401k Plan data: MIAMI DERMATOLOGY AND LASER INSTITUTE 401K RETIREMENT PLAN plan

MIAMI DERMATOLOGY AND LASER INSTITUTE 401K RETIREMENT PLAN 401k Plan overview

Plan Name	MIAMI DERMATOLOGY AND LASER INSTITUTE 401K RETIREMENT PLAN
Plan identification number	001

MIAMI DERMATOLOGY AND LASER INSTITUTE 401K 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

INTEGRATED DERMATOLOGY OF SOUTH MIAMI, LLC has sponsored the creation of one or more 401k plans.

Company Name: INTEGRATED DERMATOLOGY OF SOUTH MIAMI, LLC

Employer identification number (EIN): 270524361

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MIAMI DERMATOLOGY AND LASER INSTITUTE 401K RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 ANDREW WAIBEL 2023-10-13
001 2021-01-01 ANDREW R. WAIBEL 2022-10-13
001 2020-01-01 ANDREW R. WAIBEL 2021-10-06

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01	ANDREW WAIBEL	2023-10-13
001	2021-01-01	ANDREW R. WAIBEL	2022-10-13
001	2020-01-01	ANDREW R. WAIBEL	2021-10-06

Plan Statistics for MIAMI DERMATOLOGY AND LASER INSTITUTE 401K RETIREMENT PLAN

401k plan membership statisitcs for MIAMI DERMATOLOGY AND LASER INSTITUTE 401K RETIREMENT PLAN

Measure Date Value
2021: MIAMI DERMATOLOGY AND LASER INSTITUTE 401K RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 23
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 13
Number of retired or separated participants receiving benefits 2021-01-01 2
Number of other retired or separated participants entitled to future benefits 2021-01-01 8
Total of all active and inactive participants 2021-01-01 23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 23
Number of participants with account balances 2021-01-01 23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 3
2020: MIAMI DERMATOLOGY AND LASER INSTITUTE 401K RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 24
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 17
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 6
Total of all active and inactive participants 2020-01-01 23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 23
Number of participants with account balances 2020-01-01 22
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0

Measure	Date	Value
2021: MIAMI DERMATOLOGY AND LASER INSTITUTE 401K RETIREMENT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	23
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	13
Number of retired or separated participants receiving benefits	2021-01-01	2
Number of other retired or separated participants entitled to future benefits	2021-01-01	8
Total of all active and inactive participants	2021-01-01	23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	23
Number of participants with account balances	2021-01-01	23
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	3
2020: MIAMI DERMATOLOGY AND LASER INSTITUTE 401K RETIREMENT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	24
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	17
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	6
Total of all active and inactive participants	2020-01-01	23
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	23
Number of participants with account balances	2020-01-01	22
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0

Financial Data on MIAMI DERMATOLOGY AND LASER INSTITUTE 401K RETIREMENT PLAN

Measure	Date	Value
2021 : MIAMI DERMATOLOGY AND LASER INSTITUTE 401K RETIREMENT PLAN 2021 401k financial data
Total income from all sources	2021-12-31	$235,695
Expenses. Total of all expenses incurred	2021-12-31	$15,829
Benefits paid (including direct rollovers)	2021-12-31	$10,522
Total plan assets at end of year	2021-12-31	$431,186
Total plan assets at beginning of year	2021-12-31	$211,320
Total contributions received or receivable from participants	2021-12-31	$83,243
Expenses. Other expenses not covered elsewhere	2021-12-31	$1,041
Contributions received from other sources (not participants or employers)	2021-12-31	$4,363
Other income received	2021-12-31	$27,625
Net income (gross income less expenses)	2021-12-31	$219,866
Net plan assets at end of year (total assets less liabilities)	2021-12-31	$431,186
Net plan assets at beginning of year (total assets less liabilities)	2021-12-31	$211,320
Assets. Value of participant loans	2021-12-31	$1,402
Total contributions received or receivable from employer(s)	2021-12-31	$120,464
Expenses. Administrative service providers (salaries,fees and commissions)	2021-12-31	$4,266
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
2020 : MIAMI DERMATOLOGY AND LASER INSTITUTE 401K RETIREMENT PLAN 2020 401k financial data
Total income from all sources	2020-12-31	$212,630
Expenses. Total of all expenses incurred	2020-12-31	$1,310
Total plan assets at end of year	2020-12-31	$211,320
Total plan assets at beginning of year	2020-12-31	$0
Total contributions received or receivable from participants	2020-12-31	$82,962
Other income received	2020-12-31	$20,928
Net income (gross income less expenses)	2020-12-31	$211,320
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$211,320
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$0
Total contributions received or receivable from employer(s)	2020-12-31	$108,740
Expenses. Administrative service providers (salaries,fees and commissions)	2020-12-31	$1,310

Form 5500 Responses for MIAMI DERMATOLOGY AND LASER INSTITUTE 401K RETIREMENT PLAN

2021: MIAMI DERMATOLOGY AND LASER INSTITUTE 401K RETIREMENT PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Submission has been amended	No
2021-01-01	This submission is the final filing	No
2021-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-01-01	Plan is a collectively bargained plan	No
2021-01-01	Plan funding arrangement – Insurance	Yes
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: MIAMI DERMATOLOGY AND LASER INSTITUTE 401K RETIREMENT PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	First time form 5500 has been submitted	Yes
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

143993

Policy instance

Insurance contract or identification number	143993
Number of Individuals Covered	21
Insurance policy start date	2021-01-01
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $823
Total amount of fees paid to insurance company	USD $400
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $293
Amount paid for insurance broker fees	400
Additional information about fees paid to insurance broker	TPA COMPENSATION
Insurance broker organization code?	5

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

143993

Policy instance

Insurance contract or identification number	143993
Number of Individuals Covered	22
Insurance policy start date	2020-02-14
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $1,104
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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?	Yes
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $989
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	TPA COMPENSATION
Insurance broker organization code?	5

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Company Name:	INTEGRATED DERMATOLOGY OF SOUTH MIAMI, LLC
Employer identification number (EIN):	270524361
NAIC Classification:	621210
NAIC Description:	Offices of Dentists