401k Plan data: BLACKFORD DENTAL MANAGEMENT 401(K) PLAN plan

BLACKFORD DENTAL MANAGEMENT 401(K) PLAN 401k Plan overview

Plan Name	BLACKFORD DENTAL MANAGEMENT 401(K) PLAN
Plan identification number	001

BLACKFORD DENTAL MANAGEMENT 401(K) 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.
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.
Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

401k Sponsoring company profile

BLACKFORD DENTAL MANAGEMENT HOLDINGS, LLC has sponsored the creation of one or more 401k plans.

Company Name: BLACKFORD DENTAL MANAGEMENT HOLDINGS, LLC

Employer identification number (EIN): 473427799

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Additional information about BLACKFORD DENTAL MANAGEMENT HOLDINGS, LLC

Jurisdiction of Incorporation: State of Delaware Division of Corporations

Incorporation Date:

Company Identification Number: 5705923

More information about BLACKFORD DENTAL MANAGEMENT HOLDINGS, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BLACKFORD DENTAL MANAGEMENT 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2019-01-01
001 2018-01-01 ARMANDO YANEZ 2019-09-25
001 2017-01-01
001 2016-01-01
001 2015-01-01 EMILY LAPHAM EMILY LAPHAM 2016-10-17

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2019-01-01
001	2018-01-01	ARMANDO YANEZ	2019-09-25
001	2017-01-01
001	2016-01-01
001	2015-01-01	EMILY LAPHAM		EMILY LAPHAM	2016-10-17

Plan Statistics for BLACKFORD DENTAL MANAGEMENT 401(K) PLAN

401k plan membership statisitcs for BLACKFORD DENTAL MANAGEMENT 401(K) PLAN

Measure Date Value
2018: BLACKFORD DENTAL MANAGEMENT 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 380
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 0
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 50
Total of all active and inactive participants 2018-01-01 50
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 50
Number of participants with account balances 2018-01-01 50
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: BLACKFORD DENTAL MANAGEMENT 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 511
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 239
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 151
Total of all active and inactive participants 2017-01-01 390
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 390
Number of participants with account balances 2017-01-01 215
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: BLACKFORD DENTAL MANAGEMENT 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 440
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 444
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 64
Total of all active and inactive participants 2016-01-01 508
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 508
Number of participants with account balances 2016-01-01 198
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: BLACKFORD DENTAL MANAGEMENT 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 135
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 73
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 45
Total of all active and inactive participants 2015-01-01 118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 118
Number of participants with account balances 2015-01-01 105
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0

Measure	Date	Value
2018: BLACKFORD DENTAL MANAGEMENT 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	380
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	0
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	50
Total of all active and inactive participants	2018-01-01	50
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	50
Number of participants with account balances	2018-01-01	50
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: BLACKFORD DENTAL MANAGEMENT 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	511
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	239
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	151
Total of all active and inactive participants	2017-01-01	390
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	390
Number of participants with account balances	2017-01-01	215
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: BLACKFORD DENTAL MANAGEMENT 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	440
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	444
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	64
Total of all active and inactive participants	2016-01-01	508
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	508
Number of participants with account balances	2016-01-01	198
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: BLACKFORD DENTAL MANAGEMENT 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	135
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	73
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	45
Total of all active and inactive participants	2015-01-01	118
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	118
Number of participants with account balances	2015-01-01	105
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0

Financial Data on BLACKFORD DENTAL MANAGEMENT 401(K) PLAN

Measure	Date	Value
2018 : BLACKFORD DENTAL MANAGEMENT 401(K) PLAN 2018 401k financial data
Unrealized appreciation/depreciation of real estate assets	2018-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2018-12-31	$0
Total unrealized appreciation/depreciation of assets	2018-12-31	$0
Total transfer of assets to this plan	2018-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2018-12-31	$0
Total income from all sources (including contributions)	2018-12-31	$63,496
Total loss/gain on sale of assets	2018-12-31	$0
Total of all expenses incurred	2018-12-31	$790,420
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2018-12-31	$763,234
Expenses. Certain deemed distributions of participant loans	2018-12-31	$0
Value of total corrective distributions	2018-12-31	$1,232
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2018-12-31	$112,012
Value of total assets at end of year	2018-12-31	$834,509
Value of total assets at beginning of year	2018-12-31	$1,561,433
Total of administrative expenses incurred including professional, contract, advisory and management fees	2018-12-31	$25,954
Total income from rents	2018-12-31	$0
Total interest from all sources	2018-12-31	$98
Total dividends received (eg from common stock, registered investment company shares)	2018-12-31	$563
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2018-12-31	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2018-12-31	$0
Total dividends received from registered investment company shares (eg mutual funds)	2018-12-31	$563
Administrative expenses professional fees incurred	2018-12-31	$0
Was this plan covered by a fidelity bond	2018-12-31	Yes
Value of fidelity bond cover	2018-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2018-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2018-12-31	No
Contributions received from participants	2018-12-31	$112,012
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$4,400
Participant contributions at end of year	2018-12-31	$0
Participant contributions at beginning of year	2018-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2018-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2018-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2018-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2018-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2018-12-31	$0
Other income not declared elsewhere	2018-12-31	$0
Administrative expenses (other) incurred	2018-12-31	$0
Liabilities. Value of operating payables at beginning of year	2018-12-31	$0
Total non interest bearing cash at end of year	2018-12-31	$0
Total non interest bearing cash at beginning of year	2018-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Value of net income/loss	2018-12-31	$-726,924
Value of net assets at end of year (total assets less liabilities)	2018-12-31	$834,509
Value of net assets at beginning of year (total assets less liabilities)	2018-12-31	$1,561,433
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2018-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2018-12-31	No
Were any leases to which the plan was party in default or uncollectible	2018-12-31	No
Investment advisory and management fees	2018-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2018-12-31	$33,514
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2018-12-31	$23,555
Value of interest in pooled separate accounts at end of year	2018-12-31	$115,927
Value of interest in pooled separate accounts at beginning of year	2018-12-31	$155,071
Interest on participant loans	2018-12-31	$77
Income. Interest from loans (other than to participants)	2018-12-31	$0
Interest earned on other investments	2018-12-31	$21
Income. Interest from US Government securities	2018-12-31	$0
Income. Interest from corporate debt instruments	2018-12-31	$0
Value of interest in common/collective trusts at end of year	2018-12-31	$684,840
Value of interest in common/collective trusts at beginning of year	2018-12-31	$1,376,946
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2018-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2018-12-31	$228
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2018-12-31	$1,461
Expenses. Payments to insurance carriers foe the provision of benefits	2018-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2018-12-31	$-4,165
Net investment gain/loss from pooled separate accounts	2018-12-31	$-819
Net investment gain or loss from common/collective trusts	2018-12-31	$-44,193
Net gain/loss from 103.12 investment entities	2018-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2018-12-31	No
Was there a failure to transmit to the plan any participant contributions	2018-12-31	No
Has the plan failed to provide any benefit when due under the plan	2018-12-31	No
Contributions received in cash from employer	2018-12-31	$0
Employer contributions (assets) at end of year	2018-12-31	$0
Employer contributions (assets) at beginning of year	2018-12-31	$0
Income. Dividends from preferred stock	2018-12-31	$0
Income. Dividends from common stock	2018-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2018-12-31	$763,234
Contract administrator fees	2018-12-31	$25,954
Liabilities. Value of benefit claims payable at beginning of year	2018-12-31	$0
Did the plan have assets held for investment	2018-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2018-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2018-12-31	No
Aggregate proceeds on sale of assets	2018-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2018-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2018-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2018-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2018-12-31	Disclaimer
Accountancy firm name	2018-12-31	TROUT, EBERSOLE & GROFF LLP
Accountancy firm EIN	2018-12-31	231551315
2017 : BLACKFORD DENTAL MANAGEMENT 401(K) PLAN 2017 401k financial data
Unrealized appreciation/depreciation of real estate assets	2017-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2017-12-31	$0
Total unrealized appreciation/depreciation of assets	2017-12-31	$0
Total transfer of assets to this plan	2017-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-12-31	$0
Expenses. Interest paid	2017-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2017-12-31	$0
Total income from all sources (including contributions)	2017-12-31	$645,163
Total loss/gain on sale of assets	2017-12-31	$0
Total of all expenses incurred	2017-12-31	$802,614
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-12-31	$759,195
Expenses. Certain deemed distributions of participant loans	2017-12-31	$0
Value of total corrective distributions	2017-12-31	$22,459
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-12-31	$417,619
Value of total assets at end of year	2017-12-31	$1,561,433
Value of total assets at beginning of year	2017-12-31	$1,718,884
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-12-31	$20,960
Total income from rents	2017-12-31	$0
Total interest from all sources	2017-12-31	$1,901
Total dividends received (eg from common stock, registered investment company shares)	2017-12-31	$339
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2017-12-31	$339
Administrative expenses professional fees incurred	2017-12-31	$0
Was this plan covered by a fidelity bond	2017-12-31	Yes
Value of fidelity bond cover	2017-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2017-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2017-12-31	No
Contributions received from participants	2017-12-31	$415,187
Participant contributions at end of year	2017-12-31	$4,400
Participant contributions at beginning of year	2017-12-31	$4,503
Participant contributions at end of year	2017-12-31	$0
Participant contributions at beginning of year	2017-12-31	$11,046
Assets. Other investments not covered elsewhere at beginning of year	2017-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2017-12-31	$2,432
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2017-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2017-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-12-31	$0
Other income not declared elsewhere	2017-12-31	$0
Administrative expenses (other) incurred	2017-12-31	$0
Liabilities. Value of operating payables at beginning of year	2017-12-31	$0
Total non interest bearing cash at end of year	2017-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Income. Non cash contributions	2017-12-31	$0
Value of net income/loss	2017-12-31	$-157,451
Value of net assets at end of year (total assets less liabilities)	2017-12-31	$1,561,433
Value of net assets at beginning of year (total assets less liabilities)	2017-12-31	$1,718,884
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-12-31	No
Were any leases to which the plan was party in default or uncollectible	2017-12-31	No
Investment advisory and management fees	2017-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-12-31	$23,555
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-12-31	$10,754
Value of interest in pooled separate accounts at end of year	2017-12-31	$155,071
Value of interest in pooled separate accounts at beginning of year	2017-12-31	$147,166
Interest on participant loans	2017-12-31	$346
Income. Interest from loans (other than to participants)	2017-12-31	$0
Interest earned on other investments	2017-12-31	$1,555
Income. Interest from US Government securities	2017-12-31	$0
Income. Interest from corporate debt instruments	2017-12-31	$0
Value of interest in common/collective trusts at end of year	2017-12-31	$1,376,946
Value of interest in common/collective trusts at beginning of year	2017-12-31	$1,124,861
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-12-31	$1,461
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-12-31	$420,554
Expenses. Payments to insurance carriers foe the provision of benefits	2017-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-12-31	$3,179
Net investment gain/loss from pooled separate accounts	2017-12-31	$28,397
Net investment gain or loss from common/collective trusts	2017-12-31	$193,728
Net gain/loss from 103.12 investment entities	2017-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-12-31	No
Was there a failure to transmit to the plan any participant contributions	2017-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2017-12-31	No
Contributions received in cash from employer	2017-12-31	$0
Employer contributions (assets) at end of year	2017-12-31	$0
Employer contributions (assets) at beginning of year	2017-12-31	$0
Income. Dividends from preferred stock	2017-12-31	$0
Income. Dividends from common stock	2017-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-12-31	$759,195
Contract administrator fees	2017-12-31	$20,960
Liabilities. Value of benefit claims payable at beginning of year	2017-12-31	$0
Did the plan have assets held for investment	2017-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-12-31	No
Aggregate proceeds on sale of assets	2017-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2017-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2017-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2017-12-31	Disclaimer
Accountancy firm name	2017-12-31	TROUT, EBERSOLE & GROFF LLP
Accountancy firm EIN	2017-12-31	231551315
2016 : BLACKFORD DENTAL MANAGEMENT 401(K) PLAN 2016 401k financial data
Total transfer of assets to this plan	2016-12-31	$1,007,856
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$200
Total income from all sources (including contributions)	2016-12-31	$563,051
Total of all expenses incurred	2016-12-31	$320,452
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$303,055
Expenses. Certain deemed distributions of participant loans	2016-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$529,290
Value of total assets at end of year	2016-12-31	$1,718,884
Value of total assets at beginning of year	2016-12-31	$468,629
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$17,397
Total interest from all sources	2016-12-31	$299
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$128
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2016-12-31	$128
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2016-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$487,433
Participant contributions at end of year	2016-12-31	$4,503
Participant contributions at beginning of year	2016-12-31	$11,579
Participant contributions at end of year	2016-12-31	$11,046
Assets. Other investments not covered elsewhere at end of year	2016-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2016-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2016-12-31	$41,857
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2016-12-31	$5,305
Assets. Loans (other than to participants) at end of year	2016-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2016-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-12-31	$0
Liabilities. Value of operating payables at end of year	2016-12-31	$0
Liabilities. Value of operating payables at beginning of year	2016-12-31	$200
Total non interest bearing cash at beginning of year	2016-12-31	$202
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$242,599
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$1,718,884
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$468,429
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Investment advisory and management fees	2016-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$10,754
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$360,392
Value of interest in pooled separate accounts at end of year	2016-12-31	$147,166
Income. Interest from loans (other than to participants)	2016-12-31	$299
Interest earned on other investments	2016-12-31	$0
Value of interest in common/collective trusts at end of year	2016-12-31	$1,124,861
Value of interest in common/collective trusts at beginning of year	2016-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$12,628
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$12,628
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$420,554
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$83,828
Net investment gain/loss from pooled separate accounts	2016-12-31	$8,213
Net investment gain or loss from common/collective trusts	2016-12-31	$25,121
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Employer contributions (assets) at end of year	2016-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$297,750
Contract administrator fees	2016-12-31	$17,397
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	TROUT, EBERSOLE & GROFF LLP
Accountancy firm EIN	2016-12-31	231551315
2015 : BLACKFORD DENTAL MANAGEMENT 401(K) PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total transfer of assets from this plan	2015-12-31	$903,459
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$200
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$200
Total income from all sources (including contributions)	2015-12-31	$232,185
Total loss/gain on sale of assets	2015-12-31	$5,053
Total of all expenses incurred	2015-12-31	$74,183
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$68,059
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$200,830
Value of total assets at end of year	2015-12-31	$468,629
Value of total assets at beginning of year	2015-12-31	$1,214,086
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$6,124
Total interest from all sources	2015-12-31	$473
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$32,679
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2015-12-31	$32,679
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$1,000,000
If this is an individual account plan, was there a blackout period	2015-12-31	No
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$200,830
Participant contributions at end of year	2015-12-31	$11,579
Participant contributions at beginning of year	2015-12-31	$13,225
Participant contributions at beginning of year	2015-12-31	$33,703
Assets. Other investments not covered elsewhere at end of year	2015-12-31	$83,828
Assets. Other investments not covered elsewhere at beginning of year	2015-12-31	$425,510
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$222
Administrative expenses (other) incurred	2015-12-31	$100
Liabilities. Value of operating payables at end of year	2015-12-31	$200
Liabilities. Value of operating payables at beginning of year	2015-12-31	$200
Total non interest bearing cash at end of year	2015-12-31	$202
Total non interest bearing cash at beginning of year	2015-12-31	$200
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$158,002
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$468,429
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$1,213,886
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Investment advisory and management fees	2015-12-31	$6,024
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$360,392
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$529,178
Interest on participant loans	2015-12-31	$473
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-12-31	$12,628
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-12-31	$15,522
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-12-31	$15,522
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-6,850
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Employer contributions (assets) at beginning of year	2015-12-31	$196,526
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$68,059
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Aggregate proceeds on sale of assets	2015-12-31	$517,341
Aggregate carrying amount (costs) on sale of assets	2015-12-31	$512,288
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	TROUT, EBERSOLE & GROFF LLP
Accountancy firm EIN	2015-12-31	231551315

Form 5500 Responses for BLACKFORD DENTAL MANAGEMENT 401(K) PLAN

2018: BLACKFORD DENTAL MANAGEMENT 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: BLACKFORD DENTAL MANAGEMENT 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
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 funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: BLACKFORD DENTAL MANAGEMENT 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: BLACKFORD DENTAL MANAGEMENT 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

528394

Policy instance

Insurance contract or identification number	528394
Number of Individuals Covered	163
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $528
Total amount of fees paid to insurance company	USD $55
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $528
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	REFERRAL/SERVICE FEE

PRINCIPAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61271 )

Policy contract number

528394

Policy instance

Insurance contract or identification number	528394
Number of Individuals Covered	504
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $500
Total amount of fees paid to insurance company	USD $75
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $158
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	REFERRAL/SERVICE FEE
Insurance broker name	MANNIX, WILLIAM J.

Potentially related plans

BLACKFORD DENTAL MANAGEMENT LLC 401(K) PLAN [EIN = 461516882]

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Company Name:	BLACKFORD DENTAL MANAGEMENT HOLDINGS, LLC
Employer identification number (EIN):	473427799
NAIC Classification:	621210
NAIC Description:	Offices of Dentists

Jurisdiction of Incorporation:	State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number:	5705923