401k Plan data: DR JEFFREY A SALADIN DENTAL CORP 401K PROFIT SHARING PLAN plan

DR JEFFREY A SALADIN DENTAL CORP 401K PROFIT SHARING PLAN 401k Plan overview

Plan Name	DR JEFFREY A SALADIN DENTAL CORP 401K PROFIT SHARING PLAN
Plan identification number	002

DR JEFFREY A SALADIN DENTAL CORP 401K PROFIT SHARING PLAN Benefits

401k Plan Type

Defined 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).
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.
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.
Participant-directed brokerage accounts provided as an investment option under the plan.
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

DR. JEFFREY A. SALADIN, DENTAL CORPORATION has sponsored the creation of one or more 401k plans.

Company Name: DR. JEFFREY A. SALADIN, DENTAL CORPORATION

Employer identification number (EIN): 900217702

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DR JEFFREY A SALADIN DENTAL CORP 401K PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2021-01-01 JENNI RYKER 2022-10-17
002 2020-01-01 LANCE SORENSON 2021-09-28 LANCE SORENSON 2021-09-28
002 2019-01-01 LANCE SORENSON 2020-10-09 LANCE SORENSON 2020-10-09
002 2018-01-01
002 2017-01-01
002 2016-01-01
002 2015-01-01
002 2014-01-01
002 2013-01-01
002 2012-01-01 JEFFREY A. SALADIN 2014-10-14 JEFFREY A. SALADIN 2014-10-14

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2021-01-01	JENNI RYKER	2022-10-17
002	2020-01-01	LANCE SORENSON	2021-09-28	LANCE SORENSON	2021-09-28
002	2019-01-01	LANCE SORENSON	2020-10-09	LANCE SORENSON	2020-10-09
002	2018-01-01
002	2017-01-01
002	2016-01-01
002	2015-01-01
002	2014-01-01
002	2013-01-01
002	2012-01-01	JEFFREY A. SALADIN	2014-10-14	JEFFREY A. SALADIN	2014-10-14

Plan Statistics for DR JEFFREY A SALADIN DENTAL CORP 401K PROFIT SHARING PLAN

401k plan membership statisitcs for DR JEFFREY A SALADIN DENTAL CORP 401K PROFIT SHARING PLAN

Measure Date Value
2021: DR JEFFREY A SALADIN DENTAL CORP 401K PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 369
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 374
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 54
Total of all active and inactive participants 2021-01-01 428
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 428
Number of participants with account balances 2021-01-01 175
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 3
2020: DR JEFFREY A SALADIN DENTAL CORP 401K PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 321
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 271
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 72
Total of all active and inactive participants 2020-01-01 343
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 343
Number of participants with account balances 2020-01-01 167
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 11
2019: DR JEFFREY A SALADIN DENTAL CORP 401K PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 198
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 275
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 32
Total of all active and inactive participants 2019-01-01 307
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 307
Number of participants with account balances 2019-01-01 116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 14

Measure	Date	Value
2021: DR JEFFREY A SALADIN DENTAL CORP 401K PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	369
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	374
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	54
Total of all active and inactive participants	2021-01-01	428
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	428
Number of participants with account balances	2021-01-01	175
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	3
2020: DR JEFFREY A SALADIN DENTAL CORP 401K PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	321
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	271
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	72
Total of all active and inactive participants	2020-01-01	343
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	343
Number of participants with account balances	2020-01-01	167
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	11
2019: DR JEFFREY A SALADIN DENTAL CORP 401K PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	198
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	275
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	32
Total of all active and inactive participants	2019-01-01	307
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	307
Number of participants with account balances	2019-01-01	116
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	14

Financial Data on DR JEFFREY A SALADIN DENTAL CORP 401K PROFIT SHARING PLAN

Measure	Date	Value
2021 : DR JEFFREY A SALADIN DENTAL CORP 401K PROFIT SHARING PLAN 2021 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$33,410
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$21,321
Total income from all sources (including contributions)	2021-12-31	$2,041,776
Total of all expenses incurred	2021-12-31	$624,321
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$603,590
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$1,534,188
Value of total assets at end of year	2021-12-31	$5,809,226
Value of total assets at beginning of year	2021-12-31	$4,379,682
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$20,731
Total interest from all sources	2021-12-31	$3,906
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2021-12-31	No
Administrative expenses professional fees incurred	2021-12-31	$14,871
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$671,849
Participant contributions at end of year	2021-12-31	$76,606
Participant contributions at beginning of year	2021-12-31	$23,083
Income. Received or receivable in cash from other sources (including rollovers)	2021-12-31	$560,820
Value of other receiveables (less allowance for doubtful accounts) at end of year	2021-12-31	$2,103
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-12-31	$6,183
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-12-31	$6,183
Liabilities. Value of operating payables at end of year	2021-12-31	$27,227
Liabilities. Value of operating payables at beginning of year	2021-12-31	$15,138
Total non interest bearing cash at end of year	2021-12-31	$51,607
Total non interest bearing cash at beginning of year	2021-12-31	$22,265
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Value of net income/loss	2021-12-31	$1,417,455
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$5,775,816
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$4,358,361
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Investment advisory and management fees	2021-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2021-12-31	$5,678,615
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2021-12-31	$4,049,255
Interest on participant loans	2021-12-31	$3,906
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2021-12-31	$503,682
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$301,519
Employer contributions (assets) at end of year	2021-12-31	$295
Employer contributions (assets) at beginning of year	2021-12-31	$285,079
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$603,590
Contract administrator fees	2021-12-31	$5,860
Did the plan have assets held for investment	2021-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	LEE CPA AUDIT GROUP
Accountancy firm EIN	2021-12-31	814637885
2020 : DR JEFFREY A SALADIN DENTAL CORP 401K PROFIT SHARING PLAN 2020 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$21,321
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$7,706
Total income from all sources (including contributions)	2020-12-31	$1,514,317
Total of all expenses incurred	2020-12-31	$451,003
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$430,833
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$905,222
Value of total assets at end of year	2020-12-31	$4,379,682
Value of total assets at beginning of year	2020-12-31	$3,302,753
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$20,170
Total interest from all sources	2020-12-31	$1,893
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2020-12-31	No
Administrative expenses professional fees incurred	2020-12-31	$16,394
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$480,007
Participant contributions at end of year	2020-12-31	$23,083
Participant contributions at beginning of year	2020-12-31	$33,240
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$140,136
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2020-12-31	$6,183
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2020-12-31	$6,183
Liabilities. Value of operating payables at end of year	2020-12-31	$15,138
Liabilities. Value of operating payables at beginning of year	2020-12-31	$1,523
Total non interest bearing cash at end of year	2020-12-31	$22,265
Total non interest bearing cash at beginning of year	2020-12-31	$15,567
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Value of net income/loss	2020-12-31	$1,063,314
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$4,358,361
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$3,295,047
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2020-12-31	$4,049,255
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2020-12-31	$3,052,239
Interest on participant loans	2020-12-31	$1,893
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$607,202
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$285,079
Employer contributions (assets) at end of year	2020-12-31	$285,079
Employer contributions (assets) at beginning of year	2020-12-31	$201,707
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$430,833
Contract administrator fees	2020-12-31	$3,776
Did the plan have assets held for investment	2020-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	LEE CPA AUDIT GROUP
Accountancy firm EIN	2020-12-31	814637885
2019 : DR JEFFREY A SALADIN DENTAL CORP 401K PROFIT SHARING PLAN 2019 401k financial data
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$7,706
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$7,706
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$4,768
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2019-12-31	$4,768
Total income from all sources (including contributions)	2019-12-31	$1,130,333
Total income from all sources (including contributions)	2019-12-31	$1,130,333
Total of all expenses incurred	2019-12-31	$202,028
Total of all expenses incurred	2019-12-31	$202,028
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$197,206
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2019-12-31	$197,206
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$664,538
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2019-12-31	$664,538
Value of total assets at end of year	2019-12-31	$3,302,753
Value of total assets at end of year	2019-12-31	$3,302,753
Value of total assets at beginning of year	2019-12-31	$2,371,510
Value of total assets at beginning of year	2019-12-31	$2,371,510
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$4,822
Total of administrative expenses incurred including professional, contract, advisory and management fees	2019-12-31	$4,822
Total interest from all sources	2019-12-31	$3,119
Total interest from all sources	2019-12-31	$3,119
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2019-12-31	No
Administrative expenses professional fees incurred	2019-12-31	$1,641
Administrative expenses professional fees incurred	2019-12-31	$1,641
Was this plan covered by a fidelity bond	2019-12-31	Yes
Was this plan covered by a fidelity bond	2019-12-31	Yes
Value of fidelity bond cover	2019-12-31	$340,000
Value of fidelity bond cover	2019-12-31	$340,000
If this is an individual account plan, was there a blackout period	2019-12-31	No
If this is an individual account plan, was there a blackout period	2019-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2019-12-31	No
Contributions received from participants	2019-12-31	$352,491
Contributions received from participants	2019-12-31	$352,491
Participant contributions at end of year	2019-12-31	$33,240
Participant contributions at end of year	2019-12-31	$33,240
Participant contributions at beginning of year	2019-12-31	$53,228
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$110,339
Income. Received or receivable in cash from other sources (including rollovers)	2019-12-31	$110,339
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$6,183
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2019-12-31	$6,183
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2019-12-31	$0
Liabilities. Value of operating payables at end of year	2019-12-31	$1,523
Liabilities. Value of operating payables at end of year	2019-12-31	$1,523
Liabilities. Value of operating payables at beginning of year	2019-12-31	$4,768
Liabilities. Value of operating payables at beginning of year	2019-12-31	$4,768
Total non interest bearing cash at end of year	2019-12-31	$15,567
Total non interest bearing cash at end of year	2019-12-31	$15,567
Total non interest bearing cash at beginning of year	2019-12-31	$3,121
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Value of net income/loss	2019-12-31	$928,305
Value of net income/loss	2019-12-31	$928,305
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$3,295,047
Value of net assets at end of year (total assets less liabilities)	2019-12-31	$3,295,047
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$2,366,742
Value of net assets at beginning of year (total assets less liabilities)	2019-12-31	$2,366,742
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2019-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Were any leases to which the plan was party in default or uncollectible	2019-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$3,052,239
Value of interest in registered invesment companies (eg mutual funds) at end of year	2019-12-31	$3,052,239
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2019-12-31	$2,202,873
Interest on participant loans	2019-12-31	$3,119
Interest on participant loans	2019-12-31	$3,119
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$462,676
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2019-12-31	$462,676
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Was there a failure to transmit to the plan any participant contributions	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Has the plan failed to provide any benefit when due under the plan	2019-12-31	No
Contributions received in cash from employer	2019-12-31	$201,708
Contributions received in cash from employer	2019-12-31	$201,708
Employer contributions (assets) at end of year	2019-12-31	$201,707
Employer contributions (assets) at end of year	2019-12-31	$201,707
Employer contributions (assets) at beginning of year	2019-12-31	$112,288
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$197,206
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2019-12-31	$197,206
Contract administrator fees	2019-12-31	$3,181
Contract administrator fees	2019-12-31	$3,181
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan have assets held for investment	2019-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2019-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2019-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Opinion of an independent qualified public accountant for this plan	2019-12-31	Disclaimer
Accountancy firm name	2019-12-31	LEE CPA AUDIT GROUP
Accountancy firm name	2019-12-31	LEE CPA AUDIT GROUP
Accountancy firm EIN	2019-12-31	814637885
Accountancy firm EIN	2019-12-31	814637885

Form 5500 Responses for DR JEFFREY A SALADIN DENTAL CORP 401K PROFIT SHARING PLAN

2021: DR JEFFREY A SALADIN DENTAL CORP 401K PROFIT SHARING PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: DR JEFFREY A SALADIN DENTAL CORP 401K PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: DR JEFFREY A SALADIN DENTAL CORP 401K PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	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

109361

Policy instance

Insurance contract or identification number	109361
Number of Individuals Covered	201
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $17,726
Total amount of fees paid to insurance company	USD $7,189
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $17,726
Insurance broker organization code?	3
Amount paid for insurance broker fees	7189

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

Policy contract number

109361

Policy instance

Insurance contract or identification number	109361
Number of Individuals Covered	169
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $12,457
Total amount of fees paid to insurance company	USD $4,723
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $12,457
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

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

Policy contract number

109361

Policy instance

Insurance contract or identification number	109361
Number of Individuals Covered	124
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $9,937
Total amount of fees paid to insurance company	USD $10,896
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $9,937
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	TPA COMPENSATION

Potentially related plans

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Company Name:	DR. JEFFREY A. SALADIN, DENTAL CORPORATION
Employer identification number (EIN):	900217702
NAIC Classification:	621210
NAIC Description:	Offices of Dentists