401k Plan data: BLOOMINGTON DENTAL 401(K) PLAN plan

BLOOMINGTON DENTAL 401(K) PLAN 401k Plan overview

Plan Name	BLOOMINGTON DENTAL 401(K) PLAN
Plan identification number	001

BLOOMINGTON DENTAL 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.
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

BLOOMINGTON DENTAL has sponsored the creation of one or more 401k plans.

Company Name: BLOOMINGTON DENTAL

Employer identification number (EIN): 870624842

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BLOOMINGTON DENTAL 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 CHRIS A. NIELSON 2024-10-20
001 2022-01-01 CHRIS A. NIELSON 2023-06-29
001 2021-01-01 CHRIS A. NIELSON 2022-08-03
001 2020-01-01 CHRIS A. NIELSON 2021-10-15
001 2019-01-01 CHRIS A. NIELSON 2020-10-14
001 2018-01-01 CHRIS A. NIELSON 2019-10-01
001 2017-01-01 CHRIS A. NIELSON 2018-10-03
001 2016-01-01 CHRIS A. NIELSON 2017-10-10
001 2015-01-01 CHRIS A. NIELSON 2016-10-11
001 2014-01-01 CHRIS A. NIELSON
001 2013-01-01 CHRIS A. NIELSON
001 2012-01-01 CHRIS A. NIELSON
001 2011-01-01 CHRIS A. NIELSON
001 2010-01-01 CHRIS A. NIELSON
001 2009-01-01 CHRIS A NIELSON

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2023-01-01	CHRIS A. NIELSON	2024-10-20
001	2022-01-01	CHRIS A. NIELSON	2023-06-29
001	2021-01-01	CHRIS A. NIELSON	2022-08-03
001	2020-01-01	CHRIS A. NIELSON	2021-10-15
001	2019-01-01	CHRIS A. NIELSON	2020-10-14
001	2018-01-01	CHRIS A. NIELSON	2019-10-01
001	2017-01-01	CHRIS A. NIELSON	2018-10-03
001	2016-01-01	CHRIS A. NIELSON	2017-10-10
001	2015-01-01	CHRIS A. NIELSON	2016-10-11
001	2014-01-01	CHRIS A. NIELSON
001	2013-01-01	CHRIS A. NIELSON
001	2012-01-01	CHRIS A. NIELSON
001	2011-01-01	CHRIS A. NIELSON
001	2010-01-01	CHRIS A. NIELSON
001	2009-01-01	CHRIS A NIELSON

Plan Statistics for BLOOMINGTON DENTAL 401(K) PLAN

401k plan membership statisitcs for BLOOMINGTON DENTAL 401(K) PLAN

Measure Date Value
2014: BLOOMINGTON DENTAL 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 3
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 7
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 0
Total of all active and inactive participants 2014-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 7
Number of participants with account balances 2014-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: BLOOMINGTON DENTAL 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 3
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 0
Total of all active and inactive participants 2013-01-01 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 3
Number of participants with account balances 2013-01-01 3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: BLOOMINGTON DENTAL 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 5
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 7
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 7
Number of participants with account balances 2012-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: BLOOMINGTON DENTAL 401(K) 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 5
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 0
Total of all active and inactive participants 2011-01-01 5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 5
Number of participants with account balances 2011-01-01 5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: BLOOMINGTON DENTAL 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 3
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
Number of participants with account balances 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: BLOOMINGTON DENTAL 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 0
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 3
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 0
Total of all active and inactive participants 2009-01-01 3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 3
Number of participants with account balances 2009-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2014: BLOOMINGTON DENTAL 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	3
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	7
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	0
Total of all active and inactive participants	2014-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	7
Number of participants with account balances	2014-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: BLOOMINGTON DENTAL 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	3
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	0
Total of all active and inactive participants	2013-01-01	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	3
Number of participants with account balances	2013-01-01	3
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: BLOOMINGTON DENTAL 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	5
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	7
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	7
Number of participants with account balances	2012-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: BLOOMINGTON DENTAL 401(K) 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	5
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	0
Total of all active and inactive participants	2011-01-01	5
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	5
Number of participants with account balances	2011-01-01	5
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: BLOOMINGTON DENTAL 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	3
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
Number of participants with account balances	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: BLOOMINGTON DENTAL 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	0
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	3
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	0
Total of all active and inactive participants	2009-01-01	3
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	3
Number of participants with account balances	2009-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on BLOOMINGTON DENTAL 401(K) PLAN

Measure	Date	Value
2014 : BLOOMINGTON DENTAL 401(K) PLAN 2014 401k financial data
Transfers to/from the plan	2014-12-31	$0
Total plan liabilities at end of year	2014-12-31	$0
Total plan liabilities at beginning of year	2014-12-31	$0
Total income from all sources	2014-12-31	$44,610
Expenses. Total of all expenses incurred	2014-12-31	$3,338
Benefits paid (including direct rollovers)	2014-12-31	$0
Total plan assets at end of year	2014-12-31	$230,831
Total plan assets at beginning of year	2014-12-31	$189,559
Total contributions received or receivable from participants	2014-12-31	$28,490
Expenses. Other expenses not covered elsewhere	2014-12-31	$3,338
Contributions received from other sources (not participants or employers)	2014-12-31	$0
Other income received	2014-12-31	$7,938
Noncash contributions received	2014-12-31	$0
Net income (gross income less expenses)	2014-12-31	$41,272
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$230,831
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$189,559
Total contributions received or receivable from employer(s)	2014-12-31	$8,182
Value of certain deemed distributions of participant loans	2014-12-31	$0
Value of corrective distributions	2014-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$0
2013 : BLOOMINGTON DENTAL 401(K) PLAN 2013 401k financial data
Transfers to/from the plan	2013-12-31	$0
Total plan liabilities at end of year	2013-12-31	$0
Total plan liabilities at beginning of year	2013-12-31	$0
Total income from all sources	2013-12-31	$63,829
Expenses. Total of all expenses incurred	2013-12-31	$5,918
Benefits paid (including direct rollovers)	2013-12-31	$3,305
Total plan assets at end of year	2013-12-31	$189,559
Total plan assets at beginning of year	2013-12-31	$131,648
Total contributions received or receivable from participants	2013-12-31	$18,684
Expenses. Other expenses not covered elsewhere	2013-12-31	$2,613
Contributions received from other sources (not participants or employers)	2013-12-31	$19,686
Other income received	2013-12-31	$18,672
Noncash contributions received	2013-12-31	$0
Net income (gross income less expenses)	2013-12-31	$57,911
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$189,559
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$131,648
Total contributions received or receivable from employer(s)	2013-12-31	$6,787
Value of certain deemed distributions of participant loans	2013-12-31	$0
Value of corrective distributions	2013-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$0
2012 : BLOOMINGTON DENTAL 401(K) PLAN 2012 401k financial data
Transfers to/from the plan	2012-12-31	$0
Total plan liabilities at end of year	2012-12-31	$0
Total plan liabilities at beginning of year	2012-12-31	$0
Total income from all sources	2012-12-31	$39,876
Expenses. Total of all expenses incurred	2012-12-31	$4,039
Benefits paid (including direct rollovers)	2012-12-31	$1,879
Total plan assets at end of year	2012-12-31	$131,648
Total plan assets at beginning of year	2012-12-31	$95,811
Total contributions received or receivable from participants	2012-12-31	$18,857
Expenses. Other expenses not covered elsewhere	2012-12-31	$2,160
Contributions received from other sources (not participants or employers)	2012-12-31	$0
Other income received	2012-12-31	$13,394
Noncash contributions received	2012-12-31	$0
Net income (gross income less expenses)	2012-12-31	$35,837
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$131,648
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$95,811
Total contributions received or receivable from employer(s)	2012-12-31	$7,625
Value of certain deemed distributions of participant loans	2012-12-31	$0
Value of corrective distributions	2012-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2012-12-31	$0
2011 : BLOOMINGTON DENTAL 401(K) 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	$23,827
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	$95,811
Total plan assets at beginning of year	2011-12-31	$71,984
Total contributions received or receivable from participants	2011-12-31	$18,579
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	$-2,220
Noncash contributions received	2011-12-31	$0
Net income (gross income less expenses)	2011-12-31	$23,827
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$95,811
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$71,984
Total contributions received or receivable from employer(s)	2011-12-31	$7,468
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
2010 : BLOOMINGTON DENTAL 401(K) PLAN 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	$39,043
Expenses. Total of all expenses incurred	2010-12-31	$0
Benefits paid (including direct rollovers)	2010-12-31	$0
Total plan assets at end of year	2010-12-31	$71,984
Total plan assets at beginning of year	2010-12-31	$32,941
Value of fidelity bond covering the plan	2010-12-31	$10,000
Total contributions received or receivable from participants	2010-12-31	$20,960
Expenses. Other expenses not covered elsewhere	2010-12-31	$0
Contributions received from other sources (not participants or employers)	2010-12-31	$6,659
Other income received	2010-12-31	$4,365
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$39,043
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$71,984
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$32,941
Total contributions received or receivable from employer(s)	2010-12-31	$7,059
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

Form 5500 Responses for BLOOMINGTON DENTAL 401(K) PLAN

2014: BLOOMINGTON DENTAL 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: BLOOMINGTON DENTAL 401(K) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Insurance	Yes
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement – Insurance	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: BLOOMINGTON DENTAL 401(K) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: BLOOMINGTON DENTAL 401(K) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
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: BLOOMINGTON DENTAL 401(K) PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: BLOOMINGTON DENTAL 401(K) PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	First time form 5500 has been submitted	Yes
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

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

Policy contract number

91857

Policy instance

Insurance contract or identification number	91857
Number of Individuals Covered	6
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $2,047
Commission paid to Insurance Broker	USD $2,047
Insurance broker organization code?	3
Insurance broker name	PERIOPE, LC

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

Policy contract number

91857

Policy instance

Insurance contract or identification number	91857
Number of Individuals Covered	3
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of fees paid to insurance company	USD $1,572
Amount paid for insurance broker fees	1572
Insurance broker organization code?	3
Insurance broker name	PERIOPE, LC

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

Policy contract number

91857

Policy instance

Insurance contract or identification number	91857
Number of Individuals Covered	4
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of fees paid to insurance company	USD $1,201
Amount paid for insurance broker fees	332
Insurance broker organization code?	3
Insurance broker name	PERIOPE, L.C.

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

Policy contract number

91857

Policy instance

Insurance contract or identification number	91857
Number of Individuals Covered	5
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of fees paid to insurance company	USD $751

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

Policy contract number

91857

Policy instance

Insurance contract or identification number	91857
Number of Individuals Covered	3
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of fees paid to insurance company	USD $494

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Company Name:	BLOOMINGTON DENTAL
Employer identification number (EIN):	870624842
NAIC Classification:	621210
NAIC Description:	Offices of Dentists