401k Plan data: TWO RIVERS FAMILY DENTAL, L.L.C. 401(K) PROFIT SHARING PLAN plan

TWO RIVERS FAMILY DENTAL, L.L.C. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	TWO RIVERS FAMILY DENTAL, L.L.C. 401(K) PROFIT SHARING PLAN
Plan identification number	001

TWO RIVERS FAMILY DENTAL, L.L.C. 401(K) PROFIT SHARING PLAN 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
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.
Participant-directed brokerage accounts provided as an investment option under the plan.
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

TWO RIVERS FAMILY DENTAL, L.L.C. has sponsored the creation of one or more 401k plans.

Company Name: TWO RIVERS FAMILY DENTAL, L.L.C.

Employer identification number (EIN): 472555918

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TWO RIVERS FAMILY DENTAL, L.L.C. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2022-01-01
001 2021-01-01 CHRIS HANSEN 2022-10-14 CHRIS HANSEN 2022-10-14
001 2020-01-01 CHRIS HANSEN 2021-07-07
001 2019-01-01 CHRIS HANSEN 2020-09-30
001 2018-01-01 CHRIS HANSEN 2019-10-09
001 2017-01-01
001 2017-01-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01
001	2022-01-01
001	2021-01-01	CHRIS HANSEN	2022-10-14	CHRIS HANSEN	2022-10-14
001	2020-01-01	CHRIS HANSEN	2021-07-07
001	2019-01-01	CHRIS HANSEN	2020-09-30
001	2018-01-01	CHRIS HANSEN	2019-10-09
001	2017-01-01
001	2017-01-01

Plan Statistics for TWO RIVERS FAMILY DENTAL, L.L.C. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for TWO RIVERS FAMILY DENTAL, L.L.C. 401(K) PROFIT SHARING PLAN

Measure Date Value
2021: TWO RIVERS FAMILY DENTAL, L.L.C. 401(K) PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 16
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 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 4
Total of all active and inactive participants 2021-01-01 16
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 16
Number of participants with account balances 2021-01-01 16
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 1
2020: TWO RIVERS FAMILY DENTAL, L.L.C. 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 18
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 12
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 3
Total of all active and inactive participants 2020-01-01 15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 15
Number of participants with account balances 2020-01-01 15
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: TWO RIVERS FAMILY DENTAL, L.L.C. 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 18
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 14
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 4
Total of all active and inactive participants 2019-01-01 18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 18
Number of participants with account balances 2019-01-01 18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 1
2018: TWO RIVERS FAMILY DENTAL, L.L.C. 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 14
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 9
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 7
Total of all active and inactive participants 2018-01-01 16
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 16
Number of participants with account balances 2018-01-01 16
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: TWO RIVERS FAMILY DENTAL, L.L.C. 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 12
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 6
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 7
Total of all active and inactive participants 2017-01-01 13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 13
Number of participants with account balances 2017-01-01 13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0

Measure	Date	Value
2021: TWO RIVERS FAMILY DENTAL, L.L.C. 401(K) PROFIT SHARING PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	16
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	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	4
Total of all active and inactive participants	2021-01-01	16
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	16
Number of participants with account balances	2021-01-01	16
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	1
2020: TWO RIVERS FAMILY DENTAL, L.L.C. 401(K) PROFIT SHARING PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	18
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	12
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	3
Total of all active and inactive participants	2020-01-01	15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	15
Number of participants with account balances	2020-01-01	15
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: TWO RIVERS FAMILY DENTAL, L.L.C. 401(K) PROFIT SHARING PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	18
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	14
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	4
Total of all active and inactive participants	2019-01-01	18
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	18
Number of participants with account balances	2019-01-01	18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	1
2018: TWO RIVERS FAMILY DENTAL, L.L.C. 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	14
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	9
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	7
Total of all active and inactive participants	2018-01-01	16
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	16
Number of participants with account balances	2018-01-01	16
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: TWO RIVERS FAMILY DENTAL, L.L.C. 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	12
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	6
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	7
Total of all active and inactive participants	2017-01-01	13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	13
Number of participants with account balances	2017-01-01	13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0

Financial Data on TWO RIVERS FAMILY DENTAL, L.L.C. 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2021 : TWO RIVERS FAMILY DENTAL, L.L.C. 401(K) PROFIT SHARING 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	$271,981
Expenses. Total of all expenses incurred	2021-12-31	$38,592
Benefits paid (including direct rollovers)	2021-12-31	$30,796
Total plan assets at end of year	2021-12-31	$1,116,471
Total plan assets at beginning of year	2021-12-31	$883,082
Value of fidelity bond covering the plan	2021-12-31	$205,000
Total contributions received or receivable from participants	2021-12-31	$95,146
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	$91,943
Noncash contributions received	2021-12-31	$0
Net income (gross income less expenses)	2021-12-31	$233,389
Net plan assets at end of year (total assets less liabilities)	2021-12-31	$1,116,471
Net plan assets at beginning of year (total assets less liabilities)	2021-12-31	$883,082
Assets. Value of assets in partnership/joint-venture interests	2021-12-31	$178,954
Total contributions received or receivable from employer(s)	2021-12-31	$84,892
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	$7,796
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
2020 : TWO RIVERS FAMILY DENTAL, L.L.C. 401(K) PROFIT SHARING PLAN 2020 401k financial data
Transfers to/from the plan	2020-12-31	$0
Total plan liabilities at end of year	2020-12-31	$0
Total plan liabilities at beginning of year	2020-12-31	$0
Total income from all sources	2020-12-31	$246,561
Expenses. Total of all expenses incurred	2020-12-31	$75,294
Benefits paid (including direct rollovers)	2020-12-31	$69,157
Total plan assets at end of year	2020-12-31	$883,082
Total plan assets at beginning of year	2020-12-31	$711,815
Value of fidelity bond covering the plan	2020-12-31	$205,000
Total contributions received or receivable from participants	2020-12-31	$83,667
Expenses. Other expenses not covered elsewhere	2020-12-31	$0
Contributions received from other sources (not participants or employers)	2020-12-31	$66,531
Other income received	2020-12-31	$35,280
Noncash contributions received	2020-12-31	$0
Net income (gross income less expenses)	2020-12-31	$171,267
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$883,082
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$711,815
Assets. Value of participant loans	2020-12-31	$1,806
Assets. Value of assets in partnership/joint-venture interests	2020-12-31	$180,715
Total contributions received or receivable from employer(s)	2020-12-31	$61,083
Value of certain deemed distributions of participant loans	2020-12-31	$0
Value of corrective distributions	2020-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2020-12-31	$6,137
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
2019 : TWO RIVERS FAMILY DENTAL, L.L.C. 401(K) PROFIT SHARING PLAN 2019 401k financial data
Transfers to/from the plan	2019-12-31	$0
Total plan liabilities at end of year	2019-12-31	$0
Total plan liabilities at beginning of year	2019-12-31	$0
Total income from all sources	2019-12-31	$241,743
Expenses. Total of all expenses incurred	2019-12-31	$11,334
Benefits paid (including direct rollovers)	2019-12-31	$8,538
Total plan assets at end of year	2019-12-31	$711,815
Total plan assets at beginning of year	2019-12-31	$481,406
Value of fidelity bond covering the plan	2019-12-31	$55,000
Total contributions received or receivable from participants	2019-12-31	$72,416
Expenses. Other expenses not covered elsewhere	2019-12-31	$0
Contributions received from other sources (not participants or employers)	2019-12-31	$56,825
Other income received	2019-12-31	$50,111
Noncash contributions received	2019-12-31	$0
Net income (gross income less expenses)	2019-12-31	$230,409
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$711,815
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$481,406
Assets. Value of participant loans	2019-12-31	$3,164
Assets. Value of assets in partnership/joint-venture interests	2019-12-31	$201,212
Total contributions received or receivable from employer(s)	2019-12-31	$62,391
Value of certain deemed distributions of participant loans	2019-12-31	$0
Value of corrective distributions	2019-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2019-12-31	$2,796
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
2018 : TWO RIVERS FAMILY DENTAL, L.L.C. 401(K) PROFIT SHARING PLAN 2018 401k financial data
Transfers to/from the plan	2018-12-31	$0
Total plan liabilities at end of year	2018-12-31	$0
Total plan liabilities at beginning of year	2018-12-31	$0
Total income from all sources	2018-12-31	$29,029
Expenses. Total of all expenses incurred	2018-12-31	$36,217
Benefits paid (including direct rollovers)	2018-12-31	$34,500
Total plan assets at end of year	2018-12-31	$481,406
Total plan assets at beginning of year	2018-12-31	$488,594
Value of fidelity bond covering the plan	2018-12-31	$55,000
Total contributions received or receivable from participants	2018-12-31	$55,017
Expenses. Other expenses not covered elsewhere	2018-12-31	$0
Contributions received from other sources (not participants or employers)	2018-12-31	$0
Other income received	2018-12-31	$-83,950
Noncash contributions received	2018-12-31	$0
Net income (gross income less expenses)	2018-12-31	$-7,188
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$481,406
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$488,594
Assets. Value of participant loans	2018-12-31	$4,647
Assets. Value of assets in partnership/joint-venture interests	2018-12-31	$204,113
Total contributions received or receivable from employer(s)	2018-12-31	$57,962
Value of certain deemed distributions of participant loans	2018-12-31	$0
Value of corrective distributions	2018-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$1,717
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
2017 : TWO RIVERS FAMILY DENTAL, L.L.C. 401(K) PROFIT SHARING PLAN 2017 401k financial data
Transfers to/from the plan	2017-12-31	$0
Total plan liabilities at end of year	2017-12-31	$0
Total plan liabilities at beginning of year	2017-12-31	$0
Total income from all sources	2017-12-31	$286,092
Expenses. Total of all expenses incurred	2017-12-31	$35,602
Benefits paid (including direct rollovers)	2017-12-31	$34,500
Total plan assets at end of year	2017-12-31	$454,094
Total plan assets at beginning of year	2017-12-31	$203,604
Value of fidelity bond covering the plan	2017-12-31	$55,000
Total contributions received or receivable from participants	2017-12-31	$31,474
Expenses. Other expenses not covered elsewhere	2017-12-31	$0
Contributions received from other sources (not participants or employers)	2017-12-31	$48,215
Other income received	2017-12-31	$195,280
Noncash contributions received	2017-12-31	$0
Net income (gross income less expenses)	2017-12-31	$250,490
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$454,094
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$203,604
Assets. Value of participant loans	2017-12-31	$6,067
Assets. Value of assets in partnership/joint-venture interests	2017-12-31	$242,086
Total contributions received or receivable from employer(s)	2017-12-31	$11,123
Value of certain deemed distributions of participant loans	2017-12-31	$0
Value of corrective distributions	2017-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$1,102
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0

Form 5500 Responses for TWO RIVERS FAMILY DENTAL, L.L.C. 401(K) PROFIT SHARING PLAN

2021: TWO RIVERS FAMILY DENTAL, L.L.C. 401(K) PROFIT SHARING 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
2020: TWO RIVERS FAMILY DENTAL, L.L.C. 401(K) PROFIT SHARING PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: TWO RIVERS FAMILY DENTAL, L.L.C. 401(K) PROFIT SHARING PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: TWO RIVERS FAMILY DENTAL, L.L.C. 401(K) PROFIT SHARING PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: TWO RIVERS FAMILY DENTAL, L.L.C. 401(K) PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	TWO RIVERS FAMILY DENTAL, L.L.C.
Employer identification number (EIN):	472555918
NAIC Classification:	621210
NAIC Description:	Offices of Dentists