401k Plan data: TRUE SPIN DENTAL LLC EMPLOYEE GROUP HEALTH PLAN plan

TRUE SPIN DENTAL LLC EMPLOYEE GROUP HEALTH PLAN 401k Plan overview

Plan Name	TRUE SPIN DENTAL LLC EMPLOYEE GROUP HEALTH PLAN
Plan identification number	501

TRUE SPIN DENTAL LLC EMPLOYEE GROUP HEALTH PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision)

401k Sponsoring company profile

TRUE SPIN DENTAL LLC has sponsored the creation of one or more 401k plans.

Company Name: TRUE SPIN DENTAL LLC

Employer identification number (EIN): 900915988

NAIC Classification: 339110

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TRUE SPIN DENTAL LLC EMPLOYEE GROUP HEALTH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2020-01-01 ERIC MILMAN 2021-10-08 ERIC MILMAN 2021-10-08
501 2019-01-01 ERIC MILMAN 2021-10-08 ERIC MILMAN 2021-10-08
501 2018-01-01 ERIC MILMAN 2021-10-08 ERIC MILMAN 2021-10-08
501 2017-01-01 ERIC MILMAN ERIC MILMAN 2018-07-31

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
501	2020-01-01	ERIC MILMAN	2021-10-08	ERIC MILMAN	2021-10-08
501	2019-01-01	ERIC MILMAN	2021-10-08	ERIC MILMAN	2021-10-08
501	2018-01-01	ERIC MILMAN	2021-10-08	ERIC MILMAN	2021-10-08
501	2017-01-01	ERIC MILMAN		ERIC MILMAN	2018-07-31

Plan Statistics for TRUE SPIN DENTAL LLC EMPLOYEE GROUP HEALTH PLAN

401k plan membership statisitcs for TRUE SPIN DENTAL LLC EMPLOYEE GROUP HEALTH PLAN

Measure Date Value
2017: TRUE SPIN DENTAL LLC EMPLOYEE GROUP HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 0
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 7
Total of all active and inactive participants 2017-01-01 7
Total participants 2017-01-01 7
Number of employers contributing to the scheme 2017-01-01 1

Measure	Date	Value
2017: TRUE SPIN DENTAL LLC EMPLOYEE GROUP HEALTH PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	0
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	7
Total of all active and inactive participants	2017-01-01	7
Total participants	2017-01-01	7
Number of employers contributing to the scheme	2017-01-01	1

Form 5500 Responses for TRUE SPIN DENTAL LLC EMPLOYEE GROUP HEALTH PLAN

2017: TRUE SPIN DENTAL LLC EMPLOYEE GROUP HEALTH PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	First time form 5500 has been submitted	Yes
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 benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

ALLIED NATIONAL COMPANIES (National Association of Insurance Commissioners NAIC id number: 00000 )

Policy contract number

282868

Policy instance

Insurance contract or identification number	282868
Number of Individuals Covered	7
Insurance policy start date	2017-09-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $371
Total amount of fees paid to insurance company	USD $992
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	Yes
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 $371
Insurance broker name	SYNDICATED INSURANCE SERV INC

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Company Name:	TRUE SPIN DENTAL LLC
Employer identification number (EIN):	900915988
NAIC Classification:	339110