401k Plan data: SMILE CENTER 401(K) PLAN plan

SMILE CENTER 401(K) PLAN 401k Plan overview

Plan Name	SMILE CENTER 401(K) PLAN
Plan identification number	001

SMILE CENTER 401(K) PLAN 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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

DEERWOOD DENTAL, INC. has sponsored the creation of one or more 401k plans.

Company Name: DEERWOOD DENTAL, INC.

Employer identification number (EIN): 200500639

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SMILE CENTER 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2013-01-01 JOAN HOUGE 2013-11-12 JOAN HOUGE 2013-11-12
001 2012-01-01 JOAN HOUGE JOAN HOUGE 2013-10-07
001 2011-01-01 JOAN HOUGE JOAN HOUGE 2012-10-12
001 2009-01-01 JOAN HOUGE JOAN HOUGE 2010-10-11

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2013-01-01	JOAN HOUGE	2013-11-12	JOAN HOUGE	2013-11-12
001	2012-01-01	JOAN HOUGE		JOAN HOUGE	2013-10-07
001	2011-01-01	JOAN HOUGE		JOAN HOUGE	2012-10-12
001	2009-01-01	JOAN HOUGE		JOAN HOUGE	2010-10-11

Plan Statistics for SMILE CENTER 401(K) PLAN

401k plan membership statisitcs for SMILE CENTER 401(K) PLAN

Measure Date Value
2012: SMILE CENTER 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 150
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 129
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 12
Total of all active and inactive participants 2012-01-01 141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 141
Number of participants with account balances 2012-01-01 73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 3
2011: SMILE CENTER 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 243
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 107
Number of other retired or separated participants entitled to future benefits 2011-01-01 36
Total of all active and inactive participants 2011-01-01 143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 143
Number of participants with account balances 2011-01-01 107
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 14
2009: SMILE CENTER 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 200
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 200
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 10
Total of all active and inactive participants 2009-01-01 210
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 210
Number of participants with account balances 2009-01-01 126
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 3

Measure	Date	Value
2012: SMILE CENTER 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	150
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	129
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	12
Total of all active and inactive participants	2012-01-01	141
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	141
Number of participants with account balances	2012-01-01	73
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	3
2011: SMILE CENTER 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	243
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	107
Number of other retired or separated participants entitled to future benefits	2011-01-01	36
Total of all active and inactive participants	2011-01-01	143
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	143
Number of participants with account balances	2011-01-01	107
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	14
2009: SMILE CENTER 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	200
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	200
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	10
Total of all active and inactive participants	2009-01-01	210
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	210
Number of participants with account balances	2009-01-01	126
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	3

Financial Data on SMILE CENTER 401(K) PLAN

Measure	Date	Value
2012 : SMILE CENTER 401(K) PLAN 2012 401k financial data
Total transfer of assets from this plan	2012-12-31	$36,141
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$4,983
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-12-31	$4,983
Total income from all sources (including contributions)	2012-12-31	$420,164
Total of all expenses incurred	2012-12-31	$368,236
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-12-31	$364,662
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-12-31	$299,016
Value of total assets at end of year	2012-12-31	$1,157,774
Value of total assets at beginning of year	2012-12-31	$1,141,987
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-12-31	$3,574
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-12-31	No
Administrative expenses professional fees incurred	2012-12-31	$3,574
Was this plan covered by a fidelity bond	2012-12-31	Yes
Value of fidelity bond cover	2012-12-31	$150,000
If this is an individual account plan, was there a blackout period	2012-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2012-12-31	No
Contributions received from participants	2012-12-31	$229,913
Participant contributions at end of year	2012-12-31	$0
Participant contributions at beginning of year	2012-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2012-12-31	$4,308
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-12-31	$4,983
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-12-31	$4,983
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-12-31	No
Value of net income/loss	2012-12-31	$51,928
Value of net assets at end of year (total assets less liabilities)	2012-12-31	$1,152,791
Value of net assets at beginning of year (total assets less liabilities)	2012-12-31	$1,137,004
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-12-31	No
Were any leases to which the plan was party in default or uncollectible	2012-12-31	No
Value of interest in pooled separate accounts at end of year	2012-12-31	$1,094,292
Value of interest in pooled separate accounts at beginning of year	2012-12-31	$1,086,138
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-12-31	$63,482
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-12-31	$55,849
Net investment gain/loss from pooled separate accounts	2012-12-31	$121,148
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-12-31	No
Was there a failure to transmit to the plan any participant contributions	2012-12-31	No
Has the plan failed to provide any benefit when due under the plan	2012-12-31	No
Contributions received in cash from employer	2012-12-31	$64,795
Employer contributions (assets) at end of year	2012-12-31	$0
Employer contributions (assets) at beginning of year	2012-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-12-31	$364,662
Did the plan have assets held for investment	2012-12-31	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	2012-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2012-12-31	Disclaimer
Accountancy firm name	2012-12-31	WIPFLI LLP
Accountancy firm EIN	2012-12-31	390758449
2011 : SMILE CENTER 401(K) PLAN 2011 401k financial data
Total transfer of assets from this plan	2011-12-31	$434,285
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$4,983
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$2,030
Total income from all sources (including contributions)	2011-12-31	$293,369
Total of all expenses incurred	2011-12-31	$157,539
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$112,989
Value of total corrective distributions	2011-12-31	$43,625
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$369,164
Value of total assets at end of year	2011-12-31	$1,141,987
Value of total assets at beginning of year	2011-12-31	$1,437,489
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$925
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Administrative expenses professional fees incurred	2011-12-31	$925
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$150,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$263,822
Participant contributions at end of year	2011-12-31	$0
Participant contributions at beginning of year	2011-12-31	$3,282
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-12-31	$4,983
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$2,030
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Value of net income/loss	2011-12-31	$135,830
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$1,137,004
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$1,435,459
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in pooled separate accounts at end of year	2011-12-31	$1,086,138
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$1,403,819
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$55,849
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$29,547
Net investment gain/loss from pooled separate accounts	2011-12-31	$-75,795
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	No
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$105,342
Employer contributions (assets) at end of year	2011-12-31	$0
Employer contributions (assets) at beginning of year	2011-12-31	$841
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$112,989
Did the plan have assets held for investment	2011-12-31	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	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	WIPFLI LLP
Accountancy firm EIN	2011-12-31	390758449
2010 : SMILE CENTER 401(K) PLAN 2010 401k financial data
Total unrealized appreciation/depreciation of assets	2010-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$2,030
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2010-12-31	$0
Total income from all sources (including contributions)	2010-12-31	$549,501
Total loss/gain on sale of assets	2010-12-31	$0
Total of all expenses incurred	2010-12-31	$192,589
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2010-12-31	$153,221
Value of total corrective distributions	2010-12-31	$32,693
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2010-12-31	$394,801
Value of total assets at end of year	2010-12-31	$1,437,489
Value of total assets at beginning of year	2010-12-31	$1,078,547
Total of administrative expenses incurred including professional, contract, advisory and management fees	2010-12-31	$6,675
Total interest from all sources	2010-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2010-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2010-12-31	No
Administrative expenses professional fees incurred	2010-12-31	$6,675
Was this plan covered by a fidelity bond	2010-12-31	Yes
Value of fidelity bond cover	2010-12-31	$150,000
If this is an individual account plan, was there a blackout period	2010-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2010-12-31	No
Contributions received from participants	2010-12-31	$290,466
Participant contributions at end of year	2010-12-31	$3,282
Participant contributions at beginning of year	2010-12-31	$20,674
Income. Received or receivable in cash from other sources (including rollovers)	2010-12-31	$1,934
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2010-12-31	$2,030
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2010-12-31	No
Value of net income/loss	2010-12-31	$356,912
Value of net assets at end of year (total assets less liabilities)	2010-12-31	$1,435,459
Value of net assets at beginning of year (total assets less liabilities)	2010-12-31	$1,078,547
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2010-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2010-12-31	No
Were any leases to which the plan was party in default or uncollectible	2010-12-31	No
Value of interest in pooled separate accounts at end of year	2010-12-31	$1,403,819
Value of interest in pooled separate accounts at beginning of year	2010-12-31	$1,036,245
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2010-12-31	$29,547
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2010-12-31	$18,947
Net investment gain/loss from pooled separate accounts	2010-12-31	$154,700
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2010-12-31	No
Was there a failure to transmit to the plan any participant contributions	2010-12-31	No
Has the plan failed to provide any benefit when due under the plan	2010-12-31	No
Contributions received in cash from employer	2010-12-31	$102,401
Employer contributions (assets) at end of year	2010-12-31	$841
Employer contributions (assets) at beginning of year	2010-12-31	$2,681
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2010-12-31	$153,221
Did the plan have assets held for investment	2010-12-31	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	2010-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2010-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2010-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2010-12-31	Disclaimer
Accountancy firm name	2010-12-31	WIPFLI LLP
Accountancy firm EIN	2010-12-31	390758449

Form 5500 Responses for SMILE CENTER 401(K) PLAN

2012: SMILE CENTER 401(K) PLAN 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: SMILE CENTER 401(K) PLAN 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
2009: SMILE CENTER 401(K) PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Mulitple 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

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-821335

Policy instance

Insurance contract or identification number	GA-821335
Number of Individuals Covered	71
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
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-821335

Policy instance

Insurance contract or identification number	GA-821335
Number of Individuals Covered	99
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
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-821335

Policy instance

Insurance contract or identification number	GA-821335
Number of Individuals Covered	147
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $5,127
Total amount of fees paid to insurance company	USD $570
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Commission paid to Insurance Broker	USD $5,127
Additional information about fees paid to insurance broker	INSURANCE SERVICE COMMINSSION
Insurance broker organization code?	3
Amount paid for insurance broker fees	570
Insurance broker name	TSC

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Company Name:	DEERWOOD DENTAL, INC.
Employer identification number (EIN):	200500639
NAIC Classification:	621210
NAIC Description:	Offices of Dentists