401k Plan data: WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN plan

WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN
Plan identification number	001

WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN 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

WING ORTHODONTICS, PC has sponsored the creation of one or more 401k plans.

Company Name: WING ORTHODONTICS, PC

Employer identification number (EIN): 203372199

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01 JEFFREY WING, DDS 2021-09-27
001 2019-01-01 JEFFREY WING, DDS 2020-04-04
001 2018-01-01
001 2017-01-01
001 2016-01-01
001 2015-01-01

Plan Statistics for WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN

Measure Date Value
2020: WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 6
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 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 6
Number of participants with account balances 2020-01-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 4
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 1
Total of all active and inactive participants 2019-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 5
Number of participants with account balances 2019-01-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 7
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 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 7
Number of participants with account balances 2018-01-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 3
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 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 3
Number of participants with account balances 2017-01-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 4
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 4
Number of participants with account balances 2016-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN 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
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 0
Total of all active and inactive participants 2015-01-01 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 4
Total participants 2015-01-01 8
Number of participants with account balances 2015-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0

Measure	Date	Value
2020: WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	6
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	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	6
Number of participants with account balances	2020-01-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	4
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	1
Total of all active and inactive participants	2019-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	5
Number of participants with account balances	2019-01-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	7
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	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	7
Number of participants with account balances	2018-01-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	3
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	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	3
Number of participants with account balances	2017-01-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	4
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	4
Number of participants with account balances	2016-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN 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
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	0
Total of all active and inactive participants	2015-01-01	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	4
Total participants	2015-01-01	8
Number of participants with account balances	2015-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0

Financial Data on WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2020 : WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN 2020 401k financial data
Total plan liabilities at beginning of year	2020-12-31	$0
Total income from all sources	2020-12-31	$86,515
Expenses. Total of all expenses incurred	2020-12-31	$60
Total plan assets at end of year	2020-12-31	$311,291
Total plan assets at beginning of year	2020-12-31	$224,836
Value of fidelity bond covering the plan	2020-12-31	$50,000
Total contributions received or receivable from participants	2020-12-31	$35,200
Other income received	2020-12-31	$45,270
Net income (gross income less expenses)	2020-12-31	$86,455
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$311,291
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$224,836
Total contributions received or receivable from employer(s)	2020-12-31	$6,045
Expenses. Administrative service providers (salaries,fees and commissions)	2020-12-31	$60
2019 : WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN 2019 401k financial data
Total plan liabilities at end of year	2019-12-31	$0
Total plan liabilities at beginning of year	2019-12-31	$0
Total income from all sources	2019-12-31	$78,665
Expenses. Total of all expenses incurred	2019-12-31	$60
Benefits paid (including direct rollovers)	2019-12-31	$0
Total plan assets at end of year	2019-12-31	$224,836
Total plan assets at beginning of year	2019-12-31	$146,231
Value of fidelity bond covering the plan	2019-12-31	$50,000
Total contributions received or receivable from participants	2019-12-31	$35,200
Expenses. Other expenses not covered elsewhere	2019-12-31	$0
Contributions received from other sources (not participants or employers)	2019-12-31	$0
Other income received	2019-12-31	$37,420
Noncash contributions received	2019-12-31	$0
Net income (gross income less expenses)	2019-12-31	$78,605
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$224,836
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$146,231
Total contributions received or receivable from employer(s)	2019-12-31	$6,045
Value of certain deemed distributions of participant loans	2019-12-31	$0
Value of corrective distributions	2019-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2019-12-31	$60
2018 : WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN 2018 401k financial data
Total income from all sources	2018-12-31	$25,704
Expenses. Total of all expenses incurred	2018-12-31	$60
Benefits paid (including direct rollovers)	2018-12-31	$0
Total plan assets at end of year	2018-12-31	$146,231
Total plan assets at beginning of year	2018-12-31	$120,587
Value of fidelity bond covering the plan	2018-12-31	$50,000
Total contributions received or receivable from participants	2018-12-31	$33,700
Expenses. Other expenses not covered elsewhere	2018-12-31	$0
Contributions received from other sources (not participants or employers)	2018-12-31	$0
Other income received	2018-12-31	$-13,591
Noncash contributions received	2018-12-31	$0
Net income (gross income less expenses)	2018-12-31	$25,644
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$146,231
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$120,587
Total contributions received or receivable from employer(s)	2018-12-31	$5,595
Value of certain deemed distributions of participant loans	2018-12-31	$0
Value of corrective distributions	2018-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$60
2017 : WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources	2017-12-31	$55,816
Expenses. Total of all expenses incurred	2017-12-31	$2,361
Benefits paid (including direct rollovers)	2017-12-31	$2,191
Total plan assets at end of year	2017-12-31	$120,587
Total plan assets at beginning of year	2017-12-31	$67,132
Value of fidelity bond covering the plan	2017-12-31	$10,000
Total contributions received or receivable from participants	2017-12-31	$33,769
Expenses. Other expenses not covered elsewhere	2017-12-31	$0
Contributions received from other sources (not participants or employers)	2017-12-31	$0
Other income received	2017-12-31	$16,400
Noncash contributions received	2017-12-31	$0
Net income (gross income less expenses)	2017-12-31	$53,455
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$120,587
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$67,132
Total contributions received or receivable from employer(s)	2017-12-31	$5,647
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$170
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources	2016-12-31	$50,941
Expenses. Total of all expenses incurred	2016-12-31	$80
Total plan assets at end of year	2016-12-31	$67,132
Total plan assets at beginning of year	2016-12-31	$16,271
Value of fidelity bond covering the plan	2016-12-31	$10,000
Total contributions received or receivable from participants	2016-12-31	$37,146
Expenses. Other expenses not covered elsewhere	2016-12-31	$80
Other income received	2016-12-31	$3,597
Net income (gross income less expenses)	2016-12-31	$50,861
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$67,132
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$16,271
Total contributions received or receivable from employer(s)	2016-12-31	$10,198
2015 : WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN 2015 401k financial data
Transfers to/from the plan	2015-12-31	$0
Total plan liabilities at beginning of year	2015-12-31	$0
Total income from all sources	2015-12-31	$16,291
Expenses. Total of all expenses incurred	2015-12-31	$20
Benefits paid (including direct rollovers)	2015-12-31	$0
Total plan assets at end of year	2015-12-31	$16,271
Total plan assets at beginning of year	2015-12-31	$0
Value of fidelity bond covering the plan	2015-12-31	$1,000
Total contributions received or receivable from participants	2015-12-31	$16,567
Expenses. Other expenses not covered elsewhere	2015-12-31	$0
Other income received	2015-12-31	$-276
Noncash contributions received	2015-12-31	$0
Net income (gross income less expenses)	2015-12-31	$16,271
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$16,271
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$0
Total contributions received or receivable from employer(s)	2015-12-31	$0
Value of certain deemed distributions of participant loans	2015-12-31	$0
Value of corrective distributions	2015-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$20

Form 5500 Responses for WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN

2020: WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN 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: WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN 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: WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN 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 - Trust	Yes
2015: WING ORTHODONTICS, PC 401(K) PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	First time form 5500 has been submitted	Yes
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 - Trust	Yes

Insurance Providers Used on plan

AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )

Policy contract number

665781

Policy instance

Insurance contract or identification number	665781
Number of Individuals Covered	3
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $1,190
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,190
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	BROKER COMMISSION
Insurance broker organization code?	4

AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )

Policy contract number

665781

Policy instance

Insurance contract or identification number	665781
Number of Individuals Covered	3
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $909
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $909
Insurance broker organization code?	4

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )

Policy contract number

632763

Policy instance

Insurance contract or identification number	632763
Number of Individuals Covered	3
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $295
Total amount of fees paid to insurance company	USD $13
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $295
Insurance broker organization code?	4
Amount paid for insurance broker fees	13
Additional information about fees paid to insurance broker	SERVICES PROVIDED

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )

Policy contract number

632763

Policy instance

Insurance contract or identification number	632763
Number of Individuals Covered	3
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $455
Total amount of fees paid to insurance company	USD $26
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $455
Insurance broker organization code?	4
Amount paid for insurance broker fees	26
Additional information about fees paid to insurance broker	SERVICES PROVIDED
Insurance broker name	ROBERT J EAGLESTON

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Company Name:	WING ORTHODONTICS, PC
Employer identification number (EIN):	203372199
NAIC Classification:	621210
NAIC Description:	Offices of Dentists

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01
001	2021-01-01
001	2020-01-01	JEFFREY WING, DDS	2021-09-27
001	2019-01-01	JEFFREY WING, DDS	2020-04-04
001	2018-01-01
001	2017-01-01
001	2016-01-01
001	2015-01-01