401k Plan data: NORTHSIDE ENDODONTICS, LLC 401K PLAN plan

NORTHSIDE ENDODONTICS, LLC 401K PLAN 401k Plan overview

Plan Name	NORTHSIDE ENDODONTICS, LLC 401K PLAN
Plan identification number	001

NORTHSIDE ENDODONTICS, LLC 401K 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.
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

NORTHSIDE ENDODONTICS, LLC has sponsored the creation of one or more 401k plans.

Company Name: NORTHSIDE ENDODONTICS, LLC

Employer identification number (EIN): 202806666

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Additional information about NORTHSIDE ENDODONTICS, LLC

Jurisdiction of Incorporation: Georgia Department of States Corporations Division

Incorporation Date:

Company Identification Number: 353474

More information about NORTHSIDE ENDODONTICS, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan NORTHSIDE ENDODONTICS, LLC 401K PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2021-01-01 WILLIAM H ROUSSEAU 2021-10-04 WILLIAM H ROUSSEAU 2021-10-04
001 2020-01-01 WILLIAM H ROUSSEAU 2021-10-04
001 2019-01-01 WILLIAM H ROUSSEAU 2020-07-09 WILLIAM H ROUSSEAU 2020-07-09
001 2018-01-01 WILLIAM H ROUSSEAU 2019-09-24
001 2017-01-01 WILLIAM H. ROUSSEAU 2018-01-30
001 2016-01-01 WILLIAM H. ROUSSEAU 2017-01-30
001 2015-01-01 WILLIAM H. ROUSSEAU 2016-01-27
001 2014-01-01 WILLIAM H. ROUSSEAU 2015-01-27
001 2013-01-01 WILLIAM H. ROUSSEAU
001 2012-01-01 WILLIAM H. ROUSSEAU
001 2011-01-01 WILLIAM H. ROUSSEAU
001 2010-01-01 WILLIAM H. ROUSSEAU
001 2009-01-01 WILLIAM H. ROUSSEAU WILLIAM H. ROUSSEAU 2010-05-04

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2021-01-01	WILLIAM H ROUSSEAU	2021-10-04	WILLIAM H ROUSSEAU	2021-10-04
001	2020-01-01	WILLIAM H ROUSSEAU	2021-10-04
001	2019-01-01	WILLIAM H ROUSSEAU	2020-07-09	WILLIAM H ROUSSEAU	2020-07-09
001	2018-01-01	WILLIAM H ROUSSEAU	2019-09-24
001	2017-01-01	WILLIAM H. ROUSSEAU	2018-01-30
001	2016-01-01	WILLIAM H. ROUSSEAU	2017-01-30
001	2015-01-01	WILLIAM H. ROUSSEAU	2016-01-27
001	2014-01-01	WILLIAM H. ROUSSEAU	2015-01-27
001	2013-01-01	WILLIAM H. ROUSSEAU
001	2012-01-01	WILLIAM H. ROUSSEAU
001	2011-01-01	WILLIAM H. ROUSSEAU
001	2010-01-01	WILLIAM H. ROUSSEAU
001	2009-01-01	WILLIAM H. ROUSSEAU		WILLIAM H. ROUSSEAU	2010-05-04

Plan Statistics for NORTHSIDE ENDODONTICS, LLC 401K PLAN

401k plan membership statisitcs for NORTHSIDE ENDODONTICS, LLC 401K PLAN

Measure Date Value
2013: NORTHSIDE ENDODONTICS, LLC 401K PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 9
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 8
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 1
Total of all active and inactive participants 2013-01-01 9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 9
Number of participants with account balances 2013-01-01 9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 0
2012: NORTHSIDE ENDODONTICS, LLC 401K PLAN 2012 401k membership
Total participants, beginning-of-year 2012-01-01 8
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 8
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 1
Total of all active and inactive participants 2012-01-01 9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 9
Number of participants with account balances 2012-01-01 9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: NORTHSIDE ENDODONTICS, LLC 401K PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 9
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 8
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 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 8
Number of participants with account balances 2011-01-01 8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2010: NORTHSIDE ENDODONTICS, LLC 401K PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 9
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 8
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 8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 8
Number of participants with account balances 2010-01-01 8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 0
2009: NORTHSIDE ENDODONTICS, LLC 401K PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 9
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 6
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 1
Total of all active and inactive participants 2009-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 7
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
2013: NORTHSIDE ENDODONTICS, LLC 401K PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	9
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	8
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	1
Total of all active and inactive participants	2013-01-01	9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	9
Number of participants with account balances	2013-01-01	9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	0
2012: NORTHSIDE ENDODONTICS, LLC 401K PLAN 2012 401k membership
Total participants, beginning-of-year	2012-01-01	8
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	8
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	1
Total of all active and inactive participants	2012-01-01	9
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	9
Number of participants with account balances	2012-01-01	9
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: NORTHSIDE ENDODONTICS, LLC 401K PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	9
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	8
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	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	8
Number of participants with account balances	2011-01-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2010: NORTHSIDE ENDODONTICS, LLC 401K PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	9
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	8
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	8
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	8
Number of participants with account balances	2010-01-01	8
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	0
2009: NORTHSIDE ENDODONTICS, LLC 401K PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	9
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	6
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	1
Total of all active and inactive participants	2009-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	7
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 NORTHSIDE ENDODONTICS, LLC 401K PLAN

Measure	Date	Value
2013 : NORTHSIDE ENDODONTICS, LLC 401K PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$361,963
Expenses. Total of all expenses incurred	2013-12-31	$27,456
Benefits paid (including direct rollovers)	2013-12-31	$27,456
Total plan assets at end of year	2013-12-31	$2,094,089
Total plan assets at beginning of year	2013-12-31	$1,759,582
Value of fidelity bond covering the plan	2013-12-31	$250,000
Total contributions received or receivable from participants	2013-12-31	$75,876
Other income received	2013-12-31	$202,486
Net income (gross income less expenses)	2013-12-31	$334,507
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$2,094,089
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$1,759,582
Total contributions received or receivable from employer(s)	2013-12-31	$83,601
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : NORTHSIDE ENDODONTICS, LLC 401K PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$317,386
Expenses. Total of all expenses incurred	2012-12-31	$0
Total plan assets at end of year	2012-12-31	$1,759,582
Total plan assets at beginning of year	2012-12-31	$1,442,196
Value of fidelity bond covering the plan	2012-12-31	$250,000
Total contributions received or receivable from participants	2012-12-31	$72,342
Other income received	2012-12-31	$163,651
Net income (gross income less expenses)	2012-12-31	$317,386
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$1,759,582
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$1,442,196
Total contributions received or receivable from employer(s)	2012-12-31	$81,393
2011 : NORTHSIDE ENDODONTICS, LLC 401K PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$235,600
Expenses. Total of all expenses incurred	2011-12-31	$0
Total plan assets at end of year	2011-12-31	$1,442,196
Total plan assets at beginning of year	2011-12-31	$1,206,596
Value of fidelity bond covering the plan	2011-12-31	$250,000
Total contributions received or receivable from participants	2011-12-31	$71,456
Contributions received from other sources (not participants or employers)	2011-12-31	$92,743
Other income received	2011-12-31	$-10,382
Net income (gross income less expenses)	2011-12-31	$235,600
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$1,442,196
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$1,206,596
Total contributions received or receivable from employer(s)	2011-12-31	$81,783
2010 : NORTHSIDE ENDODONTICS, LLC 401K PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$280,356
Expenses. Total of all expenses incurred	2010-12-31	$8,312
Benefits paid (including direct rollovers)	2010-12-31	$8,312
Total plan assets at end of year	2010-12-31	$1,206,596
Total plan assets at beginning of year	2010-12-31	$934,552
Value of fidelity bond covering the plan	2010-12-31	$250,000
Total contributions received or receivable from participants	2010-12-31	$71,443
Other income received	2010-12-31	$131,063
Net income (gross income less expenses)	2010-12-31	$272,044
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$1,206,596
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$934,552
Total contributions received or receivable from employer(s)	2010-12-31	$77,850
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : NORTHSIDE ENDODONTICS, LLC 401K PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for NORTHSIDE ENDODONTICS, LLC 401K PLAN

2013: NORTHSIDE ENDODONTICS, LLC 401K PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: NORTHSIDE ENDODONTICS, LLC 401K PLAN 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: NORTHSIDE ENDODONTICS, LLC 401K 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 – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2010: NORTHSIDE ENDODONTICS, LLC 401K 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: NORTHSIDE ENDODONTICS, LLC 401K 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

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Company Name:	NORTHSIDE ENDODONTICS, LLC
Employer identification number (EIN):	202806666
NAIC Classification:	621210
NAIC Description:	Offices of Dentists

Jurisdiction of Incorporation:	Georgia Department of States Corporations Division
Incorporation Date:
Company Identification Number:	353474