401k Plan data: AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC 401(K) PROFIT SHARING PLAN AND TRUST plan

AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC 401(K) PROFIT SHARING PLAN AND TRUST 401k Plan overview

Plan Name	AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC 401(K) PROFIT SHARING PLAN AND TRUST
Plan identification number	001

AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC 401(K) PROFIT SHARING PLAN AND TRUST 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.
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

AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC has sponsored the creation of one or more 401k plans.

Company Name: AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC

Employer identification number (EIN): 454974029

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Additional information about AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division

Incorporation Date: 2012-04-03

Company Identification Number: 2095930

Legal Registered Office Address: 1991 CROCKER RD
SUITE 550
WESTLAKE
United States of America (USA)
44145

More information about AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC 401(K) PROFIT SHARING PLAN AND TRUST

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2022-01-01 ERIK WARREN 2023-10-06
001 2021-01-01
001 2020-01-01
001 2019-01-01
001 2018-01-01 ERIK WARREN, D.D.S., M.D.
001 2017-01-01 ERIK WARREN, D.D.S., M.D.

Plan Statistics for AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC 401(K) PROFIT SHARING PLAN AND TRUST

401k plan membership statisitcs for AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC 401(K) PROFIT SHARING PLAN AND TRUST

Measure Date Value
2021: AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC 401(K) PROFIT SHARING PLAN AND TRUST 2021 401k membership
Total participants, beginning-of-year 2021-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2021-01-01 7
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 0
Total of all active and inactive participants 2021-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2021-01-01 0
Total participants 2021-01-01 7
Number of participants with account balances 2021-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2021-01-01 0
2020: AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC 401(K) PROFIT SHARING PLAN AND TRUST 2020 401k membership
Total participants, beginning-of-year 2020-01-01 7
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 7
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 0
Total of all active and inactive participants 2020-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2020-01-01 0
Total participants 2020-01-01 7
Number of participants with account balances 2020-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2020-01-01 0
2019: AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC 401(K) PROFIT SHARING PLAN AND TRUST 2019 401k membership
Total participants, beginning-of-year 2019-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 7
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 0
Total of all active and inactive participants 2019-01-01 7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2019-01-01 0
Total participants 2019-01-01 7
Number of participants with account balances 2019-01-01 7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2019-01-01 0
2018: AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC 401(K) PROFIT SHARING PLAN AND TRUST 2018 401k membership
Total participants, beginning-of-year 2018-01-01 4
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 6
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 0
Total of all active and inactive participants 2018-01-01 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2018-01-01 0
Total participants 2018-01-01 6
Number of participants with account balances 2018-01-01 6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2018-01-01 0
2017: AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC 401(K) PROFIT SHARING PLAN AND TRUST 2017 401k membership
Total participants, beginning-of-year 2017-01-01 0
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 4
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 4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 4
Number of participants with account balances 2017-01-01 4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0

Measure	Date	Value
2021: AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC 401(K) PROFIT SHARING PLAN AND TRUST 2021 401k membership
Total participants, beginning-of-year	2021-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2021-01-01	7
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	0
Total of all active and inactive participants	2021-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2021-01-01	0
Total participants	2021-01-01	7
Number of participants with account balances	2021-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2021-01-01	0
2020: AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC 401(K) PROFIT SHARING PLAN AND TRUST 2020 401k membership
Total participants, beginning-of-year	2020-01-01	7
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	7
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	0
Total of all active and inactive participants	2020-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2020-01-01	0
Total participants	2020-01-01	7
Number of participants with account balances	2020-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2020-01-01	0
2019: AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC 401(K) PROFIT SHARING PLAN AND TRUST 2019 401k membership
Total participants, beginning-of-year	2019-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	7
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	0
Total of all active and inactive participants	2019-01-01	7
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2019-01-01	0
Total participants	2019-01-01	7
Number of participants with account balances	2019-01-01	7
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2019-01-01	0
2018: AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC 401(K) PROFIT SHARING PLAN AND TRUST 2018 401k membership
Total participants, beginning-of-year	2018-01-01	4
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	6
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	0
Total of all active and inactive participants	2018-01-01	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2018-01-01	0
Total participants	2018-01-01	6
Number of participants with account balances	2018-01-01	6
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2018-01-01	0
2017: AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC 401(K) PROFIT SHARING PLAN AND TRUST 2017 401k membership
Total participants, beginning-of-year	2017-01-01	0
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	4
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	4
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	4
Number of participants with account balances	2017-01-01	4
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0

Financial Data on AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC 401(K) PROFIT SHARING PLAN AND TRUST

Measure	Date	Value
2021 : AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC 401(K) PROFIT SHARING PLAN AND TRUST 2021 401k financial data
Total income from all sources	2021-12-31	$106,553
Total plan assets at end of year	2021-12-31	$377,876
Total plan assets at beginning of year	2021-12-31	$271,323
Value of fidelity bond covering the plan	2021-12-31	$100,000
Total contributions received or receivable from participants	2021-12-31	$44,106
Other income received	2021-12-31	$44,856
Net income (gross income less expenses)	2021-12-31	$106,553
Net plan assets at end of year (total assets less liabilities)	2021-12-31	$377,876
Net plan assets at beginning of year (total assets less liabilities)	2021-12-31	$271,323
Total contributions received or receivable from employer(s)	2021-12-31	$17,591
2020 : AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC 401(K) PROFIT SHARING PLAN AND TRUST 2020 401k financial data
Total income from all sources	2020-12-31	$99,811
Total plan assets at end of year	2020-12-31	$271,323
Total plan assets at beginning of year	2020-12-31	$171,512
Value of fidelity bond covering the plan	2020-12-31	$100,000
Total contributions received or receivable from participants	2020-12-31	$42,642
Other income received	2020-12-31	$39,657
Net income (gross income less expenses)	2020-12-31	$99,811
Net plan assets at end of year (total assets less liabilities)	2020-12-31	$271,323
Net plan assets at beginning of year (total assets less liabilities)	2020-12-31	$171,512
Total contributions received or receivable from employer(s)	2020-12-31	$17,512
2019 : AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC 401(K) PROFIT SHARING PLAN AND TRUST 2019 401k financial data
Total income from all sources	2019-12-31	$94,475
Total plan assets at end of year	2019-12-31	$171,512
Total plan assets at beginning of year	2019-12-31	$77,037
Value of fidelity bond covering the plan	2019-12-31	$100,000
Total contributions received or receivable from participants	2019-12-31	$42,072
Contributions received from other sources (not participants or employers)	2019-12-31	$12,765
Other income received	2019-12-31	$22,055
Net income (gross income less expenses)	2019-12-31	$94,475
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$171,512
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$77,037
Total contributions received or receivable from employer(s)	2019-12-31	$17,583
2018 : AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC 401(K) PROFIT SHARING PLAN AND TRUST 2018 401k financial data
Total income from all sources	2018-12-31	$34,479
Total plan assets at end of year	2018-12-31	$77,037
Total plan assets at beginning of year	2018-12-31	$42,558
Value of fidelity bond covering the plan	2018-12-31	$100,000
Total contributions received or receivable from participants	2018-12-31	$23,781
Other income received	2018-12-31	$-5,583
Net income (gross income less expenses)	2018-12-31	$34,479
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$77,037
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$42,558
Total contributions received or receivable from employer(s)	2018-12-31	$16,281
2017 : AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC 401(K) PROFIT SHARING PLAN AND TRUST 2017 401k financial data
Total income from all sources	2017-12-31	$42,558
Total plan assets at end of year	2017-12-31	$42,558
Total plan assets at beginning of year	2017-12-31	$0
Value of fidelity bond covering the plan	2017-12-31	$100,000
Total contributions received or receivable from participants	2017-12-31	$21,005
Contributions received from other sources (not participants or employers)	2017-12-31	$5,000
Other income received	2017-12-31	$2,748
Net income (gross income less expenses)	2017-12-31	$42,558
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$42,558
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$0
Total contributions received or receivable from employer(s)	2017-12-31	$13,805

Form 5500 Responses for AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC 401(K) PROFIT SHARING PLAN AND TRUST

2021: AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC 401(K) PROFIT SHARING PLAN AND TRUST 2021 form 5500 responses
2021-01-01	Type of plan entity	Single employer plan
2021-01-01	Plan funding arrangement – Trust	Yes
2021-01-01	Plan benefit arrangement - Trust	Yes
2020: AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC 401(K) PROFIT SHARING PLAN AND TRUST 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	Plan funding arrangement – Trust	Yes
2020-01-01	Plan benefit arrangement - Trust	Yes
2019: AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC 401(K) PROFIT SHARING PLAN AND TRUST 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC 401(K) PROFIT SHARING PLAN AND TRUST 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan funding arrangement – Trust	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement - Trust	Yes
2017: AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC 401(K) PROFIT SHARING PLAN AND TRUST 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	First time form 5500 has been submitted	Yes
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )

Policy contract number

300751

Policy instance

Insurance contract or identification number	300751
Number of Individuals Covered	4
Insurance policy start date	2018-01-01
Insurance policy end date	2018-04-06
Total amount of fees paid to insurance company	USD $1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	1
Additional information about fees paid to insurance broker	ADVISOR SERVICES TO PLAN SPONSORS
Insurance broker organization code?	7

AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )

Policy contract number

E638361

Policy instance

Insurance contract or identification number	E638361
Number of Individuals Covered	6
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Insurance broker organization code?	3

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )

Policy contract number

300751

Policy instance

Insurance contract or identification number	300751
Number of Individuals Covered	4
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of fees paid to insurance company	USD $5
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	5
Additional information about fees paid to insurance broker	ADVISOR SERVICES TO PLAN SPONSORS
Insurance broker organization code?	7
Insurance broker name	TRIAD ADVISORS INC.

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Company Name:	AMHERST ORAL SURGERY AND IMPLANT CENTER, LLC
Employer identification number (EIN):	454974029
NAIC Classification:	621210
NAIC Description:	Offices of Dentists

Jurisdiction of Incorporation:	Ohio Secretary of State Business Services Division
Incorporation Date:	2012-04-03
Company Identification Number:	2095930
Legal Registered Office Address:	1991 CROCKER RD SUITE 550 WESTLAKE United States of America (USA) 44145

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2022-01-01	ERIK WARREN	2023-10-06
001	2021-01-01
001	2020-01-01
001	2019-01-01
001	2018-01-01	ERIK WARREN, D.D.S., M.D.
001	2017-01-01	ERIK WARREN, D.D.S., M.D.