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MARK K. KOIZUMI, D.D.S., INC. PROFIT SHARING PLAN 401k Plan overview

Plan NameMARK K. KOIZUMI, D.D.S., INC. PROFIT SHARING PLAN
Plan identification number 001

MARK K. KOIZUMI, D.D.S., INC. PROFIT SHARING PLAN Benefits

401k Plan TypeDefined 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
  • Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of 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.
  • Life insurance

401k Sponsoring company profile

MARK K. KOIZUMI, D.D.S., INC. has sponsored the creation of one or more 401k plans.

Company Name:MARK K. KOIZUMI, D.D.S., INC.
Employer identification number (EIN):990171687
NAIC Classification:621210
NAIC Description:Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MARK K. KOIZUMI, D.D.S., INC. PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
0012023-01-01MARK KOIZUMI2024-06-28 MARK KOIZUMI2024-06-28
0012022-01-01
0012021-01-01
0012020-01-01
0012019-01-01
0012018-01-01
0012017-01-01MARK KOIZUMI2018-05-09 MARK KOIZUMI2018-05-09
0012016-01-01MARK KOIZUMI2017-09-15 MARK KOIZUMI2017-09-15
0012015-01-01MARK KOIZUMI2016-09-29 MARK KOIZUMI2016-09-29
0012014-01-01MARK KOIZUMI2015-03-27 MARK KOIZUMI2015-03-27
0012013-01-01MARK KOIZUMI2014-06-04 MARK KOIZUMI2014-06-04
0012012-01-01MARK KOIZUMI2013-04-12 MARK KOIZUMI2013-04-12
0012011-01-01MARK KOIZUMI2012-08-28 MARK KOIZUMI2012-08-28
0012010-01-01MARK KOIZUMI2011-08-31 MARK KOIZUMI2011-08-31

Plan Statistics for MARK K. KOIZUMI, D.D.S., INC. PROFIT SHARING PLAN

401k plan membership statisitcs for MARK K. KOIZUMI, D.D.S., INC. PROFIT SHARING PLAN

Measure Date Value
2022: MARK K. KOIZUMI, D.D.S., INC. PROFIT SHARING PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-014
Total number of active participants reported on line 7a of the Form 55002022-01-013
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-013
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2022-01-010
Total participants2022-01-013
Number of participants with account balances2022-01-013
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2022-01-010
2021: MARK K. KOIZUMI, D.D.S., INC. PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-014
Total number of active participants reported on line 7a of the Form 55002021-01-014
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-014
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2021-01-010
Total participants2021-01-014
Number of participants with account balances2021-01-013
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2021-01-010
2020: MARK K. KOIZUMI, D.D.S., INC. PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-013
Total number of active participants reported on line 7a of the Form 55002020-01-013
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-013
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2020-01-010
Total participants2020-01-013
Number of participants with account balances2020-01-013
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2020-01-010
2019: MARK K. KOIZUMI, D.D.S., INC. PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-014
Total number of active participants reported on line 7a of the Form 55002019-01-014
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-014
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2019-01-010
Total participants2019-01-014
Number of participants with account balances2019-01-013
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2019-01-010
2018: MARK K. KOIZUMI, D.D.S., INC. PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-013
Total number of active participants reported on line 7a of the Form 55002018-01-013
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-013
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2018-01-010
Total participants2018-01-013
Number of participants with account balances2018-01-013
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested2018-01-010

Financial Data on MARK K. KOIZUMI, D.D.S., INC. PROFIT SHARING PLAN

Measure Date Value
2022 : MARK K. KOIZUMI, D.D.S., INC. PROFIT SHARING PLAN 2022 401k financial data
Transfers to/from the plan2022-12-31$0
Total plan liabilities at end of year2022-12-31$0
Total plan liabilities at beginning of year2022-12-31$0
Total income from all sources2022-12-31$-4,831
Expenses. Total of all expenses incurred2022-12-31$3,500
Benefits paid (including direct rollovers)2022-12-31$3,500
Total plan assets at end of year2022-12-31$212,357
Total plan assets at beginning of year2022-12-31$220,688
Value of fidelity bond covering the plan2022-12-31$40,000
Total contributions received or receivable from participants2022-12-31$0
Expenses. Other expenses not covered elsewhere2022-12-31$0
Contributions received from other sources (not participants or employers)2022-12-31$0
Other income received2022-12-31$-4,831
Noncash contributions received2022-12-31$0
Net income (gross income less expenses)2022-12-31$-8,331
Net plan assets at end of year (total assets less liabilities)2022-12-31$212,357
Net plan assets at beginning of year (total assets less liabilities)2022-12-31$220,688
Total contributions received or receivable from employer(s)2022-12-31$0
Value of certain deemed distributions of participant loans2022-12-31$0
Value of corrective distributions2022-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2022-12-31$0
2021 : MARK K. KOIZUMI, D.D.S., INC. PROFIT SHARING PLAN 2021 401k financial data
Transfers to/from the plan2021-12-31$0
Total plan liabilities at end of year2021-12-31$0
Total plan liabilities at beginning of year2021-12-31$0
Total income from all sources2021-12-31$10,686
Expenses. Total of all expenses incurred2021-12-31$4,323
Benefits paid (including direct rollovers)2021-12-31$3,500
Total plan assets at end of year2021-12-31$220,688
Total plan assets at beginning of year2021-12-31$214,325
Value of fidelity bond covering the plan2021-12-31$40,000
Total contributions received or receivable from participants2021-12-31$0
Expenses. Other expenses not covered elsewhere2021-12-31$0
Contributions received from other sources (not participants or employers)2021-12-31$0
Other income received2021-12-31$10,686
Noncash contributions received2021-12-31$0
Net income (gross income less expenses)2021-12-31$6,363
Net plan assets at end of year (total assets less liabilities)2021-12-31$220,688
Net plan assets at beginning of year (total assets less liabilities)2021-12-31$214,325
Total contributions received or receivable from employer(s)2021-12-31$0
Value of certain deemed distributions of participant loans2021-12-31$0
Value of corrective distributions2021-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2021-12-31$823
2020 : MARK K. KOIZUMI, D.D.S., INC. PROFIT SHARING PLAN 2020 401k financial data
Total plan liabilities at beginning of year2020-12-31$0
Total income from all sources2020-12-31$9,075
Expenses. Total of all expenses incurred2020-12-31$742
Total plan assets at end of year2020-12-31$214,325
Total plan assets at beginning of year2020-12-31$205,992
Value of fidelity bond covering the plan2020-12-31$40,000
Other income received2020-12-31$9,075
Net income (gross income less expenses)2020-12-31$8,333
Net plan assets at end of year (total assets less liabilities)2020-12-31$214,325
Net plan assets at beginning of year (total assets less liabilities)2020-12-31$205,992
Expenses. Administrative service providers (salaries,fees and commissions)2020-12-31$742
2019 : MARK K. KOIZUMI, D.D.S., INC. PROFIT SHARING PLAN 2019 401k financial data
Transfers to/from the plan2019-12-31$0
Total plan liabilities at end of year2019-12-31$0
Total plan liabilities at beginning of year2019-12-31$0
Total income from all sources2019-12-31$9,926
Expenses. Total of all expenses incurred2019-12-31$4,239
Benefits paid (including direct rollovers)2019-12-31$3,500
Total plan assets at end of year2019-12-31$205,992
Total plan assets at beginning of year2019-12-31$200,305
Value of fidelity bond covering the plan2019-12-31$40,000
Total contributions received or receivable from participants2019-12-31$0
Expenses. Other expenses not covered elsewhere2019-12-31$0
Contributions received from other sources (not participants or employers)2019-12-31$0
Other income received2019-12-31$9,926
Noncash contributions received2019-12-31$0
Net income (gross income less expenses)2019-12-31$5,687
Net plan assets at end of year (total assets less liabilities)2019-12-31$205,992
Net plan assets at beginning of year (total assets less liabilities)2019-12-31$200,305
Total contributions received or receivable from employer(s)2019-12-31$0
Value of certain deemed distributions of participant loans2019-12-31$0
Value of corrective distributions2019-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2019-12-31$739
2018 : MARK K. KOIZUMI, D.D.S., INC. PROFIT SHARING PLAN 2018 401k financial data
Transfers to/from the plan2018-12-31$0
Total plan liabilities at end of year2018-12-31$0
Total plan liabilities at beginning of year2018-12-31$0
Total income from all sources2018-12-31$5,455
Expenses. Total of all expenses incurred2018-12-31$4,296
Benefits paid (including direct rollovers)2018-12-31$3,500
Total plan assets at end of year2018-12-31$200,305
Total plan assets at beginning of year2018-12-31$199,146
Value of fidelity bond covering the plan2018-12-31$40,000
Total contributions received or receivable from participants2018-12-31$0
Expenses. Other expenses not covered elsewhere2018-12-31$0
Contributions received from other sources (not participants or employers)2018-12-31$0
Other income received2018-12-31$5,455
Noncash contributions received2018-12-31$0
Net income (gross income less expenses)2018-12-31$1,159
Net plan assets at end of year (total assets less liabilities)2018-12-31$200,305
Net plan assets at beginning of year (total assets less liabilities)2018-12-31$199,146
Total contributions received or receivable from employer(s)2018-12-31$0
Value of certain deemed distributions of participant loans2018-12-31$0
Value of corrective distributions2018-12-31$0
Expenses. Administrative service providers (salaries,fees and commissions)2018-12-31$796

Form 5500 Responses for MARK K. KOIZUMI, D.D.S., INC. PROFIT SHARING PLAN

2022: MARK K. KOIZUMI, D.D.S., INC. PROFIT SHARING PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Submission has been amendedNo
2022-01-01This submission is the final filingNo
2022-01-01This return/report is a short plan year return/report (less than 12 months)No
2022-01-01Plan is a collectively bargained planNo
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan funding arrangement – TrustYes
2022-01-01Plan benefit arrangement – InsuranceYes
2022-01-01Plan benefit arrangement - TrustYes
2021: MARK K. KOIZUMI, D.D.S., INC. PROFIT SHARING PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan funding arrangement – TrustYes
2021-01-01Plan benefit arrangement – InsuranceYes
2021-01-01Plan benefit arrangement - TrustYes
2020: MARK K. KOIZUMI, D.D.S., INC. PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes
2019: MARK K. KOIZUMI, D.D.S., INC. PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan funding arrangement – TrustYes
2019-01-01Plan benefit arrangement – InsuranceYes
2019-01-01Plan benefit arrangement - TrustYes
2018: MARK K. KOIZUMI, D.D.S., INC. PROFIT SHARING PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Submission has been amendedNo
2018-01-01This submission is the final filingNo
2018-01-01This return/report is a short plan year return/report (less than 12 months)No
2018-01-01Plan is a collectively bargained planNo
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan funding arrangement – TrustYes
2018-01-01Plan benefit arrangement – InsuranceYes
2018-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

THE LAFAYETTE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65242 )
Policy contract numberC3508
Policy instance 1
Insurance contract or identification numberC3508
Number of Individuals Covered1
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $70
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,500
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $70
Insurance broker organization code?3
THE LAFAYETTE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65242 )
Policy contract numberC3508
Policy instance 1
Insurance contract or identification numberC3508
Number of Individuals Covered1
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $70
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $70
Insurance broker organization code?3
THE LAFAYETTE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65242 )
Policy contract numberC3508
Policy instance 1
Insurance contract or identification numberC3508
Number of Individuals Covered1
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $70
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Commission paid to Insurance BrokerUSD $70
Insurance broker organization code?3
THE LAFAYETTE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65242 )
Policy contract numberC3508
Policy instance 1
Insurance contract or identification numberC3508
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $70
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,500
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $70
Insurance broker organization code?3
THE LAFAYETTE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65242 )
Policy contract numberC3508
Policy instance 1
Insurance contract or identification numberC3508
Number of Individuals Covered1
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $70
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $3,500
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $70
Insurance broker organization code?3

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