401k Plan data: MIDWEST DENTAL EQUIPMENT & SUPPLY 401(K) PLAN plan

MIDWEST DENTAL EQUIPMENT & SUPPLY 401(K) PLAN 401k Plan overview

Plan Name	MIDWEST DENTAL EQUIPMENT & SUPPLY 401(K) PLAN
Plan identification number	001

MIDWEST DENTAL EQUIPMENT & SUPPLY 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
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.

401k Sponsoring company profile

MIDWEST DENTAL EQUIPMENT & SUPPLY has sponsored the creation of one or more 401k plans.

Company Name: MIDWEST DENTAL EQUIPMENT & SUPPLY

Employer identification number (EIN): 752261471

NAIC Classification: 423400

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MIDWEST DENTAL EQUIPMENT & SUPPLY 401(K) 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
001 2019-01-01 DANNY KOWALICK 2020-06-26
001 2018-01-01 DANNY KOWALICK 2019-04-29
001 2017-01-01 DANNY KOWALICK 2018-09-18
001 2016-01-01 DANNY KOWALICK 2017-05-16
001 2015-01-01 DANNY KOWALICK 2016-06-17
001 2014-01-01 DANNY KOWALICK 2015-07-06
001 2013-01-01 DANNY KOWALICK 2014-06-03
001 2012-01-01 DANNY KOWALICK 2013-08-26
001 2011-01-01 DANNY KOWALICK 2012-07-23
001 2009-01-01 DANNY KOWALICK

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01
001	2021-01-01
001	2020-01-01
001	2019-01-01	DANNY KOWALICK	2020-06-26
001	2018-01-01	DANNY KOWALICK	2019-04-29
001	2017-01-01	DANNY KOWALICK	2018-09-18
001	2016-01-01	DANNY KOWALICK	2017-05-16
001	2015-01-01	DANNY KOWALICK	2016-06-17
001	2014-01-01	DANNY KOWALICK	2015-07-06
001	2013-01-01	DANNY KOWALICK	2014-06-03
001	2012-01-01	DANNY KOWALICK	2013-08-26
001	2011-01-01	DANNY KOWALICK	2012-07-23
001	2009-01-01	DANNY KOWALICK

Plan Statistics for MIDWEST DENTAL EQUIPMENT & SUPPLY 401(K) PLAN

401k plan membership statisitcs for MIDWEST DENTAL EQUIPMENT & SUPPLY 401(K) PLAN

Measure Date Value
2022: MIDWEST DENTAL EQUIPMENT & SUPPLY 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 139
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 123
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 11
Total of all active and inactive participants 2022-01-01 134
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 134
Number of participants with account balances 2022-01-01 102
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 2
2021: MIDWEST DENTAL EQUIPMENT & SUPPLY 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 134
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 122
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 14
Total of all active and inactive participants 2021-01-01 136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 136
Number of participants with account balances 2021-01-01 92
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 6
2020: MIDWEST DENTAL EQUIPMENT & SUPPLY 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 127
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 128
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 10
Total of all active and inactive participants 2020-01-01 138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 138
Number of participants with account balances 2020-01-01 95
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 1
2009: MIDWEST DENTAL EQUIPMENT & SUPPLY 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 64
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 68
Number of retired or separated participants receiving benefits 2009-01-01 4
Number of other retired or separated participants entitled to future benefits 2009-01-01 7
Total of all active and inactive participants 2009-01-01 79
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 79
Number of participants with account balances 2009-01-01 54
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2022: MIDWEST DENTAL EQUIPMENT & SUPPLY 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	139
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	123
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	11
Total of all active and inactive participants	2022-01-01	134
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	134
Number of participants with account balances	2022-01-01	102
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	2
2021: MIDWEST DENTAL EQUIPMENT & SUPPLY 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	134
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	122
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	14
Total of all active and inactive participants	2021-01-01	136
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	136
Number of participants with account balances	2021-01-01	92
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	6
2020: MIDWEST DENTAL EQUIPMENT & SUPPLY 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	127
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	128
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	10
Total of all active and inactive participants	2020-01-01	138
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	138
Number of participants with account balances	2020-01-01	95
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	1
2009: MIDWEST DENTAL EQUIPMENT & SUPPLY 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	64
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	68
Number of retired or separated participants receiving benefits	2009-01-01	4
Number of other retired or separated participants entitled to future benefits	2009-01-01	7
Total of all active and inactive participants	2009-01-01	79
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	79
Number of participants with account balances	2009-01-01	54
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on MIDWEST DENTAL EQUIPMENT & SUPPLY 401(K) PLAN

Measure	Date	Value
2022 : MIDWEST DENTAL EQUIPMENT & SUPPLY 401(K) PLAN 2022 401k financial data
Total unrealized appreciation/depreciation of assets	2022-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2022-12-31	$10,660
Total income from all sources (including contributions)	2022-12-31	$-587,576
Total loss/gain on sale of assets	2022-12-31	$0
Total of all expenses incurred	2022-12-31	$43,088
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2022-12-31	$42,262
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2022-12-31	$860,413
Value of total assets at end of year	2022-12-31	$7,086,470
Value of total assets at beginning of year	2022-12-31	$7,727,794
Total of administrative expenses incurred including professional, contract, advisory and management fees	2022-12-31	$826
Total interest from all sources	2022-12-31	$34,208
Total dividends received (eg from common stock, registered investment company shares)	2022-12-31	$0
Administrative expenses professional fees incurred	2022-12-31	$826
Was this plan covered by a fidelity bond	2022-12-31	Yes
Value of fidelity bond cover	2022-12-31	$500,000
If this is an individual account plan, was there a blackout period	2022-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2022-12-31	No
Contributions received from participants	2022-12-31	$784,747
Participant contributions at end of year	2022-12-31	$16,050
Participant contributions at beginning of year	2022-12-31	$32,607
Income. Received or receivable in cash from other sources (including rollovers)	2022-12-31	$2,170
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2022-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2022-12-31	$10,660
Total non interest bearing cash at end of year	2022-12-31	$0
Total non interest bearing cash at beginning of year	2022-12-31	$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	2022-12-31	No
Value of net income/loss	2022-12-31	$-630,664
Value of net assets at end of year (total assets less liabilities)	2022-12-31	$7,086,470
Value of net assets at beginning of year (total assets less liabilities)	2022-12-31	$7,717,134
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2022-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2022-12-31	No
Were any leases to which the plan was party in default or uncollectible	2022-12-31	No
Value of interest in pooled separate accounts at end of year	2022-12-31	$5,728,969
Value of interest in pooled separate accounts at beginning of year	2022-12-31	$6,760,043
Interest on participant loans	2022-12-31	$672
Interest earned on other investments	2022-12-31	$33,536
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2022-12-31	$1,267,955
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2022-12-31	$885,375
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2022-12-31	$-1,482,197
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2022-12-31	No
Was there a failure to transmit to the plan any participant contributions	2022-12-31	No
Has the plan failed to provide any benefit when due under the plan	2022-12-31	No
Contributions received in cash from employer	2022-12-31	$73,496
Employer contributions (assets) at end of year	2022-12-31	$73,496
Employer contributions (assets) at beginning of year	2022-12-31	$49,769
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2022-12-31	$42,262
Did the plan have assets held for investment	2022-12-31	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	2022-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2022-12-31	No
Opinion of an independent qualified public accountant for this plan	2022-12-31	Unqualified
Accountancy firm name	2022-12-31	EISNERAMPER LLP
Accountancy firm EIN	2022-12-31	871363769
2021 : MIDWEST DENTAL EQUIPMENT & SUPPLY 401(K) PLAN 2021 401k financial data
Total unrealized appreciation/depreciation of assets	2021-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$10,660
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2021-12-31	$0
Total income from all sources (including contributions)	2021-12-31	$1,448,114
Total loss/gain on sale of assets	2021-12-31	$0
Total of all expenses incurred	2021-12-31	$306,367
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2021-12-31	$300,059
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2021-12-31	$549,556
Value of total assets at end of year	2021-12-31	$7,727,794
Value of total assets at beginning of year	2021-12-31	$6,575,387
Total of administrative expenses incurred including professional, contract, advisory and management fees	2021-12-31	$6,308
Total interest from all sources	2021-12-31	$30,968
Total dividends received (eg from common stock, registered investment company shares)	2021-12-31	$0
Administrative expenses professional fees incurred	2021-12-31	$6,308
Was this plan covered by a fidelity bond	2021-12-31	Yes
Value of fidelity bond cover	2021-12-31	$500,000
If this is an individual account plan, was there a blackout period	2021-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2021-12-31	No
Contributions received from participants	2021-12-31	$507,232
Participant contributions at end of year	2021-12-31	$32,607
Participant contributions at beginning of year	2021-12-31	$60,250
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2021-12-31	$10,660
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2021-12-31	$0
Total non interest bearing cash at end of year	2021-12-31	$0
Total non interest bearing cash at beginning of year	2021-12-31	$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	2021-12-31	No
Value of net income/loss	2021-12-31	$1,141,747
Value of net assets at end of year (total assets less liabilities)	2021-12-31	$7,717,134
Value of net assets at beginning of year (total assets less liabilities)	2021-12-31	$6,575,387
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2021-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2021-12-31	No
Were any leases to which the plan was party in default or uncollectible	2021-12-31	No
Value of interest in pooled separate accounts at end of year	2021-12-31	$6,760,043
Value of interest in pooled separate accounts at beginning of year	2021-12-31	$5,411,905
Interest on participant loans	2021-12-31	$2,857
Interest earned on other investments	2021-12-31	$28,111
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2021-12-31	$885,375
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2021-12-31	$1,051,522
Net investment gain/loss from pooled separate accounts	2021-12-31	$867,590
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2021-12-31	No
Was there a failure to transmit to the plan any participant contributions	2021-12-31	No
Has the plan failed to provide any benefit when due under the plan	2021-12-31	No
Contributions received in cash from employer	2021-12-31	$42,324
Employer contributions (assets) at end of year	2021-12-31	$49,769
Employer contributions (assets) at beginning of year	2021-12-31	$51,710
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2021-12-31	$300,059
Did the plan have assets held for investment	2021-12-31	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	2021-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2021-12-31	No
Opinion of an independent qualified public accountant for this plan	2021-12-31	Unqualified
Accountancy firm name	2021-12-31	EISNERAMPER LLP
Accountancy firm EIN	2021-12-31	871363769
2020 : MIDWEST DENTAL EQUIPMENT & SUPPLY 401(K) PLAN 2020 401k financial data
Total unrealized appreciation/depreciation of assets	2020-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2020-12-31	$0
Total income from all sources (including contributions)	2020-12-31	$1,213,192
Total loss/gain on sale of assets	2020-12-31	$0
Total of all expenses incurred	2020-12-31	$12,955
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2020-12-31	$5,766
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2020-12-31	$467,236
Value of total assets at end of year	2020-12-31	$6,575,387
Value of total assets at beginning of year	2020-12-31	$5,375,150
Total of administrative expenses incurred including professional, contract, advisory and management fees	2020-12-31	$7,189
Total interest from all sources	2020-12-31	$4,668
Total dividends received (eg from common stock, registered investment company shares)	2020-12-31	$0
Administrative expenses professional fees incurred	2020-12-31	$7,189
Was this plan covered by a fidelity bond	2020-12-31	Yes
Value of fidelity bond cover	2020-12-31	$500,000
If this is an individual account plan, was there a blackout period	2020-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2020-12-31	No
Contributions received from participants	2020-12-31	$403,052
Participant contributions at end of year	2020-12-31	$60,250
Participant contributions at beginning of year	2020-12-31	$93,923
Income. Received or receivable in cash from other sources (including rollovers)	2020-12-31	$16,124
Total non interest bearing cash at end of year	2020-12-31	$0
Total non interest bearing cash at beginning of year	2020-12-31	$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	2020-12-31	No
Value of net income/loss	2020-12-31	$1,200,237
Value of net assets at end of year (total assets less liabilities)	2020-12-31	$6,575,387
Value of net assets at beginning of year (total assets less liabilities)	2020-12-31	$5,375,150
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2020-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2020-12-31	No
Were any leases to which the plan was party in default or uncollectible	2020-12-31	No
Value of interest in pooled separate accounts at end of year	2020-12-31	$5,411,905
Value of interest in pooled separate accounts at beginning of year	2020-12-31	$4,853,816
Interest on participant loans	2020-12-31	$4,668
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2020-12-31	$1,051,522
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2020-12-31	$393,272
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2020-12-31	$741,288
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2020-12-31	No
Was there a failure to transmit to the plan any participant contributions	2020-12-31	No
Has the plan failed to provide any benefit when due under the plan	2020-12-31	No
Contributions received in cash from employer	2020-12-31	$48,060
Employer contributions (assets) at end of year	2020-12-31	$51,710
Employer contributions (assets) at beginning of year	2020-12-31	$34,139
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2020-12-31	$5,766
Did the plan have assets held for investment	2020-12-31	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	2020-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2020-12-31	No
Opinion of an independent qualified public accountant for this plan	2020-12-31	Disclaimer
Accountancy firm name	2020-12-31	EISNERAMPER LLP
Accountancy firm EIN	2020-12-31	871363769
2010 : MIDWEST DENTAL EQUIPMENT & SUPPLY 401(K) PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$345,382
Expenses. Total of all expenses incurred	2010-12-31	$36,353
Benefits paid (including direct rollovers)	2010-12-31	$27,251
Total plan assets at end of year	2010-12-31	$1,132,922
Total plan assets at beginning of year	2010-12-31	$823,893
Value of fidelity bond covering the plan	2010-12-31	$1,000,000
Total contributions received or receivable from participants	2010-12-31	$203,843
Expenses. Other expenses not covered elsewhere	2010-12-31	$2,466
Other income received	2010-12-31	$121,965
Net income (gross income less expenses)	2010-12-31	$309,029
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$1,132,922
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$823,893
Assets. Value of participant loans	2010-12-31	$12,013
Total contributions received or receivable from employer(s)	2010-12-31	$19,574
Value of corrective distributions	2010-12-31	$6,636
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : MIDWEST DENTAL EQUIPMENT & SUPPLY 401(K) 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 MIDWEST DENTAL EQUIPMENT & SUPPLY 401(K) PLAN

2022: MIDWEST DENTAL EQUIPMENT & SUPPLY 401(K) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: MIDWEST DENTAL EQUIPMENT & SUPPLY 401(K) PLAN 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 – Insurance	Yes
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: MIDWEST DENTAL EQUIPMENT & SUPPLY 401(K) 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
2009: MIDWEST DENTAL EQUIPMENT & SUPPLY 401(K) 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

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

Policy contract number

85242-1

Policy instance

Insurance contract or identification number	85242-1
Number of Individuals Covered	104
Insurance policy start date	2022-01-01
Insurance policy end date	2022-09-09
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?	Yes
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

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

Policy contract number

768838-01

Policy instance

Insurance contract or identification number	768838-01
Number of Individuals Covered	102
Insurance policy start date	2022-09-10
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $3,393
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?	Yes
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 $3,393
Insurance broker organization code?	3

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

Policy contract number

85242-1

Policy instance

Insurance contract or identification number	85242-1
Number of Individuals Covered	87
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $16,229
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 $16,229
Insurance broker organization code?	3

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

Policy contract number

85242-1

Policy instance

Insurance contract or identification number	85242-1
Number of Individuals Covered	87
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $14,717
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 $14,717
Insurance broker organization code?	3

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

Policy contract number

RM 85242-1

Policy instance

Insurance contract or identification number	RM 85242-1
Number of Individuals Covered	54
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $14,525
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?	Yes
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

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

22704

Policy instance

Insurance contract or identification number	22704
Number of Individuals Covered	0
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $1,384
Total amount of fees paid to insurance company	USD $227
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?	Yes
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:	MIDWEST DENTAL EQUIPMENT & SUPPLY
Employer identification number (EIN):	752261471
NAIC Classification:	423400