401k Plan data: DR. KELSEY MILBERT, P.A. EMPLOYEE 401(K) PLAN plan

DR. KELSEY MILBERT, P.A. EMPLOYEE 401(K) PLAN 401k Plan overview

Plan Name	DR. KELSEY MILBERT, P.A. EMPLOYEE 401(K) PLAN
Plan identification number	001

DR. KELSEY MILBERT, P.A. EMPLOYEE 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

DR. KELSEY MILBERT, P.A. has sponsored the creation of one or more 401k plans.

Company Name: DR. KELSEY MILBERT, P.A.

Employer identification number (EIN): 853018091

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DR. KELSEY MILBERT, P.A. EMPLOYEE 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2023-01-01
001 2022-01-01
001 2021-01-01

Plan Statistics for DR. KELSEY MILBERT, P.A. EMPLOYEE 401(K) PLAN

401k plan membership statisitcs for DR. KELSEY MILBERT, P.A. EMPLOYEE 401(K) PLAN

Measure Date Value
2023: DR. KELSEY MILBERT, P.A. EMPLOYEE 401(K) PLAN 2023 401k membership
Total participants, beginning-of-year 2023-01-01 13
Total number of active participants reported on line 7a of the Form 5500 2023-01-01 13
Number of retired or separated participants receiving benefits 2023-01-01 1
Number of other retired or separated participants entitled to future benefits 2023-01-01 0
Total of all active and inactive participants 2023-01-01 14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2023-01-01 0
Total participants 2023-01-01 14
Number of participants with account balances 2023-01-01 11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2023-01-01 0
2022: DR. KELSEY MILBERT, P.A. EMPLOYEE 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 13
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 12
Number of retired or separated participants receiving benefits 2022-01-01 1
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 13
Number of participants with account balances 2022-01-01 9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: DR. KELSEY MILBERT, P.A. EMPLOYEE 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 12
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 12
Number of retired or separated participants receiving benefits 2021-01-01 1
Number of other retired or separated participants entitled to future benefits 2021-01-01 0
Total of all active and inactive participants 2021-01-01 13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 13
Number of participants with account balances 2021-01-01 9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0

Measure	Date	Value
2023: DR. KELSEY MILBERT, P.A. EMPLOYEE 401(K) PLAN 2023 401k membership
Total participants, beginning-of-year	2023-01-01	13
Total number of active participants reported on line 7a of the Form 5500	2023-01-01	13
Number of retired or separated participants receiving benefits	2023-01-01	1
Number of other retired or separated participants entitled to future benefits	2023-01-01	0
Total of all active and inactive participants	2023-01-01	14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2023-01-01	0
Total participants	2023-01-01	14
Number of participants with account balances	2023-01-01	11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2023-01-01	0
2022: DR. KELSEY MILBERT, P.A. EMPLOYEE 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	13
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	12
Number of retired or separated participants receiving benefits	2022-01-01	1
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	13
Number of participants with account balances	2022-01-01	9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: DR. KELSEY MILBERT, P.A. EMPLOYEE 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	12
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	12
Number of retired or separated participants receiving benefits	2021-01-01	1
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	13
Number of participants with account balances	2021-01-01	9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0

Financial Data on DR. KELSEY MILBERT, P.A. EMPLOYEE 401(K) PLAN

Measure	Date	Value
2023 : DR. KELSEY MILBERT, P.A. EMPLOYEE 401(K) PLAN 2023 401k financial data
Transfers to/from the plan	2023-12-31	$0
Total plan liabilities at end of year	2023-12-31	$0
Total plan liabilities at beginning of year	2023-12-31	$0
Total income from all sources	2023-12-31	$180,295
Expenses. Total of all expenses incurred	2023-12-31	$83,545
Benefits paid (including direct rollovers)	2023-12-31	$80,293
Total plan assets at end of year	2023-12-31	$991,920
Total plan assets at beginning of year	2023-12-31	$895,170
Value of fidelity bond covering the plan	2023-12-31	$150,000
Assets. Value of tangible personal property	2023-12-31	$0
Total contributions received or receivable from participants	2023-12-31	$41,716
Assets. Value of loans (other than to participants)	2023-12-31	$0
Expenses. Other expenses not covered elsewhere	2023-12-31	$0
Contributions received from other sources (not participants or employers)	2023-12-31	$0
Other income received	2023-12-31	$138,579
Noncash contributions received	2023-12-31	$0
Net income (gross income less expenses)	2023-12-31	$96,750
Net plan assets at end of year (total assets less liabilities)	2023-12-31	$991,920
Net plan assets at beginning of year (total assets less liabilities)	2023-12-31	$895,170
Assets. Value of participant loans	2023-12-31	$12,226
Assets. Value of assets in partnership/joint-venture interests	2023-12-31	$0
Assets. Value of real-estate (other than employer real property)	2023-12-31	$0
Assets. Value of employer securities	2023-12-31	$0
Assets. Value of employer real property	2023-12-31	$0
Total contributions received or receivable from employer(s)	2023-12-31	$0
Value of certain deemed distributions of participant loans	2023-12-31	$0
Value of corrective distributions	2023-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2023-12-31	$3,252
2022 : DR. KELSEY MILBERT, P.A. EMPLOYEE 401(K) PLAN 2022 401k financial data
Transfers to/from the plan	2022-12-31	$0
Total plan liabilities at end of year	2022-12-31	$0
Total plan liabilities at beginning of year	2022-12-31	$0
Total income from all sources	2022-12-31	$-131,286
Expenses. Total of all expenses incurred	2022-12-31	$278,389
Benefits paid (including direct rollovers)	2022-12-31	$273,869
Total plan assets at end of year	2022-12-31	$895,170
Total plan assets at beginning of year	2022-12-31	$1,304,845
Value of fidelity bond covering the plan	2022-12-31	$150,000
Assets. Value of tangible personal property	2022-12-31	$0
Total contributions received or receivable from participants	2022-12-31	$45,667
Assets. Value of loans (other than to participants)	2022-12-31	$0
Expenses. Other expenses not covered elsewhere	2022-12-31	$0
Contributions received from other sources (not participants or employers)	2022-12-31	$68,789
Other income received	2022-12-31	$-245,742
Noncash contributions received	2022-12-31	$0
Net income (gross income less expenses)	2022-12-31	$-409,675
Net plan assets at end of year (total assets less liabilities)	2022-12-31	$895,170
Net plan assets at beginning of year (total assets less liabilities)	2022-12-31	$1,304,845
Assets. Value of participant loans	2022-12-31	$17,549
Assets. Value of assets in partnership/joint-venture interests	2022-12-31	$0
Assets. Value of real-estate (other than employer real property)	2022-12-31	$0
Assets. Value of employer securities	2022-12-31	$0
Assets. Value of employer real property	2022-12-31	$0
Total contributions received or receivable from employer(s)	2022-12-31	$0
Value of certain deemed distributions of participant loans	2022-12-31	$0
Value of corrective distributions	2022-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2022-12-31	$4,520
2021 : DR. KELSEY MILBERT, P.A. EMPLOYEE 401(K) PLAN 2021 401k financial data
Transfers to/from the plan	2021-12-31	$0
Total plan liabilities at end of year	2021-12-31	$0
Total plan liabilities at beginning of year	2021-12-31	$0
Total income from all sources	2021-12-31	$179,968
Expenses. Total of all expenses incurred	2021-12-31	$4,971
Benefits paid (including direct rollovers)	2021-12-31	$355
Total plan assets at end of year	2021-12-31	$1,304,845
Total plan assets at beginning of year	2021-12-31	$1,129,848
Value of fidelity bond covering the plan	2021-12-31	$150,000
Assets. Value of tangible personal property	2021-12-31	$0
Total contributions received or receivable from participants	2021-12-31	$29,102
Assets. Value of loans (other than to participants)	2021-12-31	$0
Expenses. Other expenses not covered elsewhere	2021-12-31	$0
Contributions received from other sources (not participants or employers)	2021-12-31	$0
Other income received	2021-12-31	$150,866
Noncash contributions received	2021-12-31	$0
Net income (gross income less expenses)	2021-12-31	$174,997
Net plan assets at end of year (total assets less liabilities)	2021-12-31	$1,304,845
Net plan assets at beginning of year (total assets less liabilities)	2021-12-31	$1,129,848
Assets. Value of participant loans	2021-12-31	$9,867
Assets. Value of assets in partnership/joint-venture interests	2021-12-31	$0
Assets. Value of real-estate (other than employer real property)	2021-12-31	$0
Assets. Value of employer securities	2021-12-31	$0
Assets. Value of employer real property	2021-12-31	$0
Total contributions received or receivable from employer(s)	2021-12-31	$0
Value of certain deemed distributions of participant loans	2021-12-31	$0
Value of corrective distributions	2021-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2021-12-31	$4,616

Form 5500 Responses for DR. KELSEY MILBERT, P.A. EMPLOYEE 401(K) PLAN

2023: DR. KELSEY MILBERT, P.A. EMPLOYEE 401(K) PLAN 2023 form 5500 responses
2023-01-01	Type of plan entity	Single employer plan
2023-01-01	This submission is the final filing	No
2023-01-01	Plan is a collectively bargained plan	No
2023-01-01	Plan funding arrangement – Trust	Yes
2023-01-01	Plan benefit arrangement - Trust	Yes
2022: DR. KELSEY MILBERT, P.A. EMPLOYEE 401(K) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	This submission is the final filing	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: DR. KELSEY MILBERT, P.A. EMPLOYEE 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 – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	DR. KELSEY MILBERT, P.A.
Employer identification number (EIN):	853018091
NAIC Classification:	621210
NAIC Description:	Offices of Dentists