401k Plan data: ADELBERG AND MONTALVAN PEDIATRIC DENTAL, P.C. CASH BALANCE PLAN plan

ADELBERG AND MONTALVAN PEDIATRIC DENTAL, P.C. CASH BALANCE PLAN 401k Plan overview

Plan Name	ADELBERG AND MONTALVAN PEDIATRIC DENTAL, P.C. CASH BALANCE PLAN
Plan identification number	002

ADELBERG AND MONTALVAN PEDIATRIC DENTAL, P.C. CASH BALANCE PLAN Benefits

401k Plan Type

Defined Benefit Pension

Plan Features/Benefits

Benefits are primarily pay related
Cash balance or similar plan - Plan has a "cash balance" formula. For this purpose, a "cash balance" formula is a benefit formula in a defined benefit plan by whatever name (for example, personal account plan, pension equity plan, life cycle plan, cash account plan, etc.) that rather than, or in addition to, expressing the accrued benefit as a life annuity commencing at normal retirement age, defines benefits for each employee in terms more common to a defined contribution plan such as a single sum distribution amount (for example, 10 percent of final average pay times years of service, or the amount of the employee's hypothetical account balance).
Frozen Plan - As of the last day of the plan year, the plan provides that no participant will get any new benefit accrual (whether because of service or compensation).

401k Sponsoring company profile

ADELBERG AND MONTALVAN PEDIATRIC DENTAL, P.C. has sponsored the creation of one or more 401k plans.

Company Name: ADELBERG AND MONTALVAN PEDIATRIC DENTAL, P.C.

Employer identification number (EIN): 043710750

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ADELBERG AND MONTALVAN PEDIATRIC DENTAL, P.C. CASH BALANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2016-01-01 ERICKA MONTALVAN ERICKA MONTALVAN 2017-02-16
002 2015-01-01 ERICKA MONTALVAN ERICKA MONTALVAN 2016-05-10
002 2014-01-01 ERICKA MONTALVAN 2015-06-17 ERICKA MONTALVAN 2015-06-17
002 2013-01-01 ERICKA MONTALVAN 2014-09-30 ERICKA MONTALVAN 2014-09-30

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2016-01-01	ERICKA MONTALVAN		ERICKA MONTALVAN	2017-02-16
002	2015-01-01	ERICKA MONTALVAN		ERICKA MONTALVAN	2016-05-10
002	2014-01-01	ERICKA MONTALVAN	2015-06-17	ERICKA MONTALVAN	2015-06-17
002	2013-01-01	ERICKA MONTALVAN	2014-09-30	ERICKA MONTALVAN	2014-09-30

Plan Statistics for ADELBERG AND MONTALVAN PEDIATRIC DENTAL, P.C. CASH BALANCE PLAN

401k plan membership statisitcs for ADELBERG AND MONTALVAN PEDIATRIC DENTAL, P.C. CASH BALANCE PLAN

Measure Date Value
2016: ADELBERG AND MONTALVAN PEDIATRIC DENTAL, P.C. CASH BALANCE PLAN 2016 401k membership
Market value of plan assets 2016-12-31 204,190
Acturial value of plan assets 2016-12-31 204,190
Funding target for retired participants and beneficiaries receiving payment 2016-12-31 0
Number of terminated vested participants 2016-12-31 1
Fundng target for terminated vested participants 2016-12-31 3,800
Active participant vested funding target 2016-12-31 209,871
Number of active participants 2016-12-31 10
Total funding liabilities for active participants 2016-12-31 209,871
Total participant count 2016-12-31 11
Total funding target for all participants 2016-12-31 213,671
Balance at beginning of prior year after applicable adjustments 2016-12-31 0
Prefunding balance at beginning of prior year after applicable adjustments 2016-12-31 0
Carryover balanced portion elected for use to offset prior years funding requirement 2016-12-31 0
Prefunding balanced used to offset prior years funding requirement 2016-12-31 0
Amount remaining of carryover balance 2016-12-31 0
Amount remaining of prefunding balance 2016-12-31 0
Present value of excess contributions 2016-12-31 0
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance 2016-12-31 24
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance 2016-12-31 0
Reductions in caryover balances due to elections or deemed elections 2016-12-31 0
Reductions in prefunding balances due to elections or deemed elections 2016-12-31 0
Balance of carryovers at beginning of current year 2016-12-31 0
Balance of prefunding at beginning of current year 2016-12-31 0
Total employer contributions 2016-12-31 2,272
Total employee contributions 2016-12-31 0
Contributions allocated toward unpaid minimum require contributions from prior years 2016-12-31 0
Contributions made to avoid restrictions adjusted to valuation date 2016-12-31 0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date 2016-12-31 2,286
Liquidity shortfalls end of Q1 2016-12-31 0
Liquidity shortfalls end of Q2 2016-12-31 0
Liquidity shortfalls end of Q3 2016-12-31 0
Liquidity shortfalls end of Q4 2016-12-31 0
Unpaid minimum required contributions for all prior years 2016-12-31 0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years 2016-12-31 0
Remaining amount of unpaid minimum required contributions 2016-12-31 0
Minimum required contributions for current year target normal cost 2016-12-31 0
Net shortfall amortization installment of oustanding balance 2016-12-31 9,482
Waiver amortization installment 2016-12-31 0
Total funding amount beforereflecting carryover/prefunding balances 2016-12-31 939
Carryover balance elected to use to offset funding requirement 2016-12-31 0
Prefunding balance elected to use to offset funding requirement 2016-12-31 0
Additional cash requirement 2016-12-31 939
Contributions allocatedtoward minimum required contributions for current year 2016-12-31 2,286
Unpaid minimum required contributions for current year 2016-12-31 0
Unpaid minimum required contributions for all years 2016-12-31 0
Total participants, beginning-of-year 2016-01-01 11
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 0
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 0
Total of all active and inactive participants 2016-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: ADELBERG AND MONTALVAN PEDIATRIC DENTAL, P.C. CASH BALANCE PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 11
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
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0

Measure	Date	Value
2016: ADELBERG AND MONTALVAN PEDIATRIC DENTAL, P.C. CASH BALANCE PLAN 2016 401k membership
Market value of plan assets	2016-12-31	204,190
Acturial value of plan assets	2016-12-31	204,190
Funding target for retired participants and beneficiaries receiving payment	2016-12-31	0
Number of terminated vested participants	2016-12-31	1
Fundng target for terminated vested participants	2016-12-31	3,800
Active participant vested funding target	2016-12-31	209,871
Number of active participants	2016-12-31	10
Total funding liabilities for active participants	2016-12-31	209,871
Total participant count	2016-12-31	11
Total funding target for all participants	2016-12-31	213,671
Balance at beginning of prior year after applicable adjustments	2016-12-31	0
Prefunding balance at beginning of prior year after applicable adjustments	2016-12-31	0
Carryover balanced portion elected for use to offset prior years funding requirement	2016-12-31	0
Prefunding balanced used to offset prior years funding requirement	2016-12-31	0
Amount remaining of carryover balance	2016-12-31	0
Amount remaining of prefunding balance	2016-12-31	0
Present value of excess contributions	2016-12-31	0
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2016-12-31	24
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2016-12-31	0
Reductions in caryover balances due to elections or deemed elections	2016-12-31	0
Reductions in prefunding balances due to elections or deemed elections	2016-12-31	0
Balance of carryovers at beginning of current year	2016-12-31	0
Balance of prefunding at beginning of current year	2016-12-31	0
Total employer contributions	2016-12-31	2,272
Total employee contributions	2016-12-31	0
Contributions allocated toward unpaid minimum require contributions from prior years	2016-12-31	0
Contributions made to avoid restrictions adjusted to valuation date	2016-12-31	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2016-12-31	2,286
Liquidity shortfalls end of Q1	2016-12-31	0
Liquidity shortfalls end of Q2	2016-12-31	0
Liquidity shortfalls end of Q3	2016-12-31	0
Liquidity shortfalls end of Q4	2016-12-31	0
Unpaid minimum required contributions for all prior years	2016-12-31	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2016-12-31	0
Remaining amount of unpaid minimum required contributions	2016-12-31	0
Minimum required contributions for current year target normal cost	2016-12-31	0
Net shortfall amortization installment of oustanding balance	2016-12-31	9,482
Waiver amortization installment	2016-12-31	0
Total funding amount beforereflecting carryover/prefunding balances	2016-12-31	939
Carryover balance elected to use to offset funding requirement	2016-12-31	0
Prefunding balance elected to use to offset funding requirement	2016-12-31	0
Additional cash requirement	2016-12-31	939
Contributions allocatedtoward minimum required contributions for current year	2016-12-31	2,286
Unpaid minimum required contributions for current year	2016-12-31	0
Unpaid minimum required contributions for all years	2016-12-31	0
Total participants, beginning-of-year	2016-01-01	11
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	0
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	0
Total of all active and inactive participants	2016-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: ADELBERG AND MONTALVAN PEDIATRIC DENTAL, P.C. CASH BALANCE PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	11
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
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0

Financial Data on ADELBERG AND MONTALVAN PEDIATRIC DENTAL, P.C. CASH BALANCE PLAN

Measure	Date	Value
2016 : ADELBERG AND MONTALVAN PEDIATRIC DENTAL, P.C. CASH BALANCE PLAN 2016 401k financial data
Transfers to/from the plan	2016-12-31	$0
Total plan liabilities at end of year	2016-12-31	$0
Total plan liabilities at beginning of year	2016-12-31	$0
Total income from all sources	2016-12-31	$14,120
Expenses. Total of all expenses incurred	2016-12-31	$214,878
Benefits paid (including direct rollovers)	2016-12-31	$214,878
Total plan assets at end of year	2016-12-31	$0
Total plan assets at beginning of year	2016-12-31	$200,758
Value of fidelity bond covering the plan	2016-12-31	$200,000
Total contributions received or receivable from participants	2016-12-31	$0
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	$11,848
Noncash contributions received	2016-12-31	$0
Net income (gross income less expenses)	2016-12-31	$-200,758
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$0
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$200,758
Total contributions received or receivable from employer(s)	2016-12-31	$2,272
Value of certain deemed distributions of participant loans	2016-12-31	$0
Value of corrective distributions	2016-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$0
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
2015 : ADELBERG AND MONTALVAN PEDIATRIC DENTAL, P.C. CASH BALANCE PLAN 2015 401k financial data
Total plan liabilities at end of year	2015-12-31	$0
Total plan liabilities at beginning of year	2015-12-31	$0
Total income from all sources	2015-12-31	$14,281
Expenses. Total of all expenses incurred	2015-12-31	$326
Total plan assets at end of year	2015-12-31	$200,758
Total plan assets at beginning of year	2015-12-31	$186,803
Value of fidelity bond covering the plan	2015-12-31	$200,000
Other income received	2015-12-31	$13,312
Net income (gross income less expenses)	2015-12-31	$13,955
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$200,758
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$186,803
Total contributions received or receivable from employer(s)	2015-12-31	$969
Expenses. Administrative service providers (salaries,fees and commissions)	2015-12-31	$326
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0

Form 5500 Responses for ADELBERG AND MONTALVAN PEDIATRIC DENTAL, P.C. CASH BALANCE PLAN

2016: ADELBERG AND MONTALVAN PEDIATRIC DENTAL, P.C. CASH BALANCE 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	Yes
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 – Trust	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: ADELBERG AND MONTALVAN PEDIATRIC DENTAL, P.C. CASH BALANCE 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

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Company Name:	ADELBERG AND MONTALVAN PEDIATRIC DENTAL, P.C.
Employer identification number (EIN):	043710750
NAIC Classification:	621210
NAIC Description:	Offices of Dentists