZ OD INC 401 K PROFIT SHARING PLAN TRUST

2014: JEROME HERNANDEZ OD INC 401 K PROFIT SHARING PLAN TRUST 2014 form 5500 responses
2014-10-01	Type of plan entity	Single employer plan
2014-10-01	Plan funding arrangement – Trust	Yes
2014-10-01	Plan benefit arrangement - Trust	Yes
2013: JEROME HERNANDEZ OD INC 401 K PROFIT SHARING PLAN TRUST 2013 form 5500 responses
2013-10-01	Type of plan entity	Single employer plan
2013-10-01	Plan funding arrangement – Trust	Yes
2013-10-01	Plan benefit arrangement - Trust	Yes
2012: JEROME HERNANDEZ OD INC 401 K PROFIT SHARING PLAN TRUST 2012 form 5500 responses
2012-10-01	Type of plan entity	Single employer plan
2012-10-01	Plan funding arrangement – Trust	Yes
2012-10-01	Plan benefit arrangement - Trust	Yes
2011: JEROME HERNANDEZ OD INC 401 K PROFIT SHARING PLAN TRUST 2011 form 5500 responses
2011-10-01	Type of plan entity	Single employer plan
2011-10-01	Plan funding arrangement – Trust	Yes
2011-10-01	Plan benefit arrangement - Trust	Yes

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Company Name:	JEROME HERNANDEZ, OD, INC.
Employer identification number (EIN):	271333007
NAIC Classification:	621320
NAIC Description:	Offices of Optometrists

Jurisdiction of Incorporation:	Florida Department of State Division of Corporations
Incorporation Date:	2009-11-17
Company Identification Number:	P09000094219
Legal Registered Office Address:	8231 S DIXIE HIGHWAY MIAMI 33143