401k Plan data: JONATHAN BLAIR WALDRON DMD PC 401(K) PROFIT SHARING PLAN plan

JONATHAN BLAIR WALDRON DMD PC 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	JONATHAN BLAIR WALDRON DMD PC 401(K) PROFIT SHARING PLAN
Plan identification number	001

JONATHAN BLAIR WALDRON DMD PC 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.
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.

401k Sponsoring company profile

JONATHAN BLAIR WALDRON DMD PC has sponsored the creation of one or more 401k plans.

Company Name: JONATHAN BLAIR WALDRON DMD PC

Employer identification number (EIN): 010688324

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Additional information about JONATHAN BLAIR WALDRON DMD PC

Jurisdiction of Incorporation: Georgia Department of States Corporations Division

Incorporation Date:

Company Identification Number: 138710

More information about JONATHAN BLAIR WALDRON DMD PC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JONATHAN BLAIR WALDRON DMD PC 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2018-01-01 JONATHAN BLAIR WALDRON JONATHAN BLAIR WALDRON 2019-03-05
001 2017-01-01 JONATHAN WALDRON JONATHAN WALDRON 2018-03-12
001 2016-01-01 JONATHAN WALDRON JONATHAN WALDRON 2017-03-29
001 2015-01-01 JONATHAN BLAIR WALDRON JONATHAN BLAIR WALDRON 2016-07-15
001 2014-01-01 JONATHAN BLAIR WALDRON JONATHAN BLAIR WALDRON 2015-07-15
001 2013-01-01 JONATHAN WALDRON JONATHAN WALDRON 2014-08-08

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
001	2018-01-01	JONATHAN BLAIR WALDRON	JONATHAN BLAIR WALDRON	2019-03-05
001	2017-01-01	JONATHAN WALDRON	JONATHAN WALDRON	2018-03-12
001	2016-01-01	JONATHAN WALDRON	JONATHAN WALDRON	2017-03-29
001	2015-01-01	JONATHAN BLAIR WALDRON	JONATHAN BLAIR WALDRON	2016-07-15
001	2014-01-01	JONATHAN BLAIR WALDRON	JONATHAN BLAIR WALDRON	2015-07-15
001	2013-01-01	JONATHAN WALDRON	JONATHAN WALDRON	2014-08-08

Plan Statistics for JONATHAN BLAIR WALDRON DMD PC 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for JONATHAN BLAIR WALDRON DMD PC 401(K) PROFIT SHARING PLAN

Measure Date Value
2018: JONATHAN BLAIR WALDRON DMD PC 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 18
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 19
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 1
Total of all active and inactive participants 2018-01-01 20
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 20
Number of participants with account balances 2018-01-01 20
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: JONATHAN BLAIR WALDRON DMD PC 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 16
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 14
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 1
Total of all active and inactive participants 2017-01-01 15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 15
Number of participants with account balances 2017-01-01 15
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: JONATHAN BLAIR WALDRON DMD PC 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 12
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 11
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 2
Total of all active and inactive participants 2016-01-01 13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 13
Number of participants with account balances 2016-01-01 13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: JONATHAN BLAIR WALDRON DMD PC 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 12
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 10
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 1
Total of all active and inactive participants 2015-01-01 11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 11
Number of participants with account balances 2015-01-01 11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: JONATHAN BLAIR WALDRON DMD PC 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 11
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 11
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 1
Total of all active and inactive participants 2014-01-01 12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 12
Number of participants with account balances 2014-01-01 12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: JONATHAN BLAIR WALDRON DMD PC 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 10
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 11
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 11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 11
Number of participants with account balances 2013-01-01 11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0

Measure	Date	Value
2018: JONATHAN BLAIR WALDRON DMD PC 401(K) PROFIT SHARING PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	18
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	19
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	1
Total of all active and inactive participants	2018-01-01	20
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	20
Number of participants with account balances	2018-01-01	20
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: JONATHAN BLAIR WALDRON DMD PC 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	16
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	14
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	1
Total of all active and inactive participants	2017-01-01	15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	15
Number of participants with account balances	2017-01-01	15
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: JONATHAN BLAIR WALDRON DMD PC 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	12
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	11
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	2
Total of all active and inactive participants	2016-01-01	13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	13
Number of participants with account balances	2016-01-01	13
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: JONATHAN BLAIR WALDRON DMD PC 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	12
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	10
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	1
Total of all active and inactive participants	2015-01-01	11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	11
Number of participants with account balances	2015-01-01	11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: JONATHAN BLAIR WALDRON DMD PC 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	11
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	11
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	1
Total of all active and inactive participants	2014-01-01	12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	12
Number of participants with account balances	2014-01-01	12
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: JONATHAN BLAIR WALDRON DMD PC 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	10
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	11
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	11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	11
Number of participants with account balances	2013-01-01	11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0

Financial Data on JONATHAN BLAIR WALDRON DMD PC 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2018 : JONATHAN BLAIR WALDRON DMD PC 401(K) PROFIT SHARING PLAN 2018 401k financial data
Total income from all sources	2018-12-31	$73,277
Expenses. Total of all expenses incurred	2018-12-31	$2,024
Benefits paid (including direct rollovers)	2018-12-31	$1,560
Total plan assets at end of year	2018-12-31	$527,991
Total plan assets at beginning of year	2018-12-31	$456,738
Value of fidelity bond covering the plan	2018-12-31	$385,000
Total contributions received or receivable from participants	2018-12-31	$85,621
Expenses. Other expenses not covered elsewhere	2018-12-31	$0
Contributions received from other sources (not participants or employers)	2018-12-31	$3,574
Other income received	2018-12-31	$-45,054
Net income (gross income less expenses)	2018-12-31	$71,253
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$527,991
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$456,738
Total contributions received or receivable from employer(s)	2018-12-31	$29,136
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$464
2017 : JONATHAN BLAIR WALDRON DMD PC 401(K) PROFIT SHARING PLAN 2017 401k financial data
Total income from all sources	2017-12-31	$158,008
Expenses. Total of all expenses incurred	2017-12-31	$11,220
Benefits paid (including direct rollovers)	2017-12-31	$10,742
Total plan assets at end of year	2017-12-31	$456,738
Total plan assets at beginning of year	2017-12-31	$309,950
Value of fidelity bond covering the plan	2017-12-31	$385,000
Total contributions received or receivable from participants	2017-12-31	$80,229
Expenses. Other expenses not covered elsewhere	2017-12-31	$0
Contributions received from other sources (not participants or employers)	2017-12-31	$0
Other income received	2017-12-31	$52,606
Net income (gross income less expenses)	2017-12-31	$146,788
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$456,738
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$309,950
Total contributions received or receivable from employer(s)	2017-12-31	$25,173
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$478
2016 : JONATHAN BLAIR WALDRON DMD PC 401(K) PROFIT SHARING PLAN 2016 401k financial data
Total income from all sources	2016-12-31	$107,196
Expenses. Total of all expenses incurred	2016-12-31	$288
Total plan assets at end of year	2016-12-31	$309,950
Total plan assets at beginning of year	2016-12-31	$203,042
Value of fidelity bond covering the plan	2016-12-31	$31,000
Total contributions received or receivable from participants	2016-12-31	$66,613
Expenses. Other expenses not covered elsewhere	2016-12-31	$0
Contributions received from other sources (not participants or employers)	2016-12-31	$0
Other income received	2016-12-31	$20,312
Net income (gross income less expenses)	2016-12-31	$106,908
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$309,950
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$203,042
Total contributions received or receivable from employer(s)	2016-12-31	$20,271
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$288
2015 : JONATHAN BLAIR WALDRON DMD PC 401(K) PROFIT SHARING PLAN 2015 401k financial data
Total income from all sources	2015-12-31	$67,120
Expenses. Total of all expenses incurred	2015-12-31	$780
Benefits paid (including direct rollovers)	2015-12-31	$411
Total plan assets at end of year	2015-12-31	$203,042
Total plan assets at beginning of year	2015-12-31	$136,702
Value of fidelity bond covering the plan	2015-12-31	$25,000
Total contributions received or receivable from participants	2015-12-31	$56,534
Expenses. Other expenses not covered elsewhere	2015-12-31	$75
Contributions received from other sources (not participants or employers)	2015-12-31	$0
Other income received	2015-12-31	$-6,713
Net income (gross income less expenses)	2015-12-31	$66,340
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$203,042
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$136,702
Total contributions received or receivable from employer(s)	2015-12-31	$17,299
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$294
2014 : JONATHAN BLAIR WALDRON DMD PC 401(K) PROFIT SHARING PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$74,424
Expenses. Total of all expenses incurred	2014-12-31	$0
Total plan assets at end of year	2014-12-31	$136,702
Total plan assets at beginning of year	2014-12-31	$62,278
Value of fidelity bond covering the plan	2014-12-31	$15,000
Total contributions received or receivable from participants	2014-12-31	$55,762
Expenses. Other expenses not covered elsewhere	2014-12-31	$0
Contributions received from other sources (not participants or employers)	2014-12-31	$0
Other income received	2014-12-31	$4,272
Net income (gross income less expenses)	2014-12-31	$74,424
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$136,702
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$62,278
Total contributions received or receivable from employer(s)	2014-12-31	$14,390
Expenses. Administrative service providers (salaries,fees and commissions)	2014-12-31	$0
2013 : JONATHAN BLAIR WALDRON DMD PC 401(K) PROFIT SHARING PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$62,400
Expenses. Total of all expenses incurred	2013-12-31	$122
Total plan assets at end of year	2013-12-31	$62,278
Value of fidelity bond covering the plan	2013-12-31	$6,300
Total contributions received or receivable from participants	2013-12-31	$45,860
Expenses. Other expenses not covered elsewhere	2013-12-31	$0
Contributions received from other sources (not participants or employers)	2013-12-31	$0
Other income received	2013-12-31	$2,511
Net income (gross income less expenses)	2013-12-31	$62,278
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$62,278
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$0
Total contributions received or receivable from employer(s)	2013-12-31	$14,029
Expenses. Administrative service providers (salaries,fees and commissions)	2013-12-31	$122

Form 5500 Responses for JONATHAN BLAIR WALDRON DMD PC 401(K) PROFIT SHARING PLAN

2018: JONATHAN BLAIR WALDRON DMD PC 401(K) PROFIT SHARING 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: JONATHAN BLAIR WALDRON DMD PC 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	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: JONATHAN BLAIR WALDRON DMD PC 401(K) PROFIT SHARING 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: JONATHAN BLAIR WALDRON DMD PC 401(K) PROFIT SHARING 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 – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: JONATHAN BLAIR WALDRON DMD PC 401(K) PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
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: JONATHAN BLAIR WALDRON DMD PC 401(K) PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	First time form 5500 has been submitted	Yes
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
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

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

110987

Policy instance

Insurance contract or identification number	110987
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Insurance broker organization code?	3

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

Policy contract number

110987

Policy instance

Insurance contract or identification number	110987
Number of Individuals Covered	19
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $2,552
Total amount of fees paid to insurance company	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,477
Insurance broker organization code?	3

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

Policy contract number

110987

Policy instance

Insurance contract or identification number	110987
Number of Individuals Covered	15
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $1,946
Total amount of fees paid to insurance company	USD $0
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,796
Insurance broker organization code?	3
Insurance broker name	BWTP P.C.

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

Policy contract number

110987

Policy instance

Insurance contract or identification number	110987
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Insurance broker organization code?	3
Insurance broker name	AMERITAS INVESTMENT CORP

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Company Name:	JONATHAN BLAIR WALDRON DMD PC
Employer identification number (EIN):	010688324
NAIC Classification:	621210
NAIC Description:	Offices of Dentists

Jurisdiction of Incorporation:	Georgia Department of States Corporations Division
Incorporation Date:
Company Identification Number:	138710