401k Plan data: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF plan

CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 401k Plan overview

Plan Name	CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF
Plan identification number	001

CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 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
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
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.
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

CHESHEIM DENTAL ASSOCIATES has sponsored the creation of one or more 401k plans.

Company Name: CHESHEIM DENTAL ASSOCIATES

Employer identification number (EIN): 201254551

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Additional information about CHESHEIM DENTAL ASSOCIATES

Jurisdiction of Incorporation: COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF STATE

Incorporation Date:

Company Identification Number: 64156

More information about CHESHEIM DENTAL ASSOCIATES

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01 ANGELA STOUT ANGELA STOUT 2019-05-07
001 2017-01-01 ANGELA STOUT
001 2016-01-01 ANGELA STOUT
001 2015-01-01 VICTORIA CASTAGNO
001 2014-01-01 ANGELA M STOUT
001 2013-01-01 RICHARD A. ROTHWELL, D.D.S.
001 2012-01-01 RICHARD A. ROTHWELL, D.D.S.
001 2011-01-01 RICHARD A. ROTHWELL, D.D.S.
001 2010-01-01 RICHARD A. ROTHWELL, D.D.S.
001 2009-01-01 RICHARD A. ROTHWELL
001 2009-01-01 RICHARD A. ROTHWELL, D.D.S.
001 2009-01-01 RICHARD A. ROTHWELL

Plan Statistics for CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF

401k plan membership statisitcs for CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF

Measure Date Value
2021: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2021 401k membership
Total participants, beginning-of-year 2021-01-01 26
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 22
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 0
Total of all active and inactive participants 2021-01-01 22
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 22
Number of participants with account balances 2021-01-01 22
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2020 401k membership
Total participants, beginning-of-year 2020-01-01 26
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 26
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 0
Total of all active and inactive participants 2020-01-01 26
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 26
Number of participants with account balances 2020-01-01 22
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 1
2019: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2019 401k membership
Total participants, beginning-of-year 2019-01-01 24
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 24
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 0
Total of all active and inactive participants 2019-01-01 24
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 24
Number of participants with account balances 2019-01-01 20
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2018 401k membership
Total participants, beginning-of-year 2018-01-01 24
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 24
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 0
Total of all active and inactive participants 2018-01-01 24
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 24
Number of participants with account balances 2018-01-01 20
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2017 401k membership
Total participants, beginning-of-year 2017-01-01 23
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 24
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 24
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 24
Number of participants with account balances 2017-01-01 18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2016 401k membership
Total participants, beginning-of-year 2016-01-01 23
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 21
Number of other retired or separated participants entitled to future benefits 2016-01-01 2
Total of all active and inactive participants 2016-01-01 23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 23
Number of participants with account balances 2016-01-01 23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2015 401k membership
Total participants, beginning-of-year 2015-01-01 23
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 18
Number of other retired or separated participants entitled to future benefits 2015-01-01 4
Total of all active and inactive participants 2015-01-01 22
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 22
Number of participants with account balances 2015-01-01 21
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 2
2014: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2014 401k membership
Total participants, beginning-of-year 2014-01-01 22
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 18
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 4
Total of all active and inactive participants 2014-01-01 22
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 22
Number of participants with account balances 2014-01-01 19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2013 401k membership
Total participants, beginning-of-year 2013-01-01 23
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 18
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 3
Total of all active and inactive participants 2013-01-01 21
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 21
Number of participants with account balances 2013-01-01 21
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 1
2012: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2012 401k membership
Total participants, beginning-of-year 2012-01-01 22
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 21
Number of retired or separated participants receiving benefits 2012-01-01 1
Number of other retired or separated participants entitled to future benefits 2012-01-01 1
Total of all active and inactive participants 2012-01-01 23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 23
Number of participants with account balances 2012-01-01 23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 1
2011: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2011 401k membership
Total participants, beginning-of-year 2011-01-01 23
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 21
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 21
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 21
Number of participants with account balances 2011-01-01 21
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2010 401k membership
Total participants, beginning-of-year 2010-01-01 21
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 22
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 22
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 22
Number of participants with account balances 2010-01-01 22
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2009 401k membership
Total participants, beginning-of-year 2009-01-01 20
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 21
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 0
Total of all active and inactive participants 2009-01-01 21
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 21
Number of participants with account balances 2009-01-01 21
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2021: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2021 401k membership
Total participants, beginning-of-year	2021-01-01	26
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	22
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	0
Total of all active and inactive participants	2021-01-01	22
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	22
Number of participants with account balances	2021-01-01	22
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2020 401k membership
Total participants, beginning-of-year	2020-01-01	26
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	26
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	0
Total of all active and inactive participants	2020-01-01	26
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	26
Number of participants with account balances	2020-01-01	22
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	1
2019: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2019 401k membership
Total participants, beginning-of-year	2019-01-01	24
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	24
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	0
Total of all active and inactive participants	2019-01-01	24
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	24
Number of participants with account balances	2019-01-01	20
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2018 401k membership
Total participants, beginning-of-year	2018-01-01	24
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	24
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	0
Total of all active and inactive participants	2018-01-01	24
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	24
Number of participants with account balances	2018-01-01	20
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2017 401k membership
Total participants, beginning-of-year	2017-01-01	23
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	24
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	24
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	24
Number of participants with account balances	2017-01-01	18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2016 401k membership
Total participants, beginning-of-year	2016-01-01	23
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	21
Number of other retired or separated participants entitled to future benefits	2016-01-01	2
Total of all active and inactive participants	2016-01-01	23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	23
Number of participants with account balances	2016-01-01	23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2015 401k membership
Total participants, beginning-of-year	2015-01-01	23
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	18
Number of other retired or separated participants entitled to future benefits	2015-01-01	4
Total of all active and inactive participants	2015-01-01	22
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	22
Number of participants with account balances	2015-01-01	21
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	2
2014: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2014 401k membership
Total participants, beginning-of-year	2014-01-01	22
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	18
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	4
Total of all active and inactive participants	2014-01-01	22
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	22
Number of participants with account balances	2014-01-01	19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2013 401k membership
Total participants, beginning-of-year	2013-01-01	23
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	18
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	3
Total of all active and inactive participants	2013-01-01	21
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	21
Number of participants with account balances	2013-01-01	21
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	1
2012: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2012 401k membership
Total participants, beginning-of-year	2012-01-01	22
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	21
Number of retired or separated participants receiving benefits	2012-01-01	1
Number of other retired or separated participants entitled to future benefits	2012-01-01	1
Total of all active and inactive participants	2012-01-01	23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	23
Number of participants with account balances	2012-01-01	23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	1
2011: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2011 401k membership
Total participants, beginning-of-year	2011-01-01	23
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	21
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	21
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	21
Number of participants with account balances	2011-01-01	21
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2010 401k membership
Total participants, beginning-of-year	2010-01-01	21
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	22
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	22
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	22
Number of participants with account balances	2010-01-01	22
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2009 401k membership
Total participants, beginning-of-year	2009-01-01	20
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	21
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	0
Total of all active and inactive participants	2009-01-01	21
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	21
Number of participants with account balances	2009-01-01	21
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF

Measure	Date	Value
2021 : CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2021 401k financial data
Total income from all sources	2021-12-31	$833,386
Expenses. Total of all expenses incurred	2021-12-31	$127,593
Benefits paid (including direct rollovers)	2021-12-31	$119,451
Total plan assets at end of year	2021-12-31	$3,657,103
Total plan assets at beginning of year	2021-12-31	$2,951,310
Value of fidelity bond covering the plan	2021-12-31	$350,000
Total contributions received or receivable from participants	2021-12-31	$148,026
Contributions received from other sources (not participants or employers)	2021-12-31	$210,494
Other income received	2021-12-31	$389,592
Net income (gross income less expenses)	2021-12-31	$705,793
Net plan assets at end of year (total assets less liabilities)	2021-12-31	$3,657,103
Net plan assets at beginning of year (total assets less liabilities)	2021-12-31	$2,951,310
Total contributions received or receivable from employer(s)	2021-12-31	$85,274
Value of corrective distributions	2021-12-31	$7,456
Expenses. Administrative service providers (salaries,fees and commissions)	2021-12-31	$686
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
2020 : CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2020 401k financial data
Total income from all sources	2020-12-31	$561,191
Expenses. Total of all expenses incurred	2020-12-31	$112,131
Benefits paid (including direct rollovers)	2020-12-31	$110,601
Total plan assets at end of year	2020-12-31	$2,951,310
Total plan assets at beginning of year	2020-12-31	$2,502,250
Value of fidelity bond covering the plan	2020-12-31	$350,000
Total contributions received or receivable from participants	2020-12-31	$106,141
Other income received	2020-12-31	$372,497
Net income (gross income less expenses)	2020-12-31	$449,060
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$2,951,310
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$2,502,250
Total contributions received or receivable from employer(s)	2020-12-31	$82,553
Expenses. Administrative service providers (salaries,fees and commissions)	2020-12-31	$1,530
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
2019 : CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2019 401k financial data
Total income from all sources	2019-12-31	$945,230
Expenses. Total of all expenses incurred	2019-12-31	$2,323,217
Benefits paid (including direct rollovers)	2019-12-31	$2,322,360
Total plan assets at end of year	2019-12-31	$2,502,250
Total plan assets at beginning of year	2019-12-31	$3,880,237
Value of fidelity bond covering the plan	2019-12-31	$350,000
Total contributions received or receivable from participants	2019-12-31	$145,230
Other income received	2019-12-31	$680,371
Net income (gross income less expenses)	2019-12-31	$-1,377,987
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$2,502,250
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$3,880,237
Total contributions received or receivable from employer(s)	2019-12-31	$119,629
Expenses. Administrative service providers (salaries,fees and commissions)	2019-12-31	$857
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
2018 : CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2018 401k financial data
Total income from all sources	2018-12-31	$21,004
Expenses. Total of all expenses incurred	2018-12-31	$9,068
Benefits paid (including direct rollovers)	2018-12-31	$8,953
Total plan assets at end of year	2018-12-31	$3,880,237
Total plan assets at beginning of year	2018-12-31	$3,868,301
Value of fidelity bond covering the plan	2018-12-31	$350,000
Total contributions received or receivable from participants	2018-12-31	$155,481
Other income received	2018-12-31	$-248,444
Net income (gross income less expenses)	2018-12-31	$11,936
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$3,880,237
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$3,868,301
Total contributions received or receivable from employer(s)	2018-12-31	$113,967
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$115
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
2017 : CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2017 401k financial data
Total plan liabilities at beginning of year	2017-12-31	$0
Total income from all sources	2017-12-31	$720,684
Expenses. Total of all expenses incurred	2017-12-31	$338,465
Benefits paid (including direct rollovers)	2017-12-31	$337,835
Total plan assets at end of year	2017-12-31	$3,868,301
Total plan assets at beginning of year	2017-12-31	$3,486,082
Value of fidelity bond covering the plan	2017-12-31	$350,000
Total contributions received or receivable from participants	2017-12-31	$144,326
Contributions received from other sources (not participants or employers)	2017-12-31	$0
Other income received	2017-12-31	$479,426
Net income (gross income less expenses)	2017-12-31	$382,219
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$3,868,301
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$3,486,082
Assets. Value of assets in partnership/joint-venture interests	2017-12-31	$1,637
Total contributions received or receivable from employer(s)	2017-12-31	$96,932
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$630
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2016 401k financial data
Total plan liabilities at end of year	2016-12-31	$0
Total plan liabilities at beginning of year	2016-12-31	$0
Total income from all sources	2016-12-31	$416,903
Expenses. Total of all expenses incurred	2016-12-31	$195
Total plan assets at end of year	2016-12-31	$3,486,082
Total plan assets at beginning of year	2016-12-31	$3,069,374
Value of fidelity bond covering the plan	2016-12-31	$350,000
Total contributions received or receivable from participants	2016-12-31	$147,301
Contributions received from other sources (not participants or employers)	2016-12-31	$10,506
Other income received	2016-12-31	$225,204
Net income (gross income less expenses)	2016-12-31	$416,708
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$3,486,082
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$3,069,374
Assets. Value of assets in partnership/joint-venture interests	2016-12-31	$45,343
Total contributions received or receivable from employer(s)	2016-12-31	$33,892
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$195
2015 : CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2015 401k financial data
Total plan liabilities at end of year	2015-12-31	$0
Total plan liabilities at beginning of year	2015-12-31	$0
Total income from all sources	2015-12-31	$54,909
Expenses. Total of all expenses incurred	2015-12-31	$975
Total plan assets at end of year	2015-12-31	$3,069,374
Total plan assets at beginning of year	2015-12-31	$3,015,440
Value of fidelity bond covering the plan	2015-12-31	$350,000
Total contributions received or receivable from participants	2015-12-31	$115,503
Other income received	2015-12-31	$-156,844
Net income (gross income less expenses)	2015-12-31	$53,934
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$3,069,374
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$3,015,440
Assets. Value of assets in partnership/joint-venture interests	2015-12-31	$45,738
Total contributions received or receivable from employer(s)	2015-12-31	$96,250
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$975
2014 : CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2014 401k financial data
Transfers to/from the plan	2014-12-31	$0
Total plan liabilities at end of year	2014-12-31	$0
Total plan liabilities at beginning of year	2014-12-31	$0
Total income from all sources	2014-12-31	$243,791
Expenses. Total of all expenses incurred	2014-12-31	$30,681
Benefits paid (including direct rollovers)	2014-12-31	$30,681
Total plan assets at end of year	2014-12-31	$3,015,440
Total plan assets at beginning of year	2014-12-31	$2,802,330
Value of fidelity bond covering the plan	2014-12-31	$350,000
Total contributions received or receivable from participants	2014-12-31	$110,866
Expenses. Other expenses not covered elsewhere	2014-12-31	$0
Contributions received from other sources (not participants or employers)	2014-12-31	$0
Other income received	2014-12-31	$36,675
Noncash contributions received	2014-12-31	$0
Net income (gross income less expenses)	2014-12-31	$213,110
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$3,015,440
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$2,802,330
Assets. Value of assets in partnership/joint-venture interests	2014-12-31	$212,866
Total contributions received or receivable from employer(s)	2014-12-31	$96,250
Value of certain deemed distributions of participant loans	2014-12-31	$0
Value of corrective distributions	2014-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2013 401k financial data
Total plan liabilities at end of year	2013-12-31	$0
Total plan liabilities at beginning of year	2013-12-31	$0
Total income from all sources	2013-12-31	$486,419
Expenses. Total of all expenses incurred	2013-12-31	$26,937
Benefits paid (including direct rollovers)	2013-12-31	$3,667
Total plan assets at end of year	2013-12-31	$2,802,330
Total plan assets at beginning of year	2013-12-31	$2,342,848
Value of fidelity bond covering the plan	2013-12-31	$250,000
Total contributions received or receivable from participants	2013-12-31	$102,856
Expenses. Other expenses not covered elsewhere	2013-12-31	$0
Contributions received from other sources (not participants or employers)	2013-12-31	$0
Other income received	2013-12-31	$272,478
Noncash contributions received	2013-12-31	$0
Net income (gross income less expenses)	2013-12-31	$459,482
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$2,802,330
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$2,342,848
Assets. Value of assets in partnership/joint-venture interests	2013-12-31	$197,119
Total contributions received or receivable from employer(s)	2013-12-31	$111,085
Value of certain deemed distributions of participant loans	2013-12-31	$0
Value of corrective distributions	2013-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$23,270
2012 : CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2012 401k financial data
Transfers to/from the plan	2012-12-31	$0
Total plan liabilities at end of year	2012-12-31	$0
Total plan liabilities at beginning of year	2012-12-31	$0
Total income from all sources	2012-12-31	$418,615
Expenses. Total of all expenses incurred	2012-12-31	$25,683
Benefits paid (including direct rollovers)	2012-12-31	$6,949
Total plan assets at end of year	2012-12-31	$2,342,848
Total plan assets at beginning of year	2012-12-31	$1,949,916
Value of fidelity bond covering the plan	2012-12-31	$250,000
Total contributions received or receivable from participants	2012-12-31	$102,880
Expenses. Other expenses not covered elsewhere	2012-12-31	$0
Contributions received from other sources (not participants or employers)	2012-12-31	$0
Other income received	2012-12-31	$205,735
Noncash contributions received	2012-12-31	$0
Net income (gross income less expenses)	2012-12-31	$392,932
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$2,342,848
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$1,949,916
Assets. Value of assets in partnership/joint-venture interests	2012-12-31	$202,651
Total contributions received or receivable from employer(s)	2012-12-31	$110,000
Value of certain deemed distributions of participant loans	2012-12-31	$0
Value of corrective distributions	2012-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$18,734
2011 : CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2011 401k financial data
Transfers to/from the plan	2011-12-31	$0
Total plan liabilities at end of year	2011-12-31	$0
Total plan liabilities at beginning of year	2011-12-31	$0
Total income from all sources	2011-12-31	$220,317
Expenses. Total of all expenses incurred	2011-12-31	$80,908
Benefits paid (including direct rollovers)	2011-12-31	$64,759
Total plan assets at end of year	2011-12-31	$1,949,916
Total plan assets at beginning of year	2011-12-31	$1,810,507
Value of fidelity bond covering the plan	2011-12-31	$250,000
Total contributions received or receivable from participants	2011-12-31	$103,954
Expenses. Other expenses not covered elsewhere	2011-12-31	$0
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$10,927
Noncash contributions received	2011-12-31	$0
Net income (gross income less expenses)	2011-12-31	$139,409
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$1,949,916
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$1,810,507
Assets. Value of assets in partnership/joint-venture interests	2011-12-31	$199,986
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2011-12-31	$12,572
Total contributions received or receivable from employer(s)	2011-12-31	$105,436
Value of certain deemed distributions of participant loans	2011-12-31	$0
Value of corrective distributions	2011-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$16,149
2010 : CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2010 401k financial data
Transfers to/from the plan	2010-12-31	$0
Total plan liabilities at end of year	2010-12-31	$0
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$447,175
Expenses. Total of all expenses incurred	2010-12-31	$834,901
Benefits paid (including direct rollovers)	2010-12-31	$816,552
Total plan assets at end of year	2010-12-31	$1,810,507
Total plan assets at beginning of year	2010-12-31	$2,198,233
Value of fidelity bond covering the plan	2010-12-31	$250,000
Total contributions received or receivable from participants	2010-12-31	$136,339
Expenses. Other expenses not covered elsewhere	2010-12-31	$0
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$173,308
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$-387,726
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$1,810,507
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$2,198,233
Assets. Value of assets in partnership/joint-venture interests	2010-12-31	$196,783
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2010-12-31	$93,563
Total contributions received or receivable from employer(s)	2010-12-31	$137,528
Value of certain deemed distributions of participant loans	2010-12-31	$0
Value of corrective distributions	2010-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$18,349

Form 5500 Responses for CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF

2021: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 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 – Trust	Yes
2021-01-01	Plan benefit arrangement – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 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 – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 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 – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 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 – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 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 – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 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 – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 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 – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 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 – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 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 – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 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 – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 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 – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 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 – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: CHESHEIM DENTAL ASSOCIATES 401(K) SAFE HARBOR PROF 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
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 – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 61571 - 1

Policy instance

Insurance contract or identification number	MR 61571 - 1
Number of Individuals Covered	22
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Are there contracts with 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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Insurance broker organization code?	4

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 61571 - 1

Policy instance

Insurance contract or identification number	MR 61571 - 1
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $12
Total amount of fees paid to insurance company	USD $0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Commission paid to Insurance Broker	USD $12
Insurance broker organization code?	4

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 61571 - 1

Policy instance

Insurance contract or identification number	MR 61571 - 1
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $118
Total amount of fees paid to insurance company	USD $0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Commission paid to Insurance Broker	USD $118
Insurance broker organization code?	4

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 61571 - 1

Policy instance

Insurance contract or identification number	MR 61571 - 1
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $218
Total amount of fees paid to insurance company	USD $0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Commission paid to Insurance Broker	USD $218
Insurance broker organization code?	4

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 61571 - 1

Policy instance

Insurance contract or identification number	MR 61571 - 1
Number of Individuals Covered	18
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $206
Total amount of fees paid to insurance company	USD $0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Commission paid to Insurance Broker	USD $130
Insurance broker organization code?	4
Insurance broker name	RAYMOND JAMES INSURANCE GROUP INC

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 61571 - 1

Policy instance

Insurance contract or identification number	MR 61571 - 1
Number of Individuals Covered	21
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $-27,692
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Commission paid to Insurance Broker	USD $-27,692
Insurance broker organization code?	4
Insurance broker name	MORGAN STANLEY INS SERVICES INC

MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )

Policy contract number

MR 61571 - 1

Policy instance

Insurance contract or identification number	MR 61571 - 1
Number of Individuals Covered	19
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $28,026
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	No
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Commission paid to Insurance Broker	USD $28,026
Insurance broker organization code?	4
Insurance broker name	MORGAN STANLEY INS SERVICES INC

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Company Name:	CHESHEIM DENTAL ASSOCIATES
Employer identification number (EIN):	201254551
NAIC Classification:	621210
NAIC Description:	Offices of Dentists

Jurisdiction of Incorporation:	COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF STATE
Incorporation Date:
Company Identification Number:	64156