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ROBERT A. RANDOLPH D.D.S 401(K) PLAN 401k Plan overview

Plan NameROBERT A. RANDOLPH D.D.S 401(K) PLAN
Plan identification number 001

ROBERT A. RANDOLPH D.D.S 401(K) PLAN Benefits

401k Plan TypeDefined Contribution Pension
Plan Features/Benefits
  • Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
  • Offset plan - Plan benefits are subject to offset for retirement benefits provided in another plan or arrangement of the employer.
  • 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.
  • Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of 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.
  • Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
  • Plan covering Self-Employed individuals.
  • 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

ROBERT A RANDOLPH D.D.S. has sponsored the creation of one or more 401k plans.

Company Name:ROBERT A RANDOLPH D.D.S.
Employer identification number (EIN):731724371
NAIC Classification:621210
NAIC Description:Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ROBERT A. RANDOLPH D.D.S 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012023-01-01
0012022-01-01ROBERT A. RANDOLPH, D.D.S.2023-06-09
0012021-01-01ROBERT A. RANDOLPH, D.D.S.2022-06-16
0012020-01-01ROBERT A. RANDOLPH, D.D.S.2021-09-07
0012019-01-01ROBERT A. RANDOLPH, D.D.S.2020-06-27
0012018-01-01
0012017-01-01
0012016-01-01
0012015-01-01
0012014-01-01ROBERT RANDOLPH2015-07-08
0012013-01-01ROBERT RANDOLPH2014-06-19
0012012-01-01ROBERT RANDOLPH2013-06-07

Plan Statistics for ROBERT A. RANDOLPH D.D.S 401(K) PLAN

401k plan membership statisitcs for ROBERT A. RANDOLPH D.D.S 401(K) PLAN

Measure Date Value
2022: ROBERT A. RANDOLPH D.D.S 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-0113
Total number of active participants reported on line 7a of the Form 55002022-01-0111
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-0111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-0111
Number of participants with account balances2022-01-0111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: ROBERT A. RANDOLPH D.D.S 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-0112
Total number of active participants reported on line 7a of the Form 55002021-01-0111
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-012
Total of all active and inactive participants2021-01-0113
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-0113
Number of participants with account balances2021-01-0113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-011
2020: ROBERT A. RANDOLPH D.D.S 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0111
Total number of active participants reported on line 7a of the Form 55002020-01-019
Number of retired or separated participants receiving benefits2020-01-011
Number of other retired or separated participants entitled to future benefits2020-01-011
Total of all active and inactive participants2020-01-0111
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-0111
Number of participants with account balances2020-01-0111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: ROBERT A. RANDOLPH D.D.S 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-0115
Total number of active participants reported on line 7a of the Form 55002019-01-0112
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-0112
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-0112
Number of participants with account balances2019-01-0111
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010

Financial Data on ROBERT A. RANDOLPH D.D.S 401(K) PLAN

Measure Date Value
2022 : ROBERT A. RANDOLPH D.D.S 401(K) PLAN 2022 401k financial data
Total plan liabilities at end of year2022-12-31$0
Total plan liabilities at beginning of year2022-12-31$0
Total income from all sources2022-12-31$-156,743
Expenses. Total of all expenses incurred2022-12-31$6,111
Benefits paid (including direct rollovers)2022-12-31$5,988
Total plan assets at end of year2022-12-31$1,183,348
Total plan assets at beginning of year2022-12-31$1,346,202
Value of fidelity bond covering the plan2022-12-31$260,000
Total contributions received or receivable from participants2022-12-31$81,501
Expenses. Other expenses not covered elsewhere2022-12-31$0
Contributions received from other sources (not participants or employers)2022-12-31$0
Other income received2022-12-31$-238,244
Noncash contributions received2022-12-31$0
Net income (gross income less expenses)2022-12-31$-162,854
Net plan assets at end of year (total assets less liabilities)2022-12-31$1,183,348
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$1,346,202
Total contributions received or receivable from employer(s)2022-12-31$0
Value of certain deemed distributions of participant loans2022-12-31$0
Value of corrective distributions2022-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$123
2021 : ROBERT A. RANDOLPH D.D.S 401(K) PLAN 2021 401k financial data
Total plan liabilities at end of year2021-12-31$0
Total plan liabilities at beginning of year2021-12-31$0
Total income from all sources2021-12-31$262,971
Expenses. Total of all expenses incurred2021-12-31$-951
Benefits paid (including direct rollovers)2021-12-31$0
Total plan assets at end of year2021-12-31$1,346,202
Total plan assets at beginning of year2021-12-31$1,082,280
Value of fidelity bond covering the plan2021-12-31$150,000
Total contributions received or receivable from participants2021-12-31$79,303
Expenses. Other expenses not covered elsewhere2021-12-31$0
Contributions received from other sources (not participants or employers)2021-12-31$0
Other income received2021-12-31$170,335
Noncash contributions received2021-12-31$0
Net income (gross income less expenses)2021-12-31$263,922
Net plan assets at end of year (total assets less liabilities)2021-12-31$1,346,202
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$1,082,280
Total contributions received or receivable from employer(s)2021-12-31$13,333
Value of certain deemed distributions of participant loans2021-12-31$0
Value of corrective distributions2021-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$-951
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2021-12-31$0
2020 : ROBERT A. RANDOLPH D.D.S 401(K) PLAN 2020 401k financial data
Total plan liabilities at end of year2020-12-31$0
Total plan liabilities at beginning of year2020-12-31$0
Total income from all sources2020-12-31$240,268
Expenses. Total of all expenses incurred2020-12-31$107,161
Benefits paid (including direct rollovers)2020-12-31$108,043
Total plan assets at end of year2020-12-31$1,082,280
Total plan assets at beginning of year2020-12-31$949,173
Value of fidelity bond covering the plan2020-12-31$150,000
Total contributions received or receivable from participants2020-12-31$61,615
Expenses. Other expenses not covered elsewhere2020-12-31$0
Contributions received from other sources (not participants or employers)2020-12-31$0
Other income received2020-12-31$147,614
Noncash contributions received2020-12-31$0
Net income (gross income less expenses)2020-12-31$133,107
Net plan assets at end of year (total assets less liabilities)2020-12-31$1,082,280
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$949,173
Total contributions received or receivable from employer(s)2020-12-31$31,039
Value of certain deemed distributions of participant loans2020-12-31$0
Value of corrective distributions2020-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$-882
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2020-12-31$0
2019 : ROBERT A. RANDOLPH D.D.S 401(K) PLAN 2019 401k financial data
Total plan liabilities at end of year2019-12-31$0
Total plan liabilities at beginning of year2019-12-31$0
Total income from all sources2019-12-31$260,758
Expenses. Total of all expenses incurred2019-12-31$7,429
Benefits paid (including direct rollovers)2019-12-31$7,093
Total plan assets at end of year2019-12-31$949,173
Total plan assets at beginning of year2019-12-31$695,844
Value of fidelity bond covering the plan2019-12-31$80,000
Total contributions received or receivable from participants2019-12-31$60,640
Expenses. Other expenses not covered elsewhere2019-12-31$0
Contributions received from other sources (not participants or employers)2019-12-31$0
Other income received2019-12-31$161,578
Noncash contributions received2019-12-31$0
Net income (gross income less expenses)2019-12-31$253,329
Net plan assets at end of year (total assets less liabilities)2019-12-31$949,173
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$695,844
Total contributions received or receivable from employer(s)2019-12-31$38,540
Value of certain deemed distributions of participant loans2019-12-31$0
Value of corrective distributions2019-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$336
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities2019-12-31$0

Form 5500 Responses for ROBERT A. RANDOLPH D.D.S 401(K) PLAN

2022: ROBERT A. RANDOLPH D.D.S 401(K) PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement - TrustYes
2021: ROBERT A. RANDOLPH D.D.S 401(K) PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement - TrustYes
2020: ROBERT A. RANDOLPH D.D.S 401(K) PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement - TrustYes
2019: ROBERT A. RANDOLPH D.D.S 401(K) PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number375349-01
Policy instance 1
Insurance contract or identification number375349-01
Number of Individuals Covered1
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number375349-01
Policy instance 1
Insurance contract or identification number375349-01
Number of Individuals Covered1
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number375349-01
Policy instance 1
Insurance contract or identification number375349-01
Number of Individuals Covered1
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )
Policy contract number375349-01
Policy instance 1
Insurance contract or identification number375349-01
Number of Individuals Covered1
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Are there contracts with allocated funds for individual policies?0
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?Yes
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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