401k Plan data: ATLANTIC DENTAL WELLNESS RETIREMENT PLAN plan

ATLANTIC DENTAL WELLNESS RETIREMENT PLAN 401k Plan overview

Plan Name	ATLANTIC DENTAL WELLNESS RETIREMENT PLAN
Plan identification number	001

ATLANTIC DENTAL WELLNESS RETIREMENT 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.
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

LEONARD T. FAZIO, DDS PC has sponsored the creation of one or more 401k plans.

Company Name: LEONARD T. FAZIO, DDS PC

Employer identification number (EIN): 202358246

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ATLANTIC DENTAL WELLNESS RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 DEBORAH WERNER 2023-09-12 DEBORAH WERNER 2023-09-12
001 2021-01-01 LEONARD FAZIO 2022-10-03 LEONARD FAZIO 2022-10-03
001 2020-01-01 DEBORAH WERNER 2021-09-14 DEBORAH WERNER 2021-09-14
001 2019-01-01 LEONARD FAZIO 2020-10-08 LEONARD FAZIO 2020-10-08
001 2018-01-01 DEBORAH WERNER 2019-09-17 DEBORAH WERNER 2019-09-17
001 2017-01-01 DEBORAH WERNER 2018-10-11 DEBORAH WERNER 2018-10-11
001 2016-01-01 LEONARD FAZIO 2017-10-05 LEONARD FAZIO 2017-10-05
001 2015-01-01 LEONARD FAZIO 2016-10-11 LEONARD FAZIO 2016-10-11
001 2014-01-01 LEONARD FAZIO 2015-10-08 LEONARD FAZIO 2015-10-08
001 2013-01-01 LEONARD FAZIO 2014-10-09 LEONARD FAZIO 2014-10-09
001 2012-01-01 LEONARD FAZIO 2013-08-28 LEONARD FAZIO 2013-08-28
001 2011-01-01 LEONARD FAZIO LEONARD FAZIO 2012-10-09
001 2010-01-01 LEONARD T FAZIO LEONARD T FAZIO 2011-10-12
001 2009-01-01
001 2009-01-01 LEONARD FAZIO
001 2008-01-01

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2022-01-01	DEBORAH WERNER	2023-09-12	DEBORAH WERNER	2023-09-12
001	2021-01-01	LEONARD FAZIO	2022-10-03	LEONARD FAZIO	2022-10-03
001	2020-01-01	DEBORAH WERNER	2021-09-14	DEBORAH WERNER	2021-09-14
001	2019-01-01	LEONARD FAZIO	2020-10-08	LEONARD FAZIO	2020-10-08
001	2018-01-01	DEBORAH WERNER	2019-09-17	DEBORAH WERNER	2019-09-17
001	2017-01-01	DEBORAH WERNER	2018-10-11	DEBORAH WERNER	2018-10-11
001	2016-01-01	LEONARD FAZIO	2017-10-05	LEONARD FAZIO	2017-10-05
001	2015-01-01	LEONARD FAZIO	2016-10-11	LEONARD FAZIO	2016-10-11
001	2014-01-01	LEONARD FAZIO	2015-10-08	LEONARD FAZIO	2015-10-08
001	2013-01-01	LEONARD FAZIO	2014-10-09	LEONARD FAZIO	2014-10-09
001	2012-01-01	LEONARD FAZIO	2013-08-28	LEONARD FAZIO	2013-08-28
001	2011-01-01	LEONARD FAZIO		LEONARD FAZIO	2012-10-09
001	2010-01-01	LEONARD T FAZIO		LEONARD T FAZIO	2011-10-12
001	2009-01-01
001	2009-01-01	LEONARD FAZIO
001	2008-01-01

Plan Statistics for ATLANTIC DENTAL WELLNESS RETIREMENT PLAN

401k plan membership statisitcs for ATLANTIC DENTAL WELLNESS RETIREMENT PLAN

Measure Date Value
2011: ATLANTIC DENTAL WELLNESS RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 6
Total of all active and inactive participants 2011-01-01 6
Total participants 2011-01-01 6
Number of participants with account balances 2011-01-01 6
2010: ATLANTIC DENTAL WELLNESS RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 5
Number of other retired or separated participants entitled to future benefits 2010-01-01 2
Total of all active and inactive participants 2010-01-01 7
Total participants 2010-01-01 7
2009: ATLANTIC DENTAL WELLNESS RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 12
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 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2011: ATLANTIC DENTAL WELLNESS RETIREMENT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	6
Total of all active and inactive participants	2011-01-01	6
Total participants	2011-01-01	6
Number of participants with account balances	2011-01-01	6
2010: ATLANTIC DENTAL WELLNESS RETIREMENT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	5
Number of other retired or separated participants entitled to future benefits	2010-01-01	2
Total of all active and inactive participants	2010-01-01	7
Total participants	2010-01-01	7
2009: ATLANTIC DENTAL WELLNESS RETIREMENT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	12
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	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on ATLANTIC DENTAL WELLNESS RETIREMENT PLAN

Measure	Date	Value
2011 : ATLANTIC DENTAL WELLNESS RETIREMENT PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$33,751
Expenses. Total of all expenses incurred	2011-12-31	$32,652
Benefits paid (including direct rollovers)	2011-12-31	$23,028
Total plan assets at end of year	2011-12-31	$197,058
Total plan assets at beginning of year	2011-12-31	$195,959
Value of fidelity bond covering the plan	2011-12-31	$50,000
Total contributions received or receivable from participants	2011-12-31	$15,218
Expenses. Other expenses not covered elsewhere	2011-12-31	$7,450
Other income received	2011-12-31	$9,838
Net income (gross income less expenses)	2011-12-31	$1,099
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$197,058
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$195,959
Assets. Value of participant loans	2011-12-31	$3,944
Total contributions received or receivable from employer(s)	2011-12-31	$8,695
Expenses. Administrative service providers (salaries,fees and commissions)	2011-12-31	$2,174
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : ATLANTIC DENTAL WELLNESS RETIREMENT PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$55,436
Expenses. Total of all expenses incurred	2010-12-31	$11,162
Benefits paid (including direct rollovers)	2010-12-31	$11,162
Total plan assets at end of year	2010-12-31	$195,959
Total plan assets at beginning of year	2010-12-31	$151,685
Value of fidelity bond covering the plan	2010-12-31	$7,000
Total contributions received or receivable from participants	2010-12-31	$27,426
Other income received	2010-12-31	$17,911
Net income (gross income less expenses)	2010-12-31	$44,274
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$195,959
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$151,685
Total contributions received or receivable from employer(s)	2010-12-31	$10,099

Form 5500 Responses for ATLANTIC DENTAL WELLNESS RETIREMENT PLAN

2011: ATLANTIC DENTAL WELLNESS RETIREMENT PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: ATLANTIC DENTAL WELLNESS RETIREMENT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: ATLANTIC DENTAL WELLNESS RETIREMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes
2008: ATLANTIC DENTAL WELLNESS RETIREMENT PLAN 2008 form 5500 responses
2008-01-01	Type of plan entity	Single employer plan
2008-01-01	Submission has been amended	No
2008-01-01	This submission is the final filing	No
2008-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2008-01-01	Plan is a collectively bargained plan	No

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

5433593

Policy instance

Insurance contract or identification number	5433593
Number of Individuals Covered	1
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0

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Company Name:	LEONARD T. FAZIO, DDS PC
Employer identification number (EIN):	202358246
NAIC Classification:	621210
NAIC Description:	Offices of Dentists