401k Plan data: PACIFIC DENTAL SERVICES, LLC EMPLOYEE BENEFIT PLAN plan

PACIFIC DENTAL SERVICES, LLC EMPLOYEE BENEFIT PLAN 401k Plan overview

Plan Name	PACIFIC DENTAL SERVICES, LLC EMPLOYEE BENEFIT PLAN
Plan identification number	501

PACIFIC DENTAL SERVICES, LLC EMPLOYEE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Dental Vision Temporary disability (accident and sickness) Prepaid legal Long-term disability cover Other welfare benefit cover

401k Sponsoring company profile

PACIFIC DENTAL SERVICES, LLC has sponsored the creation of one or more 401k plans.

Company Name: PACIFIC DENTAL SERVICES, LLC

Employer identification number (EIN): 330681491

NAIC Classification: 551112
NAIC Description: Offices of Other Holding Companies

Additional information about PACIFIC DENTAL SERVICES, LLC

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 2009-11-09

Company Identification Number: 0801192046

Legal Registered Office Address: PO BOX 19723

IRVINE
United States of America (USA)
92623

More information about PACIFIC DENTAL SERVICES, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PACIFIC DENTAL SERVICES, LLC EMPLOYEE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2013-12-01 BRADY AASE BRADY AASE 2016-09-15
501 2012-12-01 BRADY AASE
501 2011-12-01 BRADY AASE
501 2010-12-01 BRADY AASE
501 2009-12-01 BRADY AASE

Plan id#	Filing Submission Date	Name of Administrator	Name of Company Sponsor	Date Sponsor Signed
501	2013-12-01	BRADY AASE	BRADY AASE	2016-09-15
501	2012-12-01	BRADY AASE
501	2011-12-01	BRADY AASE
501	2010-12-01	BRADY AASE
501	2009-12-01	BRADY AASE

Plan Statistics for PACIFIC DENTAL SERVICES, LLC EMPLOYEE BENEFIT PLAN

401k plan membership statisitcs for PACIFIC DENTAL SERVICES, LLC EMPLOYEE BENEFIT PLAN

Measure Date Value
2013: PACIFIC DENTAL SERVICES, LLC EMPLOYEE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year 2013-12-01 4,233
Total number of active participants reported on line 7a of the Form 5500 2013-12-01 0
Number of retired or separated participants receiving benefits 2013-12-01 0
Number of other retired or separated participants entitled to future benefits 2013-12-01 0
Total of all active and inactive participants 2013-12-01 0
Total participants 2013-12-01 0
2012: PACIFIC DENTAL SERVICES, LLC EMPLOYEE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year 2012-12-01 3,172
Total number of active participants reported on line 7a of the Form 5500 2012-12-01 4,216
Number of retired or separated participants receiving benefits 2012-12-01 17
Number of other retired or separated participants entitled to future benefits 2012-12-01 0
Total of all active and inactive participants 2012-12-01 4,233
2011: PACIFIC DENTAL SERVICES, LLC EMPLOYEE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year 2011-12-01 3,117
Total number of active participants reported on line 7a of the Form 5500 2011-12-01 3,136
Number of retired or separated participants receiving benefits 2011-12-01 36
Number of other retired or separated participants entitled to future benefits 2011-12-01 0
Total of all active and inactive participants 2011-12-01 3,172
2010: PACIFIC DENTAL SERVICES, LLC EMPLOYEE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-12-01 2,476
Total number of active participants reported on line 7a of the Form 5500 2010-12-01 3,097
Number of retired or separated participants receiving benefits 2010-12-01 20
Number of other retired or separated participants entitled to future benefits 2010-12-01 0
Total of all active and inactive participants 2010-12-01 3,117
2009: PACIFIC DENTAL SERVICES, LLC EMPLOYEE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-12-01 2,069
Total number of active participants reported on line 7a of the Form 5500 2009-12-01 2,438
Number of retired or separated participants receiving benefits 2009-12-01 38
Number of other retired or separated participants entitled to future benefits 2009-12-01 0
Total of all active and inactive participants 2009-12-01 2,476

Measure	Date	Value
2013: PACIFIC DENTAL SERVICES, LLC EMPLOYEE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year	2013-12-01	4,233
Total number of active participants reported on line 7a of the Form 5500	2013-12-01	0
Number of retired or separated participants receiving benefits	2013-12-01	0
Number of other retired or separated participants entitled to future benefits	2013-12-01	0
Total of all active and inactive participants	2013-12-01	0
Total participants	2013-12-01	0
2012: PACIFIC DENTAL SERVICES, LLC EMPLOYEE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year	2012-12-01	3,172
Total number of active participants reported on line 7a of the Form 5500	2012-12-01	4,216
Number of retired or separated participants receiving benefits	2012-12-01	17
Number of other retired or separated participants entitled to future benefits	2012-12-01	0
Total of all active and inactive participants	2012-12-01	4,233
2011: PACIFIC DENTAL SERVICES, LLC EMPLOYEE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year	2011-12-01	3,117
Total number of active participants reported on line 7a of the Form 5500	2011-12-01	3,136
Number of retired or separated participants receiving benefits	2011-12-01	36
Number of other retired or separated participants entitled to future benefits	2011-12-01	0
Total of all active and inactive participants	2011-12-01	3,172
2010: PACIFIC DENTAL SERVICES, LLC EMPLOYEE BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-12-01	2,476
Total number of active participants reported on line 7a of the Form 5500	2010-12-01	3,097
Number of retired or separated participants receiving benefits	2010-12-01	20
Number of other retired or separated participants entitled to future benefits	2010-12-01	0
Total of all active and inactive participants	2010-12-01	3,117
2009: PACIFIC DENTAL SERVICES, LLC EMPLOYEE BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-12-01	2,069
Total number of active participants reported on line 7a of the Form 5500	2009-12-01	2,438
Number of retired or separated participants receiving benefits	2009-12-01	38
Number of other retired or separated participants entitled to future benefits	2009-12-01	0
Total of all active and inactive participants	2009-12-01	2,476

Form 5500 Responses for PACIFIC DENTAL SERVICES, LLC EMPLOYEE BENEFIT PLAN

2013: PACIFIC DENTAL SERVICES, LLC EMPLOYEE BENEFIT PLAN 2013 form 5500 responses
2013-12-01	Type of plan entity	Single employer plan
2013-12-01	Submission has been amended	Yes
2013-12-01	This submission is the final filing	Yes
2013-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-12-01	Plan is a collectively bargained plan	No
2013-12-01	Plan funding arrangement – Insurance	Yes
2013-12-01	Plan funding arrangement – General assets of the sponsor	Yes
2013-12-01	Plan benefit arrangement – Insurance	Yes
2013-12-01	Plan benefit arrangement – General assets of the sponsor	Yes
2012: PACIFIC DENTAL SERVICES, LLC EMPLOYEE BENEFIT PLAN 2012 form 5500 responses
2012-12-01	Type of plan entity	Single employer plan
2012-12-01	Submission has been amended	No
2012-12-01	This submission is the final filing	No
2012-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-12-01	Plan is a collectively bargained plan	No
2012-12-01	Plan funding arrangement – Insurance	Yes
2012-12-01	Plan funding arrangement – General assets of the sponsor	Yes
2012-12-01	Plan benefit arrangement – Insurance	Yes
2012-12-01	Plan benefit arrangement – General assets of the sponsor	Yes
2011: PACIFIC DENTAL SERVICES, LLC EMPLOYEE BENEFIT PLAN 2011 form 5500 responses
2011-12-01	Type of plan entity	Single employer plan
2011-12-01	Submission has been amended	No
2011-12-01	This submission is the final filing	No
2011-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-12-01	Plan is a collectively bargained plan	No
2011-12-01	Plan funding arrangement – Insurance	Yes
2011-12-01	Plan funding arrangement – General assets of the sponsor	Yes
2011-12-01	Plan benefit arrangement – Insurance	Yes
2011-12-01	Plan benefit arrangement – General assets of the sponsor	Yes
2010: PACIFIC DENTAL SERVICES, LLC EMPLOYEE BENEFIT PLAN 2010 form 5500 responses
2010-12-01	Type of plan entity	Single employer plan
2010-12-01	Submission has been amended	No
2010-12-01	This submission is the final filing	No
2010-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-12-01	Plan is a collectively bargained plan	No
2010-12-01	Plan funding arrangement – Insurance	Yes
2010-12-01	Plan funding arrangement – General assets of the sponsor	Yes
2010-12-01	Plan benefit arrangement – Insurance	Yes
2010-12-01	Plan benefit arrangement – General assets of the sponsor	Yes
2009: PACIFIC DENTAL SERVICES, LLC EMPLOYEE BENEFIT PLAN 2009 form 5500 responses
2009-12-01	Type of plan entity	Single employer plan
2009-12-01	Submission has been amended	No
2009-12-01	This submission is the final filing	No
2009-12-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-12-01	Plan is a collectively bargained plan	No
2009-12-01	Plan funding arrangement – Insurance	Yes
2009-12-01	Plan funding arrangement – General assets of the sponsor	Yes
2009-12-01	Plan benefit arrangement – Insurance	Yes
2009-12-01	Plan benefit arrangement – General assets of the sponsor	Yes

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Company Name:	PACIFIC DENTAL SERVICES, LLC
Employer identification number (EIN):	330681491
NAIC Classification:	551112
NAIC Description:	Offices of Other Holding Companies

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	2009-11-09
Company Identification Number:	0801192046
Legal Registered Office Address:	PO BOX 19723 IRVINE United States of America (USA) 92623