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MINT DENTISTRY, PLLC SUPPLEMENTAL BENEFIT PLAN 401k Plan overview

Plan NameMINT DENTISTRY, PLLC SUPPLEMENTAL BENEFIT PLAN
Plan identification number 502

MINT DENTISTRY, PLLC SUPPLEMENTAL BENEFIT PLAN Benefits

401k Plan Type
Plan Features/Benefits

    401k Sponsoring company profile

    MINT DENTISTRY, PLLC has sponsored the creation of one or more 401k plans.

    Company Name:MINT DENTISTRY, PLLC
    Employer identification number (EIN):264609067
    NAIC Classification:621210
    NAIC Description:Offices of Dentists

    Additional information about MINT DENTISTRY, PLLC

    Jurisdiction of Incorporation: Texas Secretary of State
    Incorporation Date: 2009-03-23
    Company Identification Number: 0801101314
    Legal Registered Office Address: 901 MAIN ST STE 7100

    DALLAS
    United States of America (USA)
    75202

    More information about MINT DENTISTRY, PLLC

    Form 5500 Filing Information

    Submission information for form 5500 for 401k plan MINT DENTISTRY, PLLC SUPPLEMENTAL BENEFIT PLAN

    Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
    5022017-04-01
    5022017-04-01KIM LUCAS2019-10-31

    Plan Statistics for MINT DENTISTRY, PLLC SUPPLEMENTAL BENEFIT PLAN

    401k plan membership statisitcs for MINT DENTISTRY, PLLC SUPPLEMENTAL BENEFIT PLAN

    Measure Date Value
    2017
    Total participants, beginning-of-year2017-04-01280
    Total number of active participants reported on line 7a of the Form 55002017-04-01282
    Number of retired or separated participants receiving benefits2017-04-010
    Number of other retired or separated participants entitled to future benefits2017-04-010
    Total of all active and inactive participants2017-04-01282

    Form 5500 Responses

    2017
    2017-04-01Type of plan entitySingle employer plan
    2017-04-01First time form 5500 has been submittedYes
    2017-04-01Submission has been amendedNo
    2017-04-01This submission is the final filingNo
    2017-04-01This return/report is a short plan year return/report (less than 12 months)No
    2017-04-01Plan is a collectively bargained planNo
    2017-04-01Plan funding arrangement – InsuranceYes
    2017-04-01Plan benefit arrangement – InsuranceYes

    Insurance Providers Used on plan

    THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
    Policy contract number000EU982
    Policy instance 1
    Insurance contract or identification number000EU982
    Number of Individuals Covered473
    Insurance policy start date2017-04-01
    Insurance policy end date2018-03-31
    Total amount of commissions paid to insurance brokerUSD $32,021
    Total amount of fees paid to insurance companyUSD $0
    Are there contracts with allocated funds for individual policies?0
    Are there contracts with allocated funds for group deferred annuity?No
    Are there contracts with allocated funds for types other than group deferred annuity or individual?No
    Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
    Contracts With Unallocated Funds Deposit Administration0
    Are there contracts with unallocated funds for contracts of type immediate participation guarantee?No
    Are there contracts with unallocated funds for contracts of type guaranteed investment?No
    Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?No
    Health Insurance Welfare BenefitYes
    Dental Insurance Welfare BenefitNo
    Vision Insurance Welfare BenefitYes
    Life Insurance Welfare BenefitYes
    Temporary Disability Insurance Welfare BenefitYes
    Long Term Disability Insurance Welfare BenefitYes
    Unemployment Insurance Welfare BenefitNo
    Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
    Were dividends or retroactive rate refunds paid in cash?No
    Were dividends or retroactive rate refunds paid as a credit?No
    Welfare Benefit Premiums Paid to CarrierUSD $211,978
    Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
    Commission paid to Insurance BrokerUSD $32,021
    Insurance broker organization code?3
    Insurance broker nameMOUZON BASS

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