401k Plan data: DR. CHARLES T. HOSTNIK plan

DR. CHARLES T. HOSTNIK 401k Plan overview

Plan Name	DR. CHARLES T. HOSTNIK
Plan identification number	001

DR. CHARLES T. HOSTNIK 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.
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.
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. CHARLES T. HOSTNIK has sponsored the creation of one or more 401k plans.

Company Name: DR. CHARLES T. HOSTNIK

Employer identification number (EIN): 043703424

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DR. CHARLES T. HOSTNIK

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2019-01-01 THOMAS K MCNEILL 2020-06-22 THOMAS K MCNEILL 2020-06-22
001 2018-01-01
001 2017-01-01
001 2016-01-01
001 2015-01-01
001 2014-01-01
001 2013-01-01
001 2012-01-01 THOMAS K MCNEILL CHARLES T HOSTNIK 2013-04-22
001 2011-01-01 THOMAS K MCNEILL CHARLES T HOSTNIK 2012-07-24
001 2010-01-01 THOMAS K MCNEILL CHARLES T HOSTNIK 2011-07-29
001 2009-01-01 THOMAS MCNEILL CHARLES T HOSTNIK 2010-07-29

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2019-01-01	THOMAS K MCNEILL	2020-06-22	THOMAS K MCNEILL	2020-06-22
001	2018-01-01
001	2017-01-01
001	2016-01-01
001	2015-01-01
001	2014-01-01
001	2013-01-01
001	2012-01-01	THOMAS K MCNEILL		CHARLES T HOSTNIK	2013-04-22
001	2011-01-01	THOMAS K MCNEILL		CHARLES T HOSTNIK	2012-07-24
001	2010-01-01	THOMAS K MCNEILL		CHARLES T HOSTNIK	2011-07-29
001	2009-01-01	THOMAS MCNEILL		CHARLES T HOSTNIK	2010-07-29

Plan Statistics for DR. CHARLES T. HOSTNIK

401k plan membership statisitcs for DR. CHARLES T. HOSTNIK

Measure Date Value
2019: DR. CHARLES T. HOSTNIK 2019 401k membership
Total participants, beginning-of-year 2019-01-01 1
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 1
Total of all active and inactive participants 2019-01-01 1
Total participants 2019-01-01 1
Number of participants with account balances 2019-01-01 1
2018: DR. CHARLES T. HOSTNIK 2018 401k membership
Total participants, beginning-of-year 2018-01-01 1
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 1
Total of all active and inactive participants 2018-01-01 1
Total participants 2018-01-01 1
2017: DR. CHARLES T. HOSTNIK 2017 401k membership
Total participants, beginning-of-year 2017-01-01 1
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 1
Total of all active and inactive participants 2017-01-01 1
Total participants 2017-01-01 1
2016: DR. CHARLES T. HOSTNIK 2016 401k membership
Total participants, beginning-of-year 2016-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 3
Total of all active and inactive participants 2016-01-01 3
Total participants 2016-01-01 3
2015: DR. CHARLES T. HOSTNIK 2015 401k membership
Total participants, beginning-of-year 2015-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 4
Total of all active and inactive participants 2015-01-01 4
Total participants 2015-01-01 4
2014: DR. CHARLES T. HOSTNIK 2014 401k membership
Total participants, beginning-of-year 2014-01-01 3
Number of retired or separated participants receiving benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 0
Total participants 2014-01-01 0
Number of participants with account balances 2014-01-01 0
2013: DR. CHARLES T. HOSTNIK 2013 401k membership
Total participants, beginning-of-year 2013-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 3
Total of all active and inactive participants 2013-01-01 3
Total participants 2013-01-01 3
2012: DR. CHARLES T. HOSTNIK 2012 401k membership
Total participants, beginning-of-year 2012-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 3
Total of all active and inactive participants 2012-01-01 3
Total participants 2012-01-01 3
2011: DR. CHARLES T. HOSTNIK 2011 401k membership
Total participants, beginning-of-year 2011-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 2
Number of retired or separated participants receiving benefits 2011-01-01 1
Total of all active and inactive participants 2011-01-01 3
Total participants 2011-01-01 3
Number of participants with account balances 2011-01-01 3
2010: DR. CHARLES T. HOSTNIK 2010 401k membership
Total participants, beginning-of-year 2010-01-01 2
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 2
Total of all active and inactive participants 2010-01-01 2
Total participants 2010-01-01 2
Number of participants with account balances 2010-01-01 2
2009: DR. CHARLES T. HOSTNIK 2009 401k membership
Total participants, beginning-of-year 2009-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 0
Total of all active and inactive participants 2009-01-01 0
Total participants 2009-01-01 0

Measure	Date	Value
2019: DR. CHARLES T. HOSTNIK 2019 401k membership
Total participants, beginning-of-year	2019-01-01	1
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	1
Total of all active and inactive participants	2019-01-01	1
Total participants	2019-01-01	1
Number of participants with account balances	2019-01-01	1
2018: DR. CHARLES T. HOSTNIK 2018 401k membership
Total participants, beginning-of-year	2018-01-01	1
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	1
Total of all active and inactive participants	2018-01-01	1
Total participants	2018-01-01	1
2017: DR. CHARLES T. HOSTNIK 2017 401k membership
Total participants, beginning-of-year	2017-01-01	1
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	1
Total of all active and inactive participants	2017-01-01	1
Total participants	2017-01-01	1
2016: DR. CHARLES T. HOSTNIK 2016 401k membership
Total participants, beginning-of-year	2016-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	3
Total of all active and inactive participants	2016-01-01	3
Total participants	2016-01-01	3
2015: DR. CHARLES T. HOSTNIK 2015 401k membership
Total participants, beginning-of-year	2015-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	4
Total of all active and inactive participants	2015-01-01	4
Total participants	2015-01-01	4
2014: DR. CHARLES T. HOSTNIK 2014 401k membership
Total participants, beginning-of-year	2014-01-01	3
Number of retired or separated participants receiving benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	0
Total participants	2014-01-01	0
Number of participants with account balances	2014-01-01	0
2013: DR. CHARLES T. HOSTNIK 2013 401k membership
Total participants, beginning-of-year	2013-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	3
Total of all active and inactive participants	2013-01-01	3
Total participants	2013-01-01	3
2012: DR. CHARLES T. HOSTNIK 2012 401k membership
Total participants, beginning-of-year	2012-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	3
Total of all active and inactive participants	2012-01-01	3
Total participants	2012-01-01	3
2011: DR. CHARLES T. HOSTNIK 2011 401k membership
Total participants, beginning-of-year	2011-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	2
Number of retired or separated participants receiving benefits	2011-01-01	1
Total of all active and inactive participants	2011-01-01	3
Total participants	2011-01-01	3
Number of participants with account balances	2011-01-01	3
2010: DR. CHARLES T. HOSTNIK 2010 401k membership
Total participants, beginning-of-year	2010-01-01	2
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	2
Total of all active and inactive participants	2010-01-01	2
Total participants	2010-01-01	2
Number of participants with account balances	2010-01-01	2
2009: DR. CHARLES T. HOSTNIK 2009 401k membership
Total participants, beginning-of-year	2009-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	0
Total of all active and inactive participants	2009-01-01	0
Total participants	2009-01-01	0

Financial Data on DR. CHARLES T. HOSTNIK

Measure	Date	Value
2019 : DR. CHARLES T. HOSTNIK 2019 401k financial data
Total plan liabilities at beginning of year	2019-12-31	$0
Total income from all sources	2019-12-31	$7,182
Expenses. Total of all expenses incurred	2019-12-31	$0
Total plan assets at end of year	2019-12-31	$236,605
Total plan assets at beginning of year	2019-12-31	$229,423
Value of fidelity bond covering the plan	2019-12-31	$500,000
Total contributions received or receivable from participants	2019-12-31	$0
Other income received	2019-12-31	$7,182
Net income (gross income less expenses)	2019-12-31	$7,182
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$236,605
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$229,423
Total contributions received or receivable from employer(s)	2019-12-31	$0
2018 : DR. CHARLES T. HOSTNIK 2018 401k financial data
Total income from all sources	2018-12-31	$4,973
Expenses. Total of all expenses incurred	2018-12-31	$0
Total plan assets at end of year	2018-12-31	$229,423
Total plan assets at beginning of year	2018-12-31	$224,450
Value of fidelity bond covering the plan	2018-12-31	$500,000
Other income received	2018-12-31	$4,973
Net income (gross income less expenses)	2018-12-31	$4,973
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$229,423
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$224,450
2017 : DR. CHARLES T. HOSTNIK 2017 401k financial data
Total income from all sources	2017-12-31	$0
Expenses. Total of all expenses incurred	2017-12-31	$0
Total plan assets at end of year	2017-12-31	$224,450
Total plan assets at beginning of year	2017-12-31	$224,450
Value of fidelity bond covering the plan	2017-12-31	$500,000
Net income (gross income less expenses)	2017-12-31	$0
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$224,450
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$224,450
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : DR. CHARLES T. HOSTNIK 2016 401k financial data
Transfers to/from the plan	2016-12-31	$518,687
Total income from all sources	2016-12-31	$-533,639
Expenses. Total of all expenses incurred	2016-12-31	$494,287
Benefits paid (including direct rollovers)	2016-12-31	$494,287
Total plan assets at end of year	2016-12-31	$224,450
Total plan assets at beginning of year	2016-12-31	$733,689
Value of fidelity bond covering the plan	2016-12-31	$500,000
Total contributions received or receivable from participants	2016-12-31	$14,471
Other income received	2016-12-31	$-549,450
Net income (gross income less expenses)	2016-12-31	$-1,027,926
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$224,450
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$733,689
Total contributions received or receivable from employer(s)	2016-12-31	$1,340
2015 : DR. CHARLES T. HOSTNIK 2015 401k financial data
Total income from all sources	2015-12-31	$-52,677
Expenses. Total of all expenses incurred	2015-12-31	$0
Total plan assets at end of year	2015-12-31	$733,689
Total plan assets at beginning of year	2015-12-31	$786,366
Value of fidelity bond covering the plan	2015-12-31	$500,000
Total contributions received or receivable from participants	2015-12-31	$22,309
Other income received	2015-12-31	$-77,458
Net income (gross income less expenses)	2015-12-31	$-52,677
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$733,689
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$786,366
Total contributions received or receivable from employer(s)	2015-12-31	$2,472
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
2014 : DR. CHARLES T. HOSTNIK 2014 401k financial data
Total income from all sources	2014-12-31	$139,154
Expenses. Total of all expenses incurred	2014-12-31	$0
Total plan assets at end of year	2014-12-31	$786,366
Total plan assets at beginning of year	2014-12-31	$647,212
Value of fidelity bond covering the plan	2014-12-31	$500,000
Total contributions received or receivable from participants	2014-12-31	$10,160
Other income received	2014-12-31	$125,764
Net income (gross income less expenses)	2014-12-31	$139,154
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$786,366
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$647,212
Total contributions received or receivable from employer(s)	2014-12-31	$3,230
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : DR. CHARLES T. HOSTNIK 2013 401k financial data
Total income from all sources	2013-12-31	$95,247
Expenses. Total of all expenses incurred	2013-12-31	$0
Total plan assets at end of year	2013-12-31	$647,212
Total plan assets at beginning of year	2013-12-31	$551,965
Value of fidelity bond covering the plan	2013-12-31	$500,000
Total contributions received or receivable from participants	2013-12-31	$19,616
Other income received	2013-12-31	$58,206
Net income (gross income less expenses)	2013-12-31	$95,247
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$647,212
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$551,965
Total contributions received or receivable from employer(s)	2013-12-31	$17,425
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : DR. CHARLES T. HOSTNIK 2012 401k financial data
Total income from all sources	2012-12-31	$79,278
Expenses. Total of all expenses incurred	2012-12-31	$0
Total plan assets at end of year	2012-12-31	$551,965
Total plan assets at beginning of year	2012-12-31	$472,687
Value of fidelity bond covering the plan	2012-12-31	$500,000
Total contributions received or receivable from participants	2012-12-31	$20,680
Other income received	2012-12-31	$45,628
Net income (gross income less expenses)	2012-12-31	$79,278
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$551,965
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$472,687
Total contributions received or receivable from employer(s)	2012-12-31	$12,970
2011 : DR. CHARLES T. HOSTNIK 2011 401k financial data
Total income from all sources	2011-12-31	$-90,497
Expenses. Total of all expenses incurred	2011-12-31	$0
Total plan assets at end of year	2011-12-31	$472,687
Total plan assets at beginning of year	2011-12-31	$563,184
Value of fidelity bond covering the plan	2011-12-31	$500,000
Total contributions received or receivable from participants	2011-12-31	$19,500
Other income received	2011-12-31	$-117,766
Net income (gross income less expenses)	2011-12-31	$-90,497
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$472,687
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$563,184
Total contributions received or receivable from employer(s)	2011-12-31	$7,769
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : DR. CHARLES T. HOSTNIK 2010 401k financial data
Total income from all sources	2010-12-31	$-2,599
Expenses. Total of all expenses incurred	2010-12-31	$0
Total plan assets at end of year	2010-12-31	$563,184
Total plan assets at beginning of year	2010-12-31	$565,783
Value of fidelity bond covering the plan	2010-12-31	$500,000
Total contributions received or receivable from participants	2010-12-31	$18,600
Other income received	2010-12-31	$-29,604
Net income (gross income less expenses)	2010-12-31	$-2,599
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$563,184
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$565,783
Total contributions received or receivable from employer(s)	2010-12-31	$8,405
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : DR. CHARLES T. HOSTNIK 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for DR. CHARLES T. HOSTNIK

2019: DR. CHARLES T. HOSTNIK 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
2018: DR. CHARLES T. HOSTNIK 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: DR. CHARLES T. HOSTNIK 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: DR. CHARLES T. HOSTNIK 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: DR. CHARLES T. HOSTNIK 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: DR. CHARLES T. HOSTNIK 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: DR. CHARLES T. HOSTNIK 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: DR. CHARLES T. HOSTNIK 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: DR. CHARLES T. HOSTNIK 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: DR. CHARLES T. HOSTNIK 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: DR. CHARLES T. HOSTNIK 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

ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )

Policy contract number

92508

Policy instance

Insurance contract or identification number	92508
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )

Policy contract number

92508

Policy instance

Insurance contract or identification number	92508
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )

Policy contract number

92508

Policy instance

Insurance contract or identification number	92508
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )

Policy contract number

92508

Policy instance

Insurance contract or identification number	92508
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )

Policy contract number

92508

Policy instance

Insurance contract or identification number	92508
Number of Individuals Covered	1
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )

Policy contract number

92508

Policy instance

Insurance contract or identification number	92508
Number of Individuals Covered	1
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )

Policy contract number

92508

Policy instance

Insurance contract or identification number	92508
Number of Individuals Covered	1
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )

Policy contract number

92508

Policy instance

Insurance contract or identification number	92508
Number of Individuals Covered	1
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )

Policy contract number

92508

Policy instance

Insurance contract or identification number	92508
Number of Individuals Covered	1
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

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Company Name:	DR. CHARLES T. HOSTNIK
Employer identification number (EIN):	043703424
NAIC Classification:	621210
NAIC Description:	Offices of Dentists