401k Plan data: GORE & SVANS DENTISTRY, PLLC DEFINED BENEFIT PLAN plan

GORE & SVANS DENTISTRY, PLLC DEFINED BENEFIT PLAN 401k Plan overview

Plan Name	GORE & SVANS DENTISTRY, PLLC DEFINED BENEFIT PLAN
Plan identification number	002

GORE & SVANS DENTISTRY, PLLC DEFINED BENEFIT PLAN Benefits

401k Plan Type

Defined Benefit Pension

Plan Features/Benefits

Benefits are primarily pay related
Frozen Plan - As of the last day of the plan year, the plan provides that no participant will get any new benefit accrual (whether because of service or compensation).
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

GORE & SVANS DENTISTRY, PLLC has sponsored the creation of one or more 401k plans.

Company Name: GORE & SVANS DENTISTRY, PLLC

Employer identification number (EIN): 263893578

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GORE & SVANS DENTISTRY, PLLC DEFINED BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2012-01-01 RUSSELL J. SNOW, EA, CPC, MSPA 2013-09-03
002 2011-01-01 RUSSELL J. SNOW, EA, CPC, MSPA
002 2010-01-01 RUSSELL J. SNOW, EA, CPC, MSPA
002 2009-01-01 RUSSELL J. SNOW

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
002	2012-01-01	RUSSELL J. SNOW, EA, CPC, MSPA	2013-09-03
002	2011-01-01	RUSSELL J. SNOW, EA, CPC, MSPA
002	2010-01-01	RUSSELL J. SNOW, EA, CPC, MSPA
002	2009-01-01	RUSSELL J. SNOW

Plan Statistics for GORE & SVANS DENTISTRY, PLLC DEFINED BENEFIT PLAN

401k plan membership statisitcs for GORE & SVANS DENTISTRY, PLLC DEFINED BENEFIT PLAN

Measure Date Value
2011: GORE & SVANS DENTISTRY, PLLC DEFINED BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 3
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 1
Total of all active and inactive participants 2011-01-01 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: GORE & SVANS DENTISTRY, PLLC DEFINED BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 4
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 1
Total of all active and inactive participants 2010-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: GORE & SVANS DENTISTRY, PLLC DEFINED BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 4
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 1
Total of all active and inactive participants 2009-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2011: GORE & SVANS DENTISTRY, PLLC DEFINED BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	3
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	1
Total of all active and inactive participants	2011-01-01	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: GORE & SVANS DENTISTRY, PLLC DEFINED BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	4
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	1
Total of all active and inactive participants	2010-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: GORE & SVANS DENTISTRY, PLLC DEFINED BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	4
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	1
Total of all active and inactive participants	2009-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on GORE & SVANS DENTISTRY, PLLC DEFINED BENEFIT PLAN

Measure	Date	Value
2011 : GORE & SVANS DENTISTRY, PLLC DEFINED BENEFIT PLAN 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	$-73,165
Expenses. Total of all expenses incurred	2011-12-31	$0
Benefits paid (including direct rollovers)	2011-12-31	$0
Total plan assets at end of year	2011-12-31	$338,299
Total plan assets at beginning of year	2011-12-31	$411,464
Total contributions received or receivable from participants	2011-12-31	$0
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	$-73,165
Noncash contributions received	2011-12-31	$0
Net income (gross income less expenses)	2011-12-31	$-73,165
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$338,299
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$411,464
Total contributions received or receivable from employer(s)	2011-12-31	$0
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	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : GORE & SVANS DENTISTRY, PLLC DEFINED BENEFIT PLAN 2010 401k financial data
Transfers to/from the plan	2010-12-31	$0
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$-87,405
Expenses. Total of all expenses incurred	2010-12-31	$29,629
Benefits paid (including direct rollovers)	2010-12-31	$29,629
Total plan assets at end of year	2010-12-31	$411,464
Total plan assets at beginning of year	2010-12-31	$528,498
Total contributions received or receivable from participants	2010-12-31	$0
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	$-87,405
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$-117,034
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$411,464
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$528,498
Total contributions received or receivable from employer(s)	2010-12-31	$0
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	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : GORE & SVANS DENTISTRY, PLLC DEFINED BENEFIT PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for GORE & SVANS DENTISTRY, PLLC DEFINED BENEFIT PLAN

2011: GORE & SVANS DENTISTRY, PLLC DEFINED BENEFIT 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
2010: GORE & SVANS DENTISTRY, PLLC DEFINED BENEFIT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: GORE & SVANS DENTISTRY, PLLC DEFINED BENEFIT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

HARTFORD LIFE & ANNUITY (National Association of Insurance Commissioners NAIC id number: 71153 )

Policy contract number

WL4703488

Policy instance

Insurance contract or identification number	WL4703488
Number of Individuals Covered	1
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

HARTFORD LIFE & ANNUITY (National Association of Insurance Commissioners NAIC id number: 71153 )

Policy contract number

WL4703488

Policy instance

Insurance contract or identification number	WL4703488
Number of Individuals Covered	1
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
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
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

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Company Name:	GORE & SVANS DENTISTRY, PLLC
Employer identification number (EIN):	263893578
NAIC Classification:	621210
NAIC Description:	Offices of Dentists