401k Plan data: SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN plan

SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 401k Plan overview

Plan Name	SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN
Plan identification number	001

SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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.
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

SKIP TYSON, DDS, & STEPHANIE HEANEY, DDS, PA 401(K) P has sponsored the creation of one or more 401k plans.

Company Name: SKIP TYSON, DDS, & STEPHANIE HEANEY, DDS, PA 401(K) P

Employer identification number (EIN): 061641474

NAIC Classification: 621399
NAIC Description: Offices of All Other Miscellaneous Health Practitioners

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01
001 2021-01-01
001 2020-01-01 CHESTER J. TYSON, IV 2021-07-19
001 2019-01-01 CHESTER J. TYSON, IV 2020-09-24
001 2018-01-01 CHESTER J. TYSON, IV 2019-07-30
001 2017-01-01 CHESTER J. TYSON, IV
001 2016-01-01 CHESTER J. TYSON, IV
001 2015-01-01 CHESTER J. TYSON, IV
001 2014-01-01 CHESTER J. TYSON, IV
001 2013-01-01 CHESTER J. TYSON, IV
001 2012-01-01 CHESTER J. TYSON, IV
001 2011-01-01 CHESTER J. TYSON, IV
001 2010-01-01 CHESTER J. TYSON, IV
001 2009-01-01 CHESTER J. TYSON, IV

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01
001	2021-01-01
001	2020-01-01	CHESTER J. TYSON, IV	2021-07-19
001	2019-01-01	CHESTER J. TYSON, IV	2020-09-24
001	2018-01-01	CHESTER J. TYSON, IV	2019-07-30
001	2017-01-01	CHESTER J. TYSON, IV
001	2016-01-01	CHESTER J. TYSON, IV
001	2015-01-01	CHESTER J. TYSON, IV
001	2014-01-01	CHESTER J. TYSON, IV
001	2013-01-01	CHESTER J. TYSON, IV
001	2012-01-01	CHESTER J. TYSON, IV
001	2011-01-01	CHESTER J. TYSON, IV
001	2010-01-01	CHESTER J. TYSON, IV
001	2009-01-01	CHESTER J. TYSON, IV

Plan Statistics for SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN

401k plan membership statisitcs for SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN

Measure Date Value
2017: SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 12
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 16
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 0
Total of all active and inactive participants 2017-01-01 16
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 16
Number of participants with account balances 2017-01-01 18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) 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 12
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 12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 12
Number of participants with account balances 2016-01-01 19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 0
2015: SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) 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 12
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 0
Total of all active and inactive participants 2015-01-01 12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 12
Number of participants with account balances 2015-01-01 20
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 0
2014: SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 13
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 12
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 0
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 16
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 0
2013: SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 11
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 13
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 13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 13
Number of participants with account balances 2013-01-01 15
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 13
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 11
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 11
Number of participants with account balances 2012-01-01 14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 14
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 13
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 0
Total of all active and inactive participants 2011-01-01 13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 13
Number of participants with account balances 2011-01-01 17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 15
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 14
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 0
Total of all active and inactive participants 2010-01-01 14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 14
Number of participants with account balances 2010-01-01 14
2009: SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 14
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 15
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 0
Total of all active and inactive participants 2009-01-01 15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 15
Number of participants with account balances 2009-01-01 15

Measure	Date	Value
2017: SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	12
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	16
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	0
Total of all active and inactive participants	2017-01-01	16
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	16
Number of participants with account balances	2017-01-01	18
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) 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	12
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	12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	12
Number of participants with account balances	2016-01-01	19
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	0
2015: SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) 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	12
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	0
Total of all active and inactive participants	2015-01-01	12
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	12
Number of participants with account balances	2015-01-01	20
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	0
2014: SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	13
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	12
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	0
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	16
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	0
2013: SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	11
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	13
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	13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	13
Number of participants with account balances	2013-01-01	15
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	13
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	11
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	11
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	11
Number of participants with account balances	2012-01-01	14
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	14
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	13
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	0
Total of all active and inactive participants	2011-01-01	13
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	13
Number of participants with account balances	2011-01-01	17
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	15
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	14
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	0
Total of all active and inactive participants	2010-01-01	14
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	14
Number of participants with account balances	2010-01-01	14
2009: SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	14
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	15
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	0
Total of all active and inactive participants	2009-01-01	15
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	15
Number of participants with account balances	2009-01-01	15

Financial Data on SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN

Measure	Date	Value
2017 : SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 2017 401k financial data
Total income from all sources	2017-12-31	$708,157
Expenses. Total of all expenses incurred	2017-12-31	$6,922
Benefits paid (including direct rollovers)	2017-12-31	$6,652
Total plan assets at end of year	2017-12-31	$4,301,948
Total plan assets at beginning of year	2017-12-31	$3,600,713
Value of fidelity bond covering the plan	2017-12-31	$450,000
Total contributions received or receivable from participants	2017-12-31	$70,341
Expenses. Other expenses not covered elsewhere	2017-12-31	$270
Other income received	2017-12-31	$538,833
Net income (gross income less expenses)	2017-12-31	$701,235
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$4,301,948
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$3,600,713
Total contributions received or receivable from employer(s)	2017-12-31	$98,983
2016 : SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 2016 401k financial data
Total income from all sources	2016-12-31	$475,940
Expenses. Total of all expenses incurred	2016-12-31	$8,152
Benefits paid (including direct rollovers)	2016-12-31	$4,776
Total plan assets at end of year	2016-12-31	$3,600,713
Total plan assets at beginning of year	2016-12-31	$3,132,925
Value of fidelity bond covering the plan	2016-12-31	$375,000
Total contributions received or receivable from participants	2016-12-31	$70,255
Expenses. Other expenses not covered elsewhere	2016-12-31	$3,376
Other income received	2016-12-31	$311,349
Net income (gross income less expenses)	2016-12-31	$467,788
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$3,600,713
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$3,132,925
Total contributions received or receivable from employer(s)	2016-12-31	$94,336
2015 : SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 2015 401k financial data
Total income from all sources	2015-12-31	$157,113
Total plan assets at end of year	2015-12-31	$3,132,925
Total plan assets at beginning of year	2015-12-31	$2,975,812
Value of fidelity bond covering the plan	2015-12-31	$325,000
Total contributions received or receivable from participants	2015-12-31	$66,480
Other income received	2015-12-31	$-3,968
Net income (gross income less expenses)	2015-12-31	$157,113
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$3,132,925
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$2,975,812
Total contributions received or receivable from employer(s)	2015-12-31	$94,601
2014 : SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$384,509
Expenses. Total of all expenses incurred	2014-12-31	$9,350
Benefits paid (including direct rollovers)	2014-12-31	$6,725
Total plan assets at end of year	2014-12-31	$2,975,812
Total plan assets at beginning of year	2014-12-31	$2,600,653
Value of fidelity bond covering the plan	2014-12-31	$300,000
Total contributions received or receivable from participants	2014-12-31	$63,779
Expenses. Other expenses not covered elsewhere	2014-12-31	$2,625
Other income received	2014-12-31	$218,917
Net income (gross income less expenses)	2014-12-31	$375,159
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$2,975,812
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$2,600,653
Total contributions received or receivable from employer(s)	2014-12-31	$101,813
2013 : SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$520,691
Expenses. Total of all expenses incurred	2013-12-31	$11,934
Benefits paid (including direct rollovers)	2013-12-31	$10,711
Total plan assets at end of year	2013-12-31	$2,600,653
Total plan assets at beginning of year	2013-12-31	$2,091,896
Value of fidelity bond covering the plan	2013-12-31	$270,000
Total contributions received or receivable from participants	2013-12-31	$51,775
Expenses. Other expenses not covered elsewhere	2013-12-31	$1,223
Other income received	2013-12-31	$365,363
Net income (gross income less expenses)	2013-12-31	$508,757
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$2,600,653
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$2,091,896
Total contributions received or receivable from employer(s)	2013-12-31	$103,553
2012 : SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$353,347
Expenses. Total of all expenses incurred	2012-12-31	$24,929
Benefits paid (including direct rollovers)	2012-12-31	$23,661
Total plan assets at end of year	2012-12-31	$2,091,896
Total plan assets at beginning of year	2012-12-31	$1,763,478
Value of fidelity bond covering the plan	2012-12-31	$200,000
Total contributions received or receivable from participants	2012-12-31	$61,094
Expenses. Other expenses not covered elsewhere	2012-12-31	$1,268
Other income received	2012-12-31	$190,251
Net income (gross income less expenses)	2012-12-31	$328,418
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$2,091,896
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$1,763,478
Total contributions received or receivable from employer(s)	2012-12-31	$102,002
2011 : SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$175,849
Expenses. Total of all expenses incurred	2011-12-31	$2,465
Benefits paid (including direct rollovers)	2011-12-31	$2,405
Total plan assets at end of year	2011-12-31	$1,763,478
Total plan assets at beginning of year	2011-12-31	$1,590,094
Value of fidelity bond covering the plan	2011-12-31	$200,000
Total contributions received or receivable from participants	2011-12-31	$59,458
Expenses. Other expenses not covered elsewhere	2011-12-31	$60
Other income received	2011-12-31	$7,510
Net income (gross income less expenses)	2011-12-31	$173,384
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$1,763,478
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$1,590,094
Total contributions received or receivable from employer(s)	2011-12-31	$108,881
2010 : SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$300,675
Total plan assets at end of year	2010-12-31	$1,590,094
Total plan assets at beginning of year	2010-12-31	$1,289,419
Value of fidelity bond covering the plan	2010-12-31	$150,000
Total contributions received or receivable from participants	2010-12-31	$57,329
Other income received	2010-12-31	$154,305
Net income (gross income less expenses)	2010-12-31	$300,675
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$1,590,094
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$1,289,419
Total contributions received or receivable from employer(s)	2010-12-31	$89,041

Form 5500 Responses for SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN

2017: SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
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: SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
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: SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
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: SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
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: SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
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
2012: SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: SKIP TYSON, DDS & STEPHANIE HEANEY, DDS, PA 401(K) PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

335260-01

Policy instance

Insurance contract or identification number	335260-01
Number of Individuals Covered	18
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $6
Are there contracts with allocated funds for group deferred annuity?	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 $4
Insurance broker organization code?	3
Insurance broker name	ROBERT MACK

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

335260-01

Policy instance

Insurance contract or identification number	335260-01
Number of Individuals Covered	20
Insurance policy start date	2016-01-01
Insurance policy end date	2016-12-31
Total amount of commissions paid to insurance broker	USD $4
Are there contracts with allocated funds for group deferred annuity?	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 $2
Insurance broker organization code?	3
Insurance broker name	ROBERT MACK

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

335260-01

Policy instance

Insurance contract or identification number	335260-01
Number of Individuals Covered	20
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Are there contracts with allocated funds for group deferred annuity?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3
Insurance broker name	ROBERT MACK

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

335260-01

Policy instance

Insurance contract or identification number	335260-01
Number of Individuals Covered	16
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Are there contracts with allocated funds for group deferred annuity?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3
Insurance broker name	ROBERT MACK

AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 63665 )

Policy contract number

GP4058

Policy instance

Insurance contract or identification number	GP4058
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $1,690
Are there contracts with allocated funds for group deferred annuity?	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 $768
Insurance broker organization code?	3
Insurance broker name	GOLDEN MACK & ASSOCIATES

GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68322 )

Policy contract number

335260-01

Policy instance

Insurance contract or identification number	335260-01
Number of Individuals Covered	15
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Are there contracts with allocated funds for group deferred annuity?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3
Insurance broker name	ROBERT MACK

AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 63665 )

Policy contract number

GP2952/4058

Policy instance

Insurance contract or identification number	GP2952/4058
Number of Individuals Covered	13
Insurance policy start date	2012-01-01
Insurance policy end date	2012-12-31
Total amount of commissions paid to insurance broker	USD $5,846
Are there contracts with allocated funds for group deferred annuity?	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 $2,923
Insurance broker organization code?	3
Insurance broker name	ROBERT E. MACK, JR.

AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 63665 )

Policy contract number

GP29524058

Policy instance

Insurance contract or identification number	GP29524058
Number of Individuals Covered	17
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $9,606
Are there contracts with allocated funds for group deferred annuity?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

AMERICAN GENERAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 63665 )

Policy contract number

320622

Policy instance

Insurance contract or identification number	320622
Number of Individuals Covered	14
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $2,456
Are there contracts with allocated funds for group deferred annuity?	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 $1,059
Insurance broker organization code?	3
Insurance broker name	GOLDEN MACK & ASSOCIATES, INC

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Company Name:	SKIP TYSON, DDS, & STEPHANIE HEANEY, DDS, PA 401(K) P
Employer identification number (EIN):	061641474
NAIC Classification:	621399
NAIC Description:	Offices of All Other Miscellaneous Health Practitioners