401k Plan data: MORTENSON FAMILY DENTAL HOLDINGS FLEXIBLE BENEFIT PLAN plan

MORTENSON FAMILY DENTAL HOLDINGS FLEXIBLE BENEFIT PLAN 401k Plan overview

Plan Name	MORTENSON FAMILY DENTAL HOLDINGS FLEXIBLE BENEFIT PLAN
Plan identification number	503

MORTENSON FAMILY DENTAL HOLDINGS FLEXIBLE BENEFIT PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Other welfare benefit cover Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20. Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

MORTENSON FAMILY DENTAL HOLDINGS has sponsored the creation of one or more 401k plans.

Company Name: MORTENSON FAMILY DENTAL HOLDINGS

Employer identification number (EIN): 451839908

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MORTENSON FAMILY DENTAL HOLDINGS FLEXIBLE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2022-01-01 SUZANNE MAUCK 2023-05-01
503 2021-01-01 SUZANNE MAUCK 2022-03-17
503 2020-01-01 SUZANNE MAUCK 2021-03-26
503 2019-01-01 SUZANNE MAUCK 2020-09-03
503 2019-01-01 SUZANNE MAUCK 2021-04-08
503 2017-01-01 KIMBERLY MAUPIN
503 2017-01-01 SUZANNE MAUCK 2021-04-07
503 2016-01-01 KIMBERLY MAUPIN

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
503	2022-01-01	SUZANNE MAUCK	2023-05-01
503	2021-01-01	SUZANNE MAUCK	2022-03-17
503	2020-01-01	SUZANNE MAUCK	2021-03-26
503	2019-01-01	SUZANNE MAUCK	2020-09-03
503	2019-01-01	SUZANNE MAUCK	2021-04-08
503	2017-01-01	KIMBERLY MAUPIN
503	2017-01-01	SUZANNE MAUCK	2021-04-07
503	2016-01-01	KIMBERLY MAUPIN

Plan Statistics for MORTENSON FAMILY DENTAL HOLDINGS FLEXIBLE BENEFIT PLAN

401k plan membership statisitcs for MORTENSON FAMILY DENTAL HOLDINGS FLEXIBLE BENEFIT PLAN

Measure Date Value
2022: MORTENSON FAMILY DENTAL HOLDINGS FLEXIBLE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year 2022-01-01 356
Total number of active participants reported on line 7a of the Form 5500 2022-01-01 310
Number of retired or separated participants receiving benefits 2022-01-01 46
Number of other retired or separated participants entitled to future benefits 2022-01-01 0
Total of all active and inactive participants 2022-01-01 356
Number of employers contributing to the scheme 2022-01-01 0
2021: MORTENSON FAMILY DENTAL HOLDINGS FLEXIBLE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year 2021-01-01 208
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 189
Number of retired or separated participants receiving benefits 2021-01-01 20
Number of other retired or separated participants entitled to future benefits 2021-01-01 0
Total of all active and inactive participants 2021-01-01 209
Number of employers contributing to the scheme 2021-01-01 0
2020: MORTENSON FAMILY DENTAL HOLDINGS FLEXIBLE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 205
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 177
Number of retired or separated participants receiving benefits 2020-01-01 29
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 206
Number of employers contributing to the scheme 2020-01-01 0
2019: MORTENSON FAMILY DENTAL HOLDINGS FLEXIBLE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 233
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 203
Number of retired or separated participants receiving benefits 2019-01-01 48
Number of other retired or separated participants entitled to future benefits 2019-01-01 0
Total of all active and inactive participants 2019-01-01 251
Number of employers contributing to the scheme 2019-01-01 0
2017: MORTENSON FAMILY DENTAL HOLDINGS FLEXIBLE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 164
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 138
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 0
Total of all active and inactive participants 2017-01-01 138
Number of employers contributing to the scheme 2017-01-01 0
2016: MORTENSON FAMILY DENTAL HOLDINGS FLEXIBLE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 98
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 116
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 0
Total of all active and inactive participants 2016-01-01 116

Measure	Date	Value
2022: MORTENSON FAMILY DENTAL HOLDINGS FLEXIBLE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year	2022-01-01	356
Total number of active participants reported on line 7a of the Form 5500	2022-01-01	310
Number of retired or separated participants receiving benefits	2022-01-01	46
Number of other retired or separated participants entitled to future benefits	2022-01-01	0
Total of all active and inactive participants	2022-01-01	356
Number of employers contributing to the scheme	2022-01-01	0
2021: MORTENSON FAMILY DENTAL HOLDINGS FLEXIBLE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year	2021-01-01	208
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	189
Number of retired or separated participants receiving benefits	2021-01-01	20
Number of other retired or separated participants entitled to future benefits	2021-01-01	0
Total of all active and inactive participants	2021-01-01	209
Number of employers contributing to the scheme	2021-01-01	0
2020: MORTENSON FAMILY DENTAL HOLDINGS FLEXIBLE BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	205
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	177
Number of retired or separated participants receiving benefits	2020-01-01	29
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	206
Number of employers contributing to the scheme	2020-01-01	0
2019: MORTENSON FAMILY DENTAL HOLDINGS FLEXIBLE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	233
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	203
Number of retired or separated participants receiving benefits	2019-01-01	48
Number of other retired or separated participants entitled to future benefits	2019-01-01	0
Total of all active and inactive participants	2019-01-01	251
Number of employers contributing to the scheme	2019-01-01	0
2017: MORTENSON FAMILY DENTAL HOLDINGS FLEXIBLE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	164
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	138
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	0
Total of all active and inactive participants	2017-01-01	138
Number of employers contributing to the scheme	2017-01-01	0
2016: MORTENSON FAMILY DENTAL HOLDINGS FLEXIBLE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	98
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	116
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	0
Total of all active and inactive participants	2016-01-01	116

Form 5500 Responses for MORTENSON FAMILY DENTAL HOLDINGS FLEXIBLE BENEFIT PLAN

2022: MORTENSON FAMILY DENTAL HOLDINGS FLEXIBLE BENEFIT PLAN 2022 form 5500 responses
2022-01-01	Type of plan entity	Single employer plan
2022-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: MORTENSON FAMILY DENTAL HOLDINGS FLEXIBLE BENEFIT PLAN 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: MORTENSON FAMILY DENTAL HOLDINGS FLEXIBLE BENEFIT PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: MORTENSON FAMILY DENTAL HOLDINGS FLEXIBLE BENEFIT PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	Yes
2019-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: MORTENSON FAMILY DENTAL HOLDINGS FLEXIBLE BENEFIT 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 – General assets of the sponsor	Yes
2017-01-01	Plan benefit arrangement – General assets of the sponsor	Yes
2016: MORTENSON FAMILY DENTAL HOLDINGS FLEXIBLE BENEFIT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	First time form 5500 has been submitted	Yes
2016-01-01	Submission has been amended	Yes
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – General assets of the sponsor	Yes
2016-01-01	Plan benefit arrangement – General assets of the sponsor	Yes

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Company Name:	MORTENSON FAMILY DENTAL HOLDINGS
Employer identification number (EIN):	451839908
NAIC Classification:	621210
NAIC Description:	Offices of Dentists