401k Plan data: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN plan

MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 401k Plan overview

Plan Name	MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN
Plan identification number	002

MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

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.
Partial participant-directed account plan - Participants have the opportunity to direct the investment of a portion of 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.
Participant-directed brokerage accounts provided as an investment option under the plan.
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

MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. has sponsored the creation of one or more 401k plans.

Company Name: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C.

Employer identification number (EIN): 391269454

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2022-01-01 SARAH B HEUER 2023-05-31
002 2021-01-01 SARAH B HEUER 2022-07-13
002 2020-01-01 SARAH B HEUER 2021-04-12
002 2019-01-01 SARAH B HEUER 2020-05-18
002 2018-01-01
002 2017-01-01
002 2016-06-01
002 2015-06-01
002 2014-06-01
002 2013-06-01 SARAH HEUER
002 2012-06-01 AMY BIEHL
002 2011-06-01 AMY BIEHL
002 2009-06-01 DR AMY BIEHL
002 2009-06-01 SARAH HEUER

Plan Statistics for MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN

401k plan membership statisitcs for MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN

Measure Date Value
2022: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 41
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 18
Number of retired or separated participants receiving benefits 2022-01-01 0
Number of other retired or separated participants entitled to future benefits 2022-01-01 23
Total of all active and inactive participants 2022-01-01 41
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2022-01-01 0
Total participants 2022-01-01 41
Number of participants with account balances 2022-01-01 41
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2022-01-01 0
2021: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 43
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 19
Number of retired or separated participants receiving benefits 2021-01-01 0
Number of other retired or separated participants entitled to future benefits 2021-01-01 22
Total of all active and inactive participants 2021-01-01 41
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 41
Number of participants with account balances 2021-01-01 41
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 41
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 21
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 18
Total of all active and inactive participants 2020-01-01 39
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 39
Number of participants with account balances 2020-01-01 39
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 44
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 21
Number of retired or separated participants receiving benefits 2019-01-01 0
Number of other retired or separated participants entitled to future benefits 2019-01-01 17
Total of all active and inactive participants 2019-01-01 38
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 38
Number of participants with account balances 2019-01-01 38
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 44
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 26
Number of retired or separated participants receiving benefits 2018-01-01 0
Number of other retired or separated participants entitled to future benefits 2018-01-01 17
Total of all active and inactive participants 2018-01-01 43
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 43
Number of participants with account balances 2018-01-01 43
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 41
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 26
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 17
Total of all active and inactive participants 2017-01-01 43
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 43
Number of participants with account balances 2017-01-01 43
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year 2016-06-01 40
Total number of active participants reported on line 7a of the Form 5500 2016-06-01 26
Number of retired or separated participants receiving benefits 2016-06-01 0
Number of other retired or separated participants entitled to future benefits 2016-06-01 12
Total of all active and inactive participants 2016-06-01 38
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-06-01 0
Total participants 2016-06-01 38
Number of participants with account balances 2016-06-01 38
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-06-01 0
2015: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year 2015-06-01 43
Total number of active participants reported on line 7a of the Form 5500 2015-06-01 25
Number of retired or separated participants receiving benefits 2015-06-01 0
Number of other retired or separated participants entitled to future benefits 2015-06-01 15
Total of all active and inactive participants 2015-06-01 40
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-06-01 0
Total participants 2015-06-01 40
Number of participants with account balances 2015-06-01 40
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-06-01 0
2014: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year 2014-06-01 40
Total number of active participants reported on line 7a of the Form 5500 2014-06-01 25
Number of retired or separated participants receiving benefits 2014-06-01 0
Number of other retired or separated participants entitled to future benefits 2014-06-01 17
Total of all active and inactive participants 2014-06-01 42
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-06-01 0
Total participants 2014-06-01 42
Number of participants with account balances 2014-06-01 42
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-06-01 0
2013: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year 2013-06-01 37
Total number of active participants reported on line 7a of the Form 5500 2013-06-01 27
Number of retired or separated participants receiving benefits 2013-06-01 0
Number of other retired or separated participants entitled to future benefits 2013-06-01 12
Total of all active and inactive participants 2013-06-01 39
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-06-01 0
Total participants 2013-06-01 39
Number of participants with account balances 2013-06-01 39
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-06-01 0
2012: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year 2012-06-01 36
Total number of active participants reported on line 7a of the Form 5500 2012-06-01 27
Number of retired or separated participants receiving benefits 2012-06-01 0
Number of other retired or separated participants entitled to future benefits 2012-06-01 9
Total of all active and inactive participants 2012-06-01 36
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-06-01 0
Total participants 2012-06-01 36
Number of participants with account balances 2012-06-01 36
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-06-01 0
2011: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-06-01 30
Total number of active participants reported on line 7a of the Form 5500 2011-06-01 28
Number of retired or separated participants receiving benefits 2011-06-01 0
Number of other retired or separated participants entitled to future benefits 2011-06-01 5
Total of all active and inactive participants 2011-06-01 33
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-06-01 0
Total participants 2011-06-01 33
Number of participants with account balances 2011-06-01 33
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-06-01 0
2009: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-06-01 39
Total number of active participants reported on line 7a of the Form 5500 2009-06-01 33
Number of retired or separated participants receiving benefits 2009-06-01 0
Number of other retired or separated participants entitled to future benefits 2009-06-01 6
Total of all active and inactive participants 2009-06-01 39
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-06-01 0
Total participants 2009-06-01 39
Number of participants with account balances 2009-06-01 39
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-06-01 0

Measure	Date	Value
2022: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	41
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	18
Number of retired or separated participants receiving benefits	2022-01-01	0
Number of other retired or separated participants entitled to future benefits	2022-01-01	23
Total of all active and inactive participants	2022-01-01	41
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2022-01-01	0
Total participants	2022-01-01	41
Number of participants with account balances	2022-01-01	41
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2022-01-01	0
2021: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	43
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	19
Number of retired or separated participants receiving benefits	2021-01-01	0
Number of other retired or separated participants entitled to future benefits	2021-01-01	22
Total of all active and inactive participants	2021-01-01	41
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	41
Number of participants with account balances	2021-01-01	41
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	41
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	21
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	18
Total of all active and inactive participants	2020-01-01	39
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	39
Number of participants with account balances	2020-01-01	39
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	44
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	21
Number of retired or separated participants receiving benefits	2019-01-01	0
Number of other retired or separated participants entitled to future benefits	2019-01-01	17
Total of all active and inactive participants	2019-01-01	38
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	38
Number of participants with account balances	2019-01-01	38
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	44
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	26
Number of retired or separated participants receiving benefits	2018-01-01	0
Number of other retired or separated participants entitled to future benefits	2018-01-01	17
Total of all active and inactive participants	2018-01-01	43
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	43
Number of participants with account balances	2018-01-01	43
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	41
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	26
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	17
Total of all active and inactive participants	2017-01-01	43
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	43
Number of participants with account balances	2017-01-01	43
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2016 401k membership
Total participants, beginning-of-year	2016-06-01	40
Total number of active participants reported on line 7a of the Form 5500	2016-06-01	26
Number of retired or separated participants receiving benefits	2016-06-01	0
Number of other retired or separated participants entitled to future benefits	2016-06-01	12
Total of all active and inactive participants	2016-06-01	38
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-06-01	0
Total participants	2016-06-01	38
Number of participants with account balances	2016-06-01	38
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-06-01	0
2015: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2015 401k membership
Total participants, beginning-of-year	2015-06-01	43
Total number of active participants reported on line 7a of the Form 5500	2015-06-01	25
Number of retired or separated participants receiving benefits	2015-06-01	0
Number of other retired or separated participants entitled to future benefits	2015-06-01	15
Total of all active and inactive participants	2015-06-01	40
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-06-01	0
Total participants	2015-06-01	40
Number of participants with account balances	2015-06-01	40
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-06-01	0
2014: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2014 401k membership
Total participants, beginning-of-year	2014-06-01	40
Total number of active participants reported on line 7a of the Form 5500	2014-06-01	25
Number of retired or separated participants receiving benefits	2014-06-01	0
Number of other retired or separated participants entitled to future benefits	2014-06-01	17
Total of all active and inactive participants	2014-06-01	42
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-06-01	0
Total participants	2014-06-01	42
Number of participants with account balances	2014-06-01	42
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-06-01	0
2013: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2013 401k membership
Total participants, beginning-of-year	2013-06-01	37
Total number of active participants reported on line 7a of the Form 5500	2013-06-01	27
Number of retired or separated participants receiving benefits	2013-06-01	0
Number of other retired or separated participants entitled to future benefits	2013-06-01	12
Total of all active and inactive participants	2013-06-01	39
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-06-01	0
Total participants	2013-06-01	39
Number of participants with account balances	2013-06-01	39
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-06-01	0
2012: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2012 401k membership
Total participants, beginning-of-year	2012-06-01	36
Total number of active participants reported on line 7a of the Form 5500	2012-06-01	27
Number of retired or separated participants receiving benefits	2012-06-01	0
Number of other retired or separated participants entitled to future benefits	2012-06-01	9
Total of all active and inactive participants	2012-06-01	36
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-06-01	0
Total participants	2012-06-01	36
Number of participants with account balances	2012-06-01	36
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-06-01	0
2011: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-06-01	30
Total number of active participants reported on line 7a of the Form 5500	2011-06-01	28
Number of retired or separated participants receiving benefits	2011-06-01	0
Number of other retired or separated participants entitled to future benefits	2011-06-01	5
Total of all active and inactive participants	2011-06-01	33
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-06-01	0
Total participants	2011-06-01	33
Number of participants with account balances	2011-06-01	33
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-06-01	0
2009: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-06-01	39
Total number of active participants reported on line 7a of the Form 5500	2009-06-01	33
Number of retired or separated participants receiving benefits	2009-06-01	0
Number of other retired or separated participants entitled to future benefits	2009-06-01	6
Total of all active and inactive participants	2009-06-01	39
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-06-01	0
Total participants	2009-06-01	39
Number of participants with account balances	2009-06-01	39
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-06-01	0

Financial Data on MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN

Measure	Date	Value
2022 : MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2022 401k financial data
Total income from all sources	2022-12-31	$-673,006
Expenses. Total of all expenses incurred	2022-12-31	$167,419
Benefits paid (including direct rollovers)	2022-12-31	$136,461
Total plan assets at end of year	2022-12-31	$7,229,759
Total plan assets at beginning of year	2022-12-31	$8,070,184
Value of fidelity bond covering the plan	2022-12-31	$1,200,000
Total contributions received or receivable from participants	2022-12-31	$131,960
Other income received	2022-12-31	$-982,176
Net income (gross income less expenses)	2022-12-31	$-840,425
Net plan assets at end of year (total assets less liabilities)	2022-12-31	$7,229,759
Net plan assets at beginning of year (total assets less liabilities)	2022-12-31	$8,070,184
Assets. Value of participant loans	2022-12-31	$0
Assets. Value of assets in partnership/joint-venture interests	2022-12-31	$125,989
Total contributions received or receivable from employer(s)	2022-12-31	$177,210
Expenses. Administrative service providers (salaries,fees and commissions)	2022-12-31	$30,958
2021 : MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2021 401k financial data
Total income from all sources	2021-12-31	$1,419,074
Expenses. Total of all expenses incurred	2021-12-31	$93,302
Benefits paid (including direct rollovers)	2021-12-31	$59,833
Total plan assets at end of year	2021-12-31	$8,070,184
Total plan assets at beginning of year	2021-12-31	$6,744,412
Value of fidelity bond covering the plan	2021-12-31	$830,000
Total contributions received or receivable from participants	2021-12-31	$176,438
Contributions received from other sources (not participants or employers)	2021-12-31	$42,088
Other income received	2021-12-31	$1,012,862
Net income (gross income less expenses)	2021-12-31	$1,325,772
Net plan assets at end of year (total assets less liabilities)	2021-12-31	$8,070,184
Net plan assets at beginning of year (total assets less liabilities)	2021-12-31	$6,744,412
Assets. Value of participant loans	2021-12-31	$4,106
Assets. Value of assets in partnership/joint-venture interests	2021-12-31	$199,413
Total contributions received or receivable from employer(s)	2021-12-31	$187,686
Expenses. Administrative service providers (salaries,fees and commissions)	2021-12-31	$33,469
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2021-12-31	$0
2020 : MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2020 401k financial data
Total income from all sources	2020-12-31	$1,444,562
Expenses. Total of all expenses incurred	2020-12-31	$1,266,428
Benefits paid (including direct rollovers)	2020-12-31	$1,237,449
Total plan assets at end of year	2020-12-31	$6,744,412
Total plan assets at beginning of year	2020-12-31	$6,566,278
Value of fidelity bond covering the plan	2020-12-31	$830,000
Total contributions received or receivable from participants	2020-12-31	$165,285
Other income received	2020-12-31	$1,104,884
Net income (gross income less expenses)	2020-12-31	$178,134
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$6,744,412
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$6,566,278
Assets. Value of participant loans	2020-12-31	$11,730
Assets. Value of assets in partnership/joint-venture interests	2020-12-31	$135,808
Total contributions received or receivable from employer(s)	2020-12-31	$174,393
Expenses. Administrative service providers (salaries,fees and commissions)	2020-12-31	$28,979
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2020-12-31	$0
2019 : MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2019 401k financial data
Total income from all sources	2019-12-31	$1,677,931
Expenses. Total of all expenses incurred	2019-12-31	$1,034,903
Benefits paid (including direct rollovers)	2019-12-31	$964,992
Total plan assets at end of year	2019-12-31	$6,566,278
Total plan assets at beginning of year	2019-12-31	$5,923,250
Value of fidelity bond covering the plan	2019-12-31	$1,200,000
Total contributions received or receivable from participants	2019-12-31	$160,856
Other income received	2019-12-31	$1,358,375
Net income (gross income less expenses)	2019-12-31	$643,028
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$6,566,278
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$5,923,250
Assets. Value of participant loans	2019-12-31	$19,067
Assets. Value of assets in partnership/joint-venture interests	2019-12-31	$256,718
Total contributions received or receivable from employer(s)	2019-12-31	$158,700
Expenses. Administrative service providers (salaries,fees and commissions)	2019-12-31	$69,911
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$0
2018 : MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2018 401k financial data
Total income from all sources	2018-12-31	$-360,809
Expenses. Total of all expenses incurred	2018-12-31	$1,479,283
Benefits paid (including direct rollovers)	2018-12-31	$1,383,730
Total plan assets at end of year	2018-12-31	$5,923,250
Total plan assets at beginning of year	2018-12-31	$7,763,342
Value of fidelity bond covering the plan	2018-12-31	$1,200,000
Total contributions received or receivable from participants	2018-12-31	$168,576
Other income received	2018-12-31	$-721,287
Net income (gross income less expenses)	2018-12-31	$-1,840,092
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$5,923,250
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$7,763,342
Assets. Value of participant loans	2018-12-31	$25,908
Assets. Value of assets in partnership/joint-venture interests	2018-12-31	$326,688
Total contributions received or receivable from employer(s)	2018-12-31	$191,902
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$95,553
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
2017 : MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2017 401k financial data
Total income from all sources	2017-12-31	$1,568,691
Expenses. Total of all expenses incurred	2017-12-31	$256,470
Benefits paid (including direct rollovers)	2017-12-31	$186,668
Total plan assets at end of year	2017-12-31	$7,763,342
Total plan assets at beginning of year	2017-12-31	$6,451,121
Value of fidelity bond covering the plan	2017-12-31	$1,150,000
Total contributions received or receivable from participants	2017-12-31	$170,899
Contributions received from other sources (not participants or employers)	2017-12-31	$4,117
Other income received	2017-12-31	$1,184,322
Net income (gross income less expenses)	2017-12-31	$1,312,221
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$7,763,342
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$6,451,121
Assets. Value of participant loans	2017-12-31	$41,298
Assets. Value of assets in partnership/joint-venture interests	2017-12-31	$593,590
Total contributions received or receivable from employer(s)	2017-12-31	$209,353
Expenses. Administrative service providers (salaries,fees and commissions)	2017-12-31	$69,802
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-12-31	$0
2016 : MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2016 401k financial data
Total income from all sources	2016-12-31	$381,729
Expenses. Total of all expenses incurred	2016-12-31	$574,613
Benefits paid (including direct rollovers)	2016-12-31	$547,017
Total plan assets at end of year	2016-12-31	$6,451,121
Total plan assets at beginning of year	2016-12-31	$6,644,005
Value of fidelity bond covering the plan	2016-12-31	$1,200,000
Total contributions received or receivable from participants	2016-12-31	$45,031
Contributions received from other sources (not participants or employers)	2016-12-31	$6,019
Other income received	2016-12-31	$237,162
Net income (gross income less expenses)	2016-12-31	$-192,884
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$6,451,121
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$6,644,005
Assets. Value of participant loans	2016-12-31	$27,171
Assets. Value of assets in partnership/joint-venture interests	2016-12-31	$613,967
Total contributions received or receivable from employer(s)	2016-12-31	$93,517
Expenses. Administrative service providers (salaries,fees and commissions)	2016-12-31	$27,596
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Total income from all sources	2016-05-31	$27,102
Expenses. Total of all expenses incurred	2016-05-31	$78,868
Benefits paid (including direct rollovers)	2016-05-31	$29,886
Total plan assets at end of year	2016-05-31	$6,644,005
Total plan assets at beginning of year	2016-05-31	$6,695,771
Value of fidelity bond covering the plan	2016-05-31	$1,300,000
Total contributions received or receivable from participants	2016-05-31	$139,075
Other income received	2016-05-31	$-224,112
Net income (gross income less expenses)	2016-05-31	$-51,766
Net plan assets at end of year (total assets less liabilities)	2016-05-31	$6,644,005
Net plan assets at beginning of year (total assets less liabilities)	2016-05-31	$6,695,771
Assets. Value of participant loans	2016-05-31	$53,235
Assets. Value of assets in partnership/joint-venture interests	2016-05-31	$663,603
Total contributions received or receivable from employer(s)	2016-05-31	$112,139
Expenses. Administrative service providers (salaries,fees and commissions)	2016-05-31	$48,982
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-05-31	$0
2015 : MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2015 401k financial data
Total income from all sources	2015-05-31	$748,117
Expenses. Total of all expenses incurred	2015-05-31	$1,051,079
Benefits paid (including direct rollovers)	2015-05-31	$1,004,977
Total plan assets at end of year	2015-05-31	$6,695,771
Total plan assets at beginning of year	2015-05-31	$6,998,733
Value of fidelity bond covering the plan	2015-05-31	$1,300,000
Total contributions received or receivable from participants	2015-05-31	$121,622
Contributions received from other sources (not participants or employers)	2015-05-31	$0
Other income received	2015-05-31	$458,297
Net income (gross income less expenses)	2015-05-31	$-302,962
Net plan assets at end of year (total assets less liabilities)	2015-05-31	$6,695,771
Net plan assets at beginning of year (total assets less liabilities)	2015-05-31	$6,998,733
Assets. Value of participant loans	2015-05-31	$77,881
Assets. Value of assets in partnership/joint-venture interests	2015-05-31	$676,501
Total contributions received or receivable from employer(s)	2015-05-31	$168,198
Expenses. Administrative service providers (salaries,fees and commissions)	2015-05-31	$46,102
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-05-31	$0
2014 : MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2014 401k financial data
Total income from all sources	2014-05-31	$1,233,755
Expenses. Total of all expenses incurred	2014-05-31	$1,953,555
Benefits paid (including direct rollovers)	2014-05-31	$1,899,399
Total plan assets at end of year	2014-05-31	$6,998,733
Total plan assets at beginning of year	2014-05-31	$7,718,533
Value of fidelity bond covering the plan	2014-05-31	$1,300,000
Total contributions received or receivable from participants	2014-05-31	$168,622
Expenses. Other expenses not covered elsewhere	2014-05-31	$54,156
Other income received	2014-05-31	$922,085
Net income (gross income less expenses)	2014-05-31	$-719,800
Net plan assets at end of year (total assets less liabilities)	2014-05-31	$6,998,733
Net plan assets at beginning of year (total assets less liabilities)	2014-05-31	$7,718,533
Assets. Value of participant loans	2014-05-31	$120,148
Assets. Value of assets in partnership/joint-venture interests	2014-05-31	$667,988
Total contributions received or receivable from employer(s)	2014-05-31	$143,048
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-05-31	$0
2013 : MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2013 401k financial data
Total income from all sources	2013-05-31	$1,386,768
Expenses. Total of all expenses incurred	2013-05-31	$31,135
Benefits paid (including direct rollovers)	2013-05-31	$31,135
Total plan assets at end of year	2013-05-31	$7,718,533
Total plan assets at beginning of year	2013-05-31	$6,362,900
Value of fidelity bond covering the plan	2013-05-31	$1,300,000
Total contributions received or receivable from participants	2013-05-31	$160,165
Other income received	2013-05-31	$1,032,781
Net income (gross income less expenses)	2013-05-31	$1,355,633
Net plan assets at end of year (total assets less liabilities)	2013-05-31	$7,718,533
Net plan assets at beginning of year (total assets less liabilities)	2013-05-31	$6,362,900
Assets. Value of participant loans	2013-05-31	$151,363
Assets. Value of assets in partnership/joint-venture interests	2013-05-31	$632,543
Total contributions received or receivable from employer(s)	2013-05-31	$193,822
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-05-31	$0
2012 : MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2012 401k financial data
Total income from all sources	2012-05-31	$-67,545
Expenses. Total of all expenses incurred	2012-05-31	$49,163
Benefits paid (including direct rollovers)	2012-05-31	$49,163
Total plan assets at end of year	2012-05-31	$6,362,900
Total plan assets at beginning of year	2012-05-31	$6,479,608
Value of fidelity bond covering the plan	2012-05-31	$1,100,000
Total contributions received or receivable from participants	2012-05-31	$159,204
Other income received	2012-05-31	$-455,855
Net income (gross income less expenses)	2012-05-31	$-116,708
Net plan assets at end of year (total assets less liabilities)	2012-05-31	$6,362,900
Net plan assets at beginning of year (total assets less liabilities)	2012-05-31	$6,479,608
Assets. Value of participant loans	2012-05-31	$5,358
Assets. Value of assets in partnership/joint-venture interests	2012-05-31	$582,382
Total contributions received or receivable from employer(s)	2012-05-31	$229,106
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-05-31	$0
2011 : MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2011 401k financial data
Total income from all sources	2011-05-31	$1,478,658
Expenses. Total of all expenses incurred	2011-05-31	$559,039
Benefits paid (including direct rollovers)	2011-05-31	$559,039
Total plan assets at end of year	2011-05-31	$6,479,608
Total plan assets at beginning of year	2011-05-31	$5,559,989
Value of fidelity bond covering the plan	2011-05-31	$875,000
Total contributions received or receivable from participants	2011-05-31	$161,413
Other income received	2011-05-31	$1,125,531
Net income (gross income less expenses)	2011-05-31	$919,619
Net plan assets at end of year (total assets less liabilities)	2011-05-31	$6,479,608
Net plan assets at beginning of year (total assets less liabilities)	2011-05-31	$5,559,989
Assets. Value of participant loans	2011-05-31	$7,347
Assets. Value of assets in partnership/joint-venture interests	2011-05-31	$559,893
Total contributions received or receivable from employer(s)	2011-05-31	$191,714
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-05-31	$0

Form 5500 Responses for MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN

2022: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Submission has been amended	No
2022-01-01	This submission is the final filing	No
2022-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-01-01	Plan is a collectively bargained plan	No
2022-01-01	Plan funding arrangement – Insurance	Yes
2022-01-01	Plan funding arrangement – Trust	Yes
2022-01-01	Plan benefit arrangement – Insurance	Yes
2022-01-01	Plan benefit arrangement - Trust	Yes
2021: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) 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 – Insurance	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 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 – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
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 – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2016 form 5500 responses
2016-06-01	Type of plan entity	Single employer plan
2016-06-01	Submission has been amended	No
2016-06-01	This submission is the final filing	No
2016-06-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2016-06-01	Plan is a collectively bargained plan	No
2016-06-01	Plan funding arrangement – Trust	Yes
2016-06-01	Plan benefit arrangement - Trust	Yes
2015: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2015 form 5500 responses
2015-06-01	Type of plan entity	Single employer plan
2015-06-01	Submission has been amended	No
2015-06-01	This submission is the final filing	No
2015-06-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-06-01	Plan is a collectively bargained plan	No
2015-06-01	Plan funding arrangement – Trust	Yes
2015-06-01	Plan benefit arrangement - Trust	Yes
2014: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2014 form 5500 responses
2014-06-01	Type of plan entity	Single employer plan
2014-06-01	Submission has been amended	No
2014-06-01	This submission is the final filing	No
2014-06-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-06-01	Plan is a collectively bargained plan	No
2014-06-01	Plan funding arrangement – Trust	Yes
2014-06-01	Plan benefit arrangement - Trust	Yes
2013: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2013 form 5500 responses
2013-06-01	Type of plan entity	Single employer plan
2013-06-01	Submission has been amended	No
2013-06-01	This submission is the final filing	No
2013-06-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-06-01	Plan is a collectively bargained plan	No
2013-06-01	Plan funding arrangement – Trust	Yes
2013-06-01	Plan benefit arrangement - Trust	Yes
2012: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2012 form 5500 responses
2012-06-01	Type of plan entity	Single employer plan
2012-06-01	Submission has been amended	No
2012-06-01	This submission is the final filing	No
2012-06-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-06-01	Plan is a collectively bargained plan	No
2012-06-01	Plan funding arrangement – Trust	Yes
2012-06-01	Plan benefit arrangement - Trust	Yes
2011: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2011 form 5500 responses
2011-06-01	Type of plan entity	Single employer plan
2011-06-01	Submission has been amended	No
2011-06-01	This submission is the final filing	No
2011-06-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-06-01	Plan is a collectively bargained plan	No
2011-06-01	Plan funding arrangement – Trust	Yes
2011-06-01	Plan benefit arrangement - Trust	Yes
2009: MEDICAL ARTS COMPLEX DENTAL CENTER, S.C. PROFIT SHARING 401(K) PLAN 2009 form 5500 responses
2009-06-01	Type of plan entity	Single employer plan
2009-06-01	Submission has been amended	Yes
2009-06-01	This submission is the final filing	No
2009-06-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-06-01	Plan is a collectively bargained plan	No
2009-06-01	Plan funding arrangement – Trust	Yes
2009-06-01	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

142827

Policy instance

Insurance contract or identification number	142827
Number of Individuals Covered	41
Insurance policy start date	2022-01-21
Insurance policy end date	2022-12-31
Total amount of commissions paid to insurance broker	USD $24,805
Total amount of fees paid to insurance company	USD $50
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?	No
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 $24,805
Insurance broker organization code?	3
Amount paid for insurance broker fees	50
Additional information about fees paid to insurance broker	TPA FORUM PAYMENTS

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

Policy contract number

142827

Policy instance

Insurance contract or identification number	142827
Number of Individuals Covered	39
Insurance policy start date	2021-01-21
Insurance policy end date	2021-12-31
Total amount of commissions paid to insurance broker	USD $24,903
Total amount of fees paid to insurance company	USD $396
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?	No
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 $24,903
Insurance broker organization code?	3
Amount paid for insurance broker fees	396
Additional information about fees paid to insurance broker	TPA FORUM PAYMENTS

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

Policy contract number

142827

Policy instance

Insurance contract or identification number	142827
Number of Individuals Covered	36
Insurance policy start date	2020-01-21
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $18,143
Total amount of fees paid to insurance company	USD $15,515
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?	No
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 $18,143
Insurance broker organization code?	3
Amount paid for insurance broker fees	15515
Additional information about fees paid to insurance broker	TPA FORUM PAYMENTS

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Company Name:	MEDICAL ARTS COMPLEX DENTAL CENTER, S.C.
Employer identification number (EIN):	391269454
NAIC Classification:	621210
NAIC Description:	Offices of Dentists

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
002	2022-01-01	SARAH B HEUER	2023-05-31
002	2021-01-01	SARAH B HEUER	2022-07-13
002	2020-01-01	SARAH B HEUER	2021-04-12
002	2019-01-01	SARAH B HEUER	2020-05-18
002	2018-01-01
002	2017-01-01
002	2016-06-01
002	2015-06-01
002	2014-06-01
002	2013-06-01	SARAH HEUER
002	2012-06-01	AMY BIEHL
002	2011-06-01	AMY BIEHL
002	2009-06-01	DR AMY BIEHL
002	2009-06-01	SARAH HEUER