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| Plan Name | MDIS MULTIPLE EMPLOYER 401(K) SAVINGS PLAN |
| Plan identification number | 002 |
| 401k Plan Type | Defined Contribution Pension |
| Plan Features/Benefits |
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| Company Name: | DEREK R. KAELIN DDS, LLC DBA JAMES RIVER DENTAL |
| Employer identification number (EIN): | 274602114 |
| NAIC Classification: | 621210 |
| NAIC Description: | Offices of Dentists |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 002 | 2021-01-01 | FIDUCIARY SERVICES | 2022-09-19 | ||
| 002 | 2020-01-01 | FIDUCIARY SERVICES | 2021-08-09 | ||
| 002 | 2019-01-01 | FIDUCIARY SERVICES | 2020-10-15 | ||
| 002 | 2018-01-01 | GREG RUSSELL | 2019-07-30 | GREG RUSSELL | 2019-07-30 |
| 002 | 2017-01-01 | GREG RUSSELL | 2018-08-22 | GREG RUSSELL | 2018-08-22 |
| 002 | 2016-07-01 | GREG RUSSELL | 2017-10-10 | GREG RUSSELL | 2017-10-10 |
| 002 | 2016-07-01 | GREG RUSSELL | 2017-09-26 | GREG RUSSELL | 2017-09-26 |
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