401k Plan data: KAMBIZ MOIN, DMD, MPH, PA 401(K) PLAN plan

KAMBIZ MOIN, DMD, MPH, PA 401(K) PLAN 401k Plan overview

Plan Name	KAMBIZ MOIN, DMD, MPH, PA 401(K) PLAN
Plan identification number	003

KAMBIZ MOIN, DMD, MPH, PA 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
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.

401k Sponsoring company profile

KAMBIZ MOIN, D.M.D., M.P.H., P.A. has sponsored the creation of one or more 401k plans.

Company Name: KAMBIZ MOIN, D.M.D., M.P.H., P.A.

Employer identification number (EIN): 020324852

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan KAMBIZ MOIN, DMD, MPH, PA 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
003 2015-01-01 KAMBIZ MOIN 2016-01-14
003 2014-12-01 KAMBIZ MOIN 2015-10-01
003 2013-12-01 KAMBIZ MOIN 2015-03-21
003 2012-12-01 KAMBIZ MOIN
003 2011-12-01 KAMBIZ MOIN
003 2009-12-01 KAMBIZ MOIN
003 2009-12-01 KAMBIZ MOIN
003 2008-12-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
003	2015-01-01	KAMBIZ MOIN	2016-01-14
003	2014-12-01	KAMBIZ MOIN	2015-10-01
003	2013-12-01	KAMBIZ MOIN	2015-03-21
003	2012-12-01	KAMBIZ MOIN
003	2011-12-01	KAMBIZ MOIN
003	2009-12-01	KAMBIZ MOIN
003	2009-12-01	KAMBIZ MOIN
003	2008-12-01

Plan Statistics for KAMBIZ MOIN, DMD, MPH, PA 401(K) PLAN

401k plan membership statisitcs for KAMBIZ MOIN, DMD, MPH, PA 401(K) PLAN

Measure Date Value
2012: KAMBIZ MOIN, DMD, MPH, PA 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-12-01 8
Total number of active participants reported on line 7a of the Form 5500 2012-12-01 11
Number of retired or separated participants receiving benefits 2012-12-01 0
Number of other retired or separated participants entitled to future benefits 2012-12-01 0
Total of all active and inactive participants 2012-12-01 11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-12-01 0
Total participants 2012-12-01 11
Number of participants with account balances 2012-12-01 11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-12-01 1
2011: KAMBIZ MOIN, DMD, MPH, PA 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-12-01 10
Total number of active participants reported on line 7a of the Form 5500 2011-12-01 8
Number of retired or separated participants receiving benefits 2011-12-01 0
Number of other retired or separated participants entitled to future benefits 2011-12-01 0
Total of all active and inactive participants 2011-12-01 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-12-01 0
Total participants 2011-12-01 8
Number of participants with account balances 2011-12-01 8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-12-01 0
2009: KAMBIZ MOIN, DMD, MPH, PA 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-12-01 9
Total number of active participants reported on line 7a of the Form 5500 2009-12-01 9
Number of retired or separated participants receiving benefits 2009-12-01 0
Number of other retired or separated participants entitled to future benefits 2009-12-01 0
Total of all active and inactive participants 2009-12-01 9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-12-01 0
Total participants 2009-12-01 9
Number of participants with account balances 2009-12-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-12-01 0

Measure	Date	Value
2012: KAMBIZ MOIN, DMD, MPH, PA 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-12-01	8
Total number of active participants reported on line 7a of the Form 5500	2012-12-01	11
Number of retired or separated participants receiving benefits	2012-12-01	0
Number of other retired or separated participants entitled to future benefits	2012-12-01	0
Total of all active and inactive participants	2012-12-01	11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-12-01	0
Total participants	2012-12-01	11
Number of participants with account balances	2012-12-01	11
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-12-01	1
2011: KAMBIZ MOIN, DMD, MPH, PA 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-12-01	10
Total number of active participants reported on line 7a of the Form 5500	2011-12-01	8
Number of retired or separated participants receiving benefits	2011-12-01	0
Number of other retired or separated participants entitled to future benefits	2011-12-01	0
Total of all active and inactive participants	2011-12-01	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-12-01	0
Total participants	2011-12-01	8
Number of participants with account balances	2011-12-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-12-01	0
2009: KAMBIZ MOIN, DMD, MPH, PA 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-12-01	9
Total number of active participants reported on line 7a of the Form 5500	2009-12-01	9
Number of retired or separated participants receiving benefits	2009-12-01	0
Number of other retired or separated participants entitled to future benefits	2009-12-01	0
Total of all active and inactive participants	2009-12-01	9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-12-01	0
Total participants	2009-12-01	9
Number of participants with account balances	2009-12-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-12-01	0

Financial Data on KAMBIZ MOIN, DMD, MPH, PA 401(K) PLAN

Measure	Date	Value
2013 : KAMBIZ MOIN, DMD, MPH, PA 401(K) PLAN 2013 401k financial data
Total income from all sources	2013-11-30	$142,499
Total plan assets at end of year	2013-11-30	$3,219,469
Total plan assets at beginning of year	2013-11-30	$3,076,970
Value of fidelity bond covering the plan	2013-11-30	$90,000
Total contributions received or receivable from participants	2013-11-30	$58,561
Other income received	2013-11-30	$27,006
Net income (gross income less expenses)	2013-11-30	$142,499
Net plan assets at end of year (total assets less liabilities)	2013-11-30	$3,219,469
Net plan assets at beginning of year (total assets less liabilities)	2013-11-30	$3,076,970
Total contributions received or receivable from employer(s)	2013-11-30	$56,932
2012 : KAMBIZ MOIN, DMD, MPH, PA 401(K) PLAN 2012 401k financial data
Total plan liabilities at end of year	2012-11-30	$0
Total plan liabilities at beginning of year	2012-11-30	$7,653
Total income from all sources	2012-11-30	$2,790,280
Expenses. Total of all expenses incurred	2012-11-30	$1,052
Benefits paid (including direct rollovers)	2012-11-30	$1,052
Total plan assets at end of year	2012-11-30	$3,077,370
Total plan assets at beginning of year	2012-11-30	$295,795
Value of fidelity bond covering the plan	2012-11-30	$2,000,000
Total contributions received or receivable from participants	2012-11-30	$44,797
Contributions received from other sources (not participants or employers)	2012-11-30	$2,656,813
Other income received	2012-11-30	$42,672
Net income (gross income less expenses)	2012-11-30	$2,789,228
Net plan assets at end of year (total assets less liabilities)	2012-11-30	$3,077,370
Net plan assets at beginning of year (total assets less liabilities)	2012-11-30	$288,142
Total contributions received or receivable from employer(s)	2012-11-30	$45,998
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-11-30	$0
2011 : KAMBIZ MOIN, DMD, MPH, PA 401(K) PLAN 2011 401k financial data
Total plan liabilities at end of year	2011-11-30	$7,653
Total plan liabilities at beginning of year	2011-11-30	$0
Total income from all sources	2011-11-30	$61,902
Expenses. Total of all expenses incurred	2011-11-30	$3,074
Benefits paid (including direct rollovers)	2011-11-30	$3,074
Total plan assets at end of year	2011-11-30	$295,795
Total plan assets at beginning of year	2011-11-30	$229,314
Value of fidelity bond covering the plan	2011-11-30	$2,000,000
Total contributions received or receivable from participants	2011-11-30	$36,797
Other income received	2011-11-30	$15,233
Net income (gross income less expenses)	2011-11-30	$58,828
Net plan assets at end of year (total assets less liabilities)	2011-11-30	$288,142
Net plan assets at beginning of year (total assets less liabilities)	2011-11-30	$229,314
Total contributions received or receivable from employer(s)	2011-11-30	$9,872
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-11-30	$0

Form 5500 Responses for KAMBIZ MOIN, DMD, MPH, PA 401(K) PLAN

2012: KAMBIZ MOIN, DMD, MPH, PA 401(K) PLAN 2012 form 5500 responses
2012-12-01	Type of plan entity	Single employer plan
2012-12-01	Plan funding arrangement – Trust	Yes
2012-12-01	Plan benefit arrangement - Trust	Yes
2011: KAMBIZ MOIN, DMD, MPH, PA 401(K) PLAN 2011 form 5500 responses
2011-12-01	Type of plan entity	Single employer plan
2011-12-01	Submission has been amended	Yes
2011-12-01	Plan funding arrangement – Trust	Yes
2011-12-01	Plan benefit arrangement - Trust	Yes
2009: KAMBIZ MOIN, DMD, MPH, PA 401(K) PLAN 2009 form 5500 responses
2009-12-01	Type of plan entity	Single employer plan
2009-12-01	Submission has been amended	No
2009-12-01	This submission is the final filing	No
2009-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-12-01	Plan is a collectively bargained plan	No
2009-12-01	Plan funding arrangement – Trust	Yes
2009-12-01	Plan benefit arrangement - Trust	Yes
2008: KAMBIZ MOIN, DMD, MPH, PA 401(K) PLAN 2008 form 5500 responses
2008-12-01	Type of plan entity	Single employer plan
2008-12-01	Submission has been amended	No
2008-12-01	This submission is the final filing	No
2008-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-12-01	Plan is a collectively bargained plan	No

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Company Name:	KAMBIZ MOIN, D.M.D., M.P.H., P.A.
Employer identification number (EIN):	020324852
NAIC Classification:	621210
NAIC Description:	Offices of Dentists