DAVID F PAVLICK DMD has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan CANTON REGIONAL CHAMBER HEALTH FUND
| Measure | Date | Value |
|---|
| 2020 : CANTON REGIONAL CHAMBER HEALTH FUND 2020 401k financial data |
|---|
| Transfers to/from the plan | 2020-12-31 | $3 |
| Total plan liabilities at end of year | 2020-12-31 | $2,130 |
| Total plan liabilities at beginning of year | 2020-12-31 | $824 |
| Total income from all sources | 2020-12-31 | $20,556 |
| Expenses. Total of all expenses incurred | 2020-12-31 | $20,506 |
| Benefits paid (including direct rollovers) | 2020-12-31 | $1,836 |
| Total plan assets at end of year | 2020-12-31 | $-186 |
| Total plan assets at beginning of year | 2020-12-31 | $-1,545 |
| Total contributions received or receivable from participants | 2020-12-31 | $10,278 |
| Expenses. Other expenses not covered elsewhere | 2020-12-31 | $15 |
| Net income (gross income less expenses) | 2020-12-31 | $50 |
| Net plan assets at end of year (total assets less liabilities) | 2020-12-31 | $-2,316 |
| Net plan assets at beginning of year (total assets less liabilities) | 2020-12-31 | $-2,369 |
| Total contributions received or receivable from employer(s) | 2020-12-31 | $10,278 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2020-12-31 | $18,655 |
| 2019 : CANTON REGIONAL CHAMBER HEALTH FUND 2019 401k financial data |
|---|
| Transfers to/from the plan | 2019-12-31 | $-9 |
| Total plan liabilities at end of year | 2019-12-31 | $824 |
| Total plan liabilities at beginning of year | 2019-12-31 | $0 |
| Total income from all sources | 2019-12-31 | $8,784 |
| Expenses. Total of all expenses incurred | 2019-12-31 | $11,143 |
| Benefits paid (including direct rollovers) | 2019-12-31 | $5,146 |
| Total plan assets at end of year | 2019-12-31 | $-1,544 |
| Total plan assets at beginning of year | 2019-12-31 | $0 |
| Expenses. Other expenses not covered elsewhere | 2019-12-31 | $0 |
| Net income (gross income less expenses) | 2019-12-31 | $-2,359 |
| Net plan assets at end of year (total assets less liabilities) | 2019-12-31 | $-2,368 |
| Net plan assets at beginning of year (total assets less liabilities) | 2019-12-31 | $0 |
| Total contributions received or receivable from employer(s) | 2019-12-31 | $8,784 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2019-12-31 | $5,997 |
| 2020: CANTON REGIONAL CHAMBER HEALTH FUND 2020 form 5500 responses |
|---|
| 2020-01-01 | Type of plan entity | Single employer plan |
| 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 benefit arrangement – Insurance | Yes |
| 2019: CANTON REGIONAL CHAMBER HEALTH FUND 2019 form 5500 responses |
|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | First time form 5500 has been submitted | Yes |
| 2019-01-01 | Submission has been amended | No |
| 2019-01-01 | This submission is the final filing | No |
| 2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-01-01 | Plan is a collectively bargained plan | No |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| MCKINLEY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 77216 ) |
| Policy contract number | HF1775 |
| Policy instance | 1 |
| Insurance contract or identification number | HF1775 | | Number of Individuals Covered | 4 | | Insurance policy start date | 2020-01-01 | | Insurance policy end date | 2020-12-31 | | Total amount of commissions paid to insurance broker | USD $900 | | Are there contracts with allocated funds for individual policies? | 1 | | 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? | No | | Health Insurance Welfare Benefit | Yes | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $20,556 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $900 |
|
| MCKINLEY LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 77216 ) |
| Policy contract number | HF1775 |
| Policy instance | 1 |
| Insurance contract or identification number | HF1775 | | Number of Individuals Covered | 3 | | Insurance policy start date | 2019-07-01 | | Insurance policy end date | 2019-12-31 | | Total amount of commissions paid to insurance broker | USD $317 | | Total amount of fees paid to insurance company | USD $0 | | Are there contracts with allocated funds for individual policies? | 1 | | 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? | No | | Health Insurance Welfare Benefit | Yes | | 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 | | Welfare Benefit Premiums Paid to Carrier | USD $8,784 | | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | | Commission paid to Insurance Broker | USD $317 | | Amount paid for insurance broker fees | 0 |
|
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