401k Plan data: FAMILY & COSMETIC GENTLE DENTISTRY 401(K) PROFIT SHARING PLAN plan

FAMILY & COSMETIC GENTLE DENTISTRY 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	FAMILY & COSMETIC GENTLE DENTISTRY 401(K) PROFIT SHARING PLAN
Plan identification number	003

FAMILY & COSMETIC GENTLE DENTISTRY 401(K) PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

GENTLE DENTISTRY MANAGEMENT, INC. has sponsored the creation of one or more 401k plans.

Company Name: GENTLE DENTISTRY MANAGEMENT, INC.

Employer identification number (EIN): 473247565

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FAMILY & COSMETIC GENTLE DENTISTRY 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2018-01-01
003 2017-01-01 CAROL CLURE CAROL CLURE 2018-10-15
003 2016-01-01 SHERI CARLSON SHERI CARLSON 2017-08-22

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
003	2018-01-01
003	2017-01-01	CAROL CLURE	CAROL CLURE	2018-10-15
003	2016-01-01	SHERI CARLSON	SHERI CARLSON	2017-08-22

Plan Statistics for FAMILY & COSMETIC GENTLE DENTISTRY 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for FAMILY & COSMETIC GENTLE DENTISTRY 401(K) PROFIT SHARING PLAN

Measure Date Value
2018: FAMILY & COSMETIC GENTLE DENTISTRY 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 182
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 141
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 40
Total of all active and inactive participants 2018-01-01 181
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 181
Number of participants with account balances 2018-01-01 120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 20
2017: FAMILY & COSMETIC GENTLE DENTISTRY 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 167
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 120
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 53
Total of all active and inactive participants 2017-01-01 173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 173
Number of participants with account balances 2017-01-01 126
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 26
2016: FAMILY & COSMETIC GENTLE DENTISTRY 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 164
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 126
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 35
Total of all active and inactive participants 2016-01-01 161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 161
Number of participants with account balances 2016-01-01 113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 14

Measure	Date	Value
2018: FAMILY & COSMETIC GENTLE DENTISTRY 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	182
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	141
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	40
Total of all active and inactive participants	2018-01-01	181
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	181
Number of participants with account balances	2018-01-01	120
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	20
2017: FAMILY & COSMETIC GENTLE DENTISTRY 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	167
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	120
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	53
Total of all active and inactive participants	2017-01-01	173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	173
Number of participants with account balances	2017-01-01	126
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	26
2016: FAMILY & COSMETIC GENTLE DENTISTRY 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	164
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	126
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	35
Total of all active and inactive participants	2016-01-01	161
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	161
Number of participants with account balances	2016-01-01	113
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	14

Financial Data on FAMILY & COSMETIC GENTLE DENTISTRY 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2018 : FAMILY & COSMETIC GENTLE DENTISTRY 401(K) PROFIT SHARING PLAN 2018 401k financial data
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$460
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$308,839
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$729,411
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$713,223
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$503,717
Value of total assets at end of year	2018-12-31	$2,534,772
Value of total assets at beginning of year	2018-12-31	$2,954,884
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$16,188
Total interest from all sources	2018-12-31	$2,091
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	No
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$300,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$394,863
Participant contributions at end of year	2018-12-31	$45,409
Participant contributions at beginning of year	2018-12-31	$66,335
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2018-12-31	$460
Other income not declared elsewhere	2018-12-31	$0
Administrative expenses (other) incurred	2018-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-420,572
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$2,534,312
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$2,954,884
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$0
Value of interest in pooled separate accounts at end of year	2018-12-31	$2,468,191
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$2,866,500
Interest on participant loans	2018-12-31	$2,091
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$21,172
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$22,049
Net investment gain/loss from pooled separate accounts	2018-12-31	$-196,969
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$108,854
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$713,223
Contract administrator fees	2018-12-31	$16,188
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	SMITH, SCHAFER AND ASSOCIATES, LTD.
Accountancy firm EIN	2018-12-31	411489071
2017 : FAMILY & COSMETIC GENTLE DENTISTRY 401(K) PROFIT SHARING PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$748,902
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$167,315
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$154,884
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$411,481
Value of total assets at end of year	2017-12-31	$2,954,884
Value of total assets at beginning of year	2017-12-31	$2,373,297
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$12,431
Total interest from all sources	2017-12-31	$2,832
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$300,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$314,703
Participant contributions at end of year	2017-12-31	$66,335
Participant contributions at beginning of year	2017-12-31	$57,230
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$5,589
Other income not declared elsewhere	2017-12-31	$5
Administrative expenses (other) incurred	2017-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Value of net income/loss	2017-12-31	$581,587
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$2,954,884
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$2,373,297
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$2,296,000
Value of interest in pooled separate accounts at end of year	2017-12-31	$2,866,500
Interest on participant loans	2017-12-31	$2,832
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$22,049
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$20,067
Net investment gain/loss from pooled separate accounts	2017-12-31	$334,584
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	No
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$91,189
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$154,884
Contract administrator fees	2017-12-31	$12,431
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	SMITH, SCHAFER AND ASSOCIATES, LTD.
Accountancy firm EIN	2017-12-31	411489071
2016 : FAMILY & COSMETIC GENTLE DENTISTRY 401(K) PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources (including contributions)	2016-12-31	$711,275
Total of all expenses incurred	2016-12-31	$191,070
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$177,055
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$542,538
Value of total assets at end of year	2016-12-31	$2,373,297
Value of total assets at beginning of year	2016-12-31	$1,853,092
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$14,015
Total interest from all sources	2016-12-31	$1,968
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$300,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$278,413
Participant contributions at end of year	2016-12-31	$57,230
Participant contributions at beginning of year	2016-12-31	$28,724
Participant contributions at beginning of year	2016-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$175,619
Other income not declared elsewhere	2016-12-31	$13
Administrative expenses (other) incurred	2016-12-31	$1,040
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$520,205
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$2,373,297
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$1,853,092
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$2,296,000
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$1,799,011
Interest on participant loans	2016-12-31	$1,968
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$20,067
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$25,357
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$166,756
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Contributions received in cash from employer	2016-12-31	$88,506
Employer contributions (assets) at beginning of year	2016-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$177,055
Contract administrator fees	2016-12-31	$12,975
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	SMITH, SCHAFER AND ASSOCIATES, LTD.
Accountancy firm EIN	2016-12-31	411489071

Form 5500 Responses for FAMILY & COSMETIC GENTLE DENTISTRY 401(K) PROFIT SHARING PLAN

2018: FAMILY & COSMETIC GENTLE DENTISTRY 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: FAMILY & COSMETIC GENTLE DENTISTRY 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: FAMILY & COSMETIC GENTLE DENTISTRY 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 – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

805170

Policy instance

Insurance contract or identification number	805170
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $14,035
Total amount of fees paid to insurance company	USD $2,797
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $14,035
Insurance broker organization code?	3
Amount paid for insurance broker fees	2797

TRANSAMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 86231 )

Policy contract number

805170

Policy instance

Insurance contract or identification number	805170
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $12,826
Total amount of fees paid to insurance company	USD $2,576
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $12,826
Insurance broker organization code?	3
Amount paid for insurance broker fees	2576
Insurance broker name	TAX SHELTERED COMPENSATION, INC.

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Company Name:	GENTLE DENTISTRY MANAGEMENT, INC.
Employer identification number (EIN):	473247565
NAIC Classification:	621210
NAIC Description:	Offices of Dentists