401k Plan data: CAPROCK ORAL & MAXILLOFACIAL SURGERY, P.A. RETIREMENT PLAN & TRUST plan

CAPROCK ORAL & MAXILLOFACIAL SURGERY, P.A. RETIREMENT PLAN & TRUST 401k Plan overview

Plan Name	CAPROCK ORAL & MAXILLOFACIAL SURGERY, P.A. RETIREMENT PLAN & TRUST
Plan identification number	001

CAPROCK ORAL & MAXILLOFACIAL SURGERY, P.A. RETIREMENT PLAN & TRUST Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Age/Service Weighted or new comparability or similar plan - Age/Service Weighted Plan: Allocations are based on age, service, or age and service. New comparability or similar plan: Allocations are based on participant classifications and a classification(s) consists entirely or predominantly of highly compensated employees; or the plan provides an additional allocation rate on compensation above a specified threshold, and the theshold or additional rate exceeds the maximum threshold or rate allowed under the permitted disparity rules of section 401(l).
Profit-sharing
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

CAPROCK ORAL & MAXILLOFACIAL SURGERY, P.A. has sponsored the creation of one or more 401k plans.

Company Name: CAPROCK ORAL & MAXILLOFACIAL SURGERY, P.A.

Employer identification number (EIN): 752398115

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CAPROCK ORAL & MAXILLOFACIAL SURGERY, P.A. RETIREMENT PLAN & TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2015-01-01 GLADYS J. WHITTEN, D.M.D. 2016-09-15
001 2014-01-01 GLADYS J. WHITTEN, D.M.D. 2015-10-08
001 2013-01-01 GLADYS J. WHITTEN, D.M.D. 2014-10-14
001 2012-01-01 GLADYS J. WHITTEN, D.M.D. 2013-09-24
001 2011-01-01 GLADYS J. WHITTEN, D.M.D.
001 2009-01-01 GLADYS J. WHITTEN, D.M.D.
001 2009-01-01 GLADYS J. WHITTEN, D.M.D.

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2015-01-01	GLADYS J. WHITTEN, D.M.D.	2016-09-15
001	2014-01-01	GLADYS J. WHITTEN, D.M.D.	2015-10-08
001	2013-01-01	GLADYS J. WHITTEN, D.M.D.	2014-10-14
001	2012-01-01	GLADYS J. WHITTEN, D.M.D.	2013-09-24
001	2011-01-01	GLADYS J. WHITTEN, D.M.D.
001	2009-01-01	GLADYS J. WHITTEN, D.M.D.
001	2009-01-01	GLADYS J. WHITTEN, D.M.D.

Plan Statistics for CAPROCK ORAL & MAXILLOFACIAL SURGERY, P.A. RETIREMENT PLAN & TRUST

401k plan membership statisitcs for CAPROCK ORAL & MAXILLOFACIAL SURGERY, P.A. RETIREMENT PLAN & TRUST

Measure Date Value
2011: CAPROCK ORAL & MAXILLOFACIAL SURGERY, P.A. RETIREMENT PLAN & TRUST 2011 401k membership
Total participants, beginning-of-year 2011-01-01 10
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 7
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 3
Total of all active and inactive participants 2011-01-01 10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 10
Number of participants with account balances 2011-01-01 9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 1
2009: CAPROCK ORAL & MAXILLOFACIAL SURGERY, P.A. RETIREMENT PLAN & TRUST 2009 401k membership
Total participants, beginning-of-year 2009-01-01 15
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 7
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 2
Total of all active and inactive participants 2009-01-01 9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 9
Number of participants with account balances 2009-01-01 8
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: CAPROCK ORAL & MAXILLOFACIAL SURGERY, P.A. RETIREMENT PLAN & TRUST 2011 401k membership
Total participants, beginning-of-year	2011-01-01	10
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	7
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	3
Total of all active and inactive participants	2011-01-01	10
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	10
Number of participants with account balances	2011-01-01	9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	1
2009: CAPROCK ORAL & MAXILLOFACIAL SURGERY, P.A. RETIREMENT PLAN & TRUST 2009 401k membership
Total participants, beginning-of-year	2009-01-01	15
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	7
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	2
Total of all active and inactive participants	2009-01-01	9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	9
Number of participants with account balances	2009-01-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on CAPROCK ORAL & MAXILLOFACIAL SURGERY, P.A. RETIREMENT PLAN & TRUST

Measure	Date	Value
2011 : CAPROCK ORAL & MAXILLOFACIAL SURGERY, P.A. RETIREMENT PLAN & TRUST 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	$122,379
Expenses. Total of all expenses incurred	2011-12-31	$5,723
Benefits paid (including direct rollovers)	2011-12-31	$0
Total plan assets at end of year	2011-12-31	$837,130
Total plan assets at beginning of year	2011-12-31	$720,474
Value of fidelity bond covering the plan	2011-12-31	$100,000
Total contributions received or receivable from participants	2011-12-31	$45,730
Expenses. Other expenses not covered elsewhere	2011-12-31	$0
Contributions received from other sources (not participants or employers)	2011-12-31	$15,288
Other income received	2011-12-31	$25,001
Noncash contributions received	2011-12-31	$0
Net income (gross income less expenses)	2011-12-31	$116,656
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$837,130
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$720,474
Assets. Value of assets in partnership/joint-venture interests	2011-12-31	$49,708
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2011-12-31	$18,418
Total contributions received or receivable from employer(s)	2011-12-31	$36,360
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	$5,723
2010 : CAPROCK ORAL & MAXILLOFACIAL SURGERY, P.A. RETIREMENT PLAN & TRUST 2010 401k financial data
Transfers to/from the plan	2010-12-31	$0
Total plan liabilities at end of year	2010-12-31	$0
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$140,866
Expenses. Total of all expenses incurred	2010-12-31	$4,980
Benefits paid (including direct rollovers)	2010-12-31	$0
Total plan assets at end of year	2010-12-31	$720,474
Total plan assets at beginning of year	2010-12-31	$584,588
Value of fidelity bond covering the plan	2010-12-31	$100,000
Total contributions received or receivable from participants	2010-12-31	$45,480
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	$58,125
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$135,886
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$720,474
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$584,588
Assets. Value of assets in partnership/joint-venture interests	2010-12-31	$49,345
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2010-12-31	$37,889
Total contributions received or receivable from employer(s)	2010-12-31	$37,261
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	$4,980

Form 5500 Responses for CAPROCK ORAL & MAXILLOFACIAL SURGERY, P.A. RETIREMENT PLAN & TRUST

2011: CAPROCK ORAL & MAXILLOFACIAL SURGERY, P.A. RETIREMENT PLAN & TRUST 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: CAPROCK ORAL & MAXILLOFACIAL SURGERY, P.A. RETIREMENT PLAN & TRUST 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	CAPROCK ORAL & MAXILLOFACIAL SURGERY, P.A.
Employer identification number (EIN):	752398115
NAIC Classification:	621210
NAIC Description:	Offices of Dentists