401k Plan data: SOUTH SOUND DENTAL CARE CASH BALANCE PLAN plan

SOUTH SOUND DENTAL CARE CASH BALANCE PLAN 401k Plan overview

Plan Name	SOUTH SOUND DENTAL CARE CASH BALANCE PLAN
Plan identification number	002

SOUTH SOUND DENTAL CARE CASH BALANCE PLAN Benefits

401k Plan Type

Defined Benefit Pension

Plan Features/Benefits

Benefits are primarily flat dollar (includes dollars per year of service)
Cash balance or similar plan - Plan has a "cash balance" formula. For this purpose, a "cash balance" formula is a benefit formula in a defined benefit plan by whatever name (for example, personal account plan, pension equity plan, life cycle plan, cash account plan, etc.) that rather than, or in addition to, expressing the accrued benefit as a life annuity commencing at normal retirement age, defines benefits for each employee in terms more common to a defined contribution plan such as a single sum distribution amount (for example, 10 percent of final average pay times years of service, or the amount of the employee's hypothetical account balance).
Frozen Plan - As of the last day of the plan year, the plan provides that no participant will get any new benefit accrual (whether because of service or compensation).
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

MOONA KHAN, DDS, PS DBA SOUTH SOUND DENTAL CENTER has sponsored the creation of one or more 401k plans.

Company Name: MOONA KHAN, DDS, PS DBA SOUTH SOUND DENTAL CENTER

Employer identification number (EIN): 461676836

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SOUTH SOUND DENTAL CARE CASH BALANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2020-10-01
002 2019-10-01
002 2018-10-01
002 2017-10-01
002 2016-10-01
002 2015-10-01
002 2014-10-01
002 2013-10-01 RUSSELL SNOW, EA, CPC, MSPA 2015-06-30

Plan Statistics for SOUTH SOUND DENTAL CARE CASH BALANCE PLAN

401k plan membership statisitcs for SOUTH SOUND DENTAL CARE CASH BALANCE PLAN

Measure Date Value
2020: SOUTH SOUND DENTAL CARE CASH BALANCE PLAN 2020 401k membership
Market value of plan assets 2020-09-30 309,486
Acturial value of plan assets 2020-09-30 309,486
Funding target for retired participants and beneficiaries receiving payment 2020-09-30 0
Number of terminated vested participants 2020-09-30 2
Fundng target for terminated vested participants 2020-09-30 6,357
Active participant vested funding target 2020-09-30 322,160
Number of active participants 2020-09-30 7
Total funding liabilities for active participants 2020-09-30 322,160
Total participant count 2020-09-30 9
Total funding target for all participants 2020-09-30 328,517
Balance at beginning of prior year after applicable adjustments 2020-09-30 0
Prefunding balance at beginning of prior year after applicable adjustments 2020-09-30 0
Carryover balanced portion elected for use to offset prior years funding requirement 2020-09-30 0
Prefunding balanced used to offset prior years funding requirement 2020-09-30 0
Amount remaining of carryover balance 2020-09-30 0
Amount remaining of prefunding balance 2020-09-30 0
Present value of excess contributions 2020-09-30 861
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance 2020-09-30 861
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance 2020-09-30 0
Reductions in caryover balances due to elections or deemed elections 2020-09-30 0
Reductions in prefunding balances due to elections or deemed elections 2020-09-30 0
Balance of carryovers at beginning of current year 2020-09-30 0
Balance of prefunding at beginning of current year 2020-09-30 0
Total employer contributions 2020-09-30 10,500
Total employee contributions 2020-09-30 0
Contributions allocated toward unpaid minimum require contributions from prior years 2020-09-30 0
Contributions made to avoid restrictions adjusted to valuation date 2020-09-30 0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date 2020-09-30 10,899
Unpaid minimum required contributions for all prior years 2020-09-30 0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years 2020-09-30 0
Remaining amount of unpaid minimum required contributions 2020-09-30 0
Minimum required contributions for current year target normal cost 2020-09-30 0
Net shortfall amortization installment of oustanding balance 2020-09-30 19,031
Waiver amortization installment 2020-09-30 0
Total funding amount beforereflecting carryover/prefunding balances 2020-09-30 2,577
Carryover balance elected to use to offset funding requirement 2020-09-30 0
Prefunding balance elected to use to offset funding requirement 2020-09-30 0
Additional cash requirement 2020-09-30 2,577
Contributions allocatedtoward minimum required contributions for current year 2020-09-30 10,899
Unpaid minimum required contributions for current year 2020-09-30 0
Unpaid minimum required contributions for all years 2020-09-30 0
2019: SOUTH SOUND DENTAL CARE CASH BALANCE PLAN 2019 401k membership
Market value of plan assets 2019-09-30 285,615
Acturial value of plan assets 2019-09-30 285,615
Funding target for retired participants and beneficiaries receiving payment 2019-09-30 0
Number of terminated vested participants 2019-09-30 0
Fundng target for terminated vested participants 2019-09-30 0
Active participant vested funding target 2019-09-30 250,656
Number of active participants 2019-09-30 9
Total funding liabilities for active participants 2019-09-30 250,656
Total participant count 2019-09-30 9
Total funding target for all participants 2019-09-30 250,656
Balance at beginning of prior year after applicable adjustments 2019-09-30 0
Prefunding balance at beginning of prior year after applicable adjustments 2019-09-30 0
Carryover balanced portion elected for use to offset prior years funding requirement 2019-09-30 0
Prefunding balanced used to offset prior years funding requirement 2019-09-30 0
Amount remaining of carryover balance 2019-09-30 0
Amount remaining of prefunding balance 2019-09-30 0
Present value of excess contributions 2019-09-30 23,863
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance 2019-09-30 23,863
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance 2019-09-30 0
Reductions in caryover balances due to elections or deemed elections 2019-09-30 0
Reductions in prefunding balances due to elections or deemed elections 2019-09-30 0
Balance of carryovers at beginning of current year 2019-09-30 0
Balance of prefunding at beginning of current year 2019-09-30 0
Total employer contributions 2019-09-30 10,500
Total employee contributions 2019-09-30 0
Contributions allocated toward unpaid minimum require contributions from prior years 2019-09-30 0
Contributions made to avoid restrictions adjusted to valuation date 2019-09-30 0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date 2019-09-30 10,526
Unpaid minimum required contributions for all prior years 2019-09-30 0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years 2019-09-30 0
Remaining amount of unpaid minimum required contributions 2019-09-30 0
Minimum required contributions for current year target normal cost 2019-09-30 44,623
Net shortfall amortization installment of oustanding balance 2019-09-30 0
Waiver amortization installment 2019-09-30 0
Total funding amount beforereflecting carryover/prefunding balances 2019-09-30 9,665
Carryover balance elected to use to offset funding requirement 2019-09-30 0
Prefunding balance elected to use to offset funding requirement 2019-09-30 0
Additional cash requirement 2019-09-30 9,665
Contributions allocatedtoward minimum required contributions for current year 2019-09-30 10,526
Unpaid minimum required contributions for current year 2019-09-30 0
Unpaid minimum required contributions for all years 2019-09-30 0
2018: SOUTH SOUND DENTAL CARE CASH BALANCE PLAN 2018 401k membership
Market value of plan assets 2018-09-30 250,436
Acturial value of plan assets 2018-09-30 250,436
Funding target for retired participants and beneficiaries receiving payment 2018-09-30 0
Number of terminated vested participants 2018-09-30 0
Fundng target for terminated vested participants 2018-09-30 0
Active participant vested funding target 2018-09-30 203,258
Number of active participants 2018-09-30 9
Total funding liabilities for active participants 2018-09-30 204,753
Total participant count 2018-09-30 9
Total funding target for all participants 2018-09-30 204,753
Balance at beginning of prior year after applicable adjustments 2018-09-30 0
Prefunding balance at beginning of prior year after applicable adjustments 2018-09-30 0
Carryover balanced portion elected for use to offset prior years funding requirement 2018-09-30 0
Prefunding balanced used to offset prior years funding requirement 2018-09-30 0
Amount remaining of carryover balance 2018-09-30 0
Amount remaining of prefunding balance 2018-09-30 0
Present value of excess contributions 2018-09-30 29,600
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance 2018-09-30 29,600
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance 2018-09-30 0
Reductions in caryover balances due to elections or deemed elections 2018-09-30 0
Reductions in prefunding balances due to elections or deemed elections 2018-09-30 0
Balance of carryovers at beginning of current year 2018-09-30 0
Balance of prefunding at beginning of current year 2018-09-30 0
Total employer contributions 2018-09-30 25,000
Total employee contributions 2018-09-30 0
Contributions allocated toward unpaid minimum require contributions from prior years 2018-09-30 0
Contributions made to avoid restrictions adjusted to valuation date 2018-09-30 0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date 2018-09-30 24,143
Unpaid minimum required contributions for all prior years 2018-09-30 0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years 2018-09-30 0
Remaining amount of unpaid minimum required contributions 2018-09-30 0
Minimum required contributions for current year target normal cost 2018-09-30 45,963
Net shortfall amortization installment of oustanding balance 2018-09-30 0
Waiver amortization installment 2018-09-30 0
Total funding amount beforereflecting carryover/prefunding balances 2018-09-30 280
Carryover balance elected to use to offset funding requirement 2018-09-30 0
Prefunding balance elected to use to offset funding requirement 2018-09-30 0
Additional cash requirement 2018-09-30 280
Contributions allocatedtoward minimum required contributions for current year 2018-09-30 24,143
Unpaid minimum required contributions for current year 2018-09-30 0
Unpaid minimum required contributions for all years 2018-09-30 0
2017: SOUTH SOUND DENTAL CARE CASH BALANCE PLAN 2017 401k membership
Market value of plan assets 2017-09-30 207,268
Acturial value of plan assets 2017-09-30 207,268
Funding target for retired participants and beneficiaries receiving payment 2017-09-30 0
Number of terminated vested participants 2017-09-30 0
Fundng target for terminated vested participants 2017-09-30 0
Active participant vested funding target 2017-09-30 141,346
Number of active participants 2017-09-30 7
Total funding liabilities for active participants 2017-09-30 141,346
Total participant count 2017-09-30 7
Total funding target for all participants 2017-09-30 141,346
Balance at beginning of prior year after applicable adjustments 2017-09-30 0
Prefunding balance at beginning of prior year after applicable adjustments 2017-09-30 0
Carryover balanced portion elected for use to offset prior years funding requirement 2017-09-30 0
Prefunding balanced used to offset prior years funding requirement 2017-09-30 0
Amount remaining of carryover balance 2017-09-30 0
Amount remaining of prefunding balance 2017-09-30 0
Present value of excess contributions 2017-09-30 49,048
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance 2017-09-30 49,048
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance 2017-09-30 0
Reductions in caryover balances due to elections or deemed elections 2017-09-30 0
Reductions in prefunding balances due to elections or deemed elections 2017-09-30 0
Balance of carryovers at beginning of current year 2017-09-30 0
Balance of prefunding at beginning of current year 2017-09-30 0
Total employer contributions 2017-09-30 30,000
Total employee contributions 2017-09-30 0
Contributions allocated toward unpaid minimum require contributions from prior years 2017-09-30 0
Contributions made to avoid restrictions adjusted to valuation date 2017-09-30 0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date 2017-09-30 29,600
Unpaid minimum required contributions for all prior years 2017-09-30 0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years 2017-09-30 0
Remaining amount of unpaid minimum required contributions 2017-09-30 0
Minimum required contributions for current year target normal cost 2017-09-30 43,226
Net shortfall amortization installment of oustanding balance 2017-09-30 0
Waiver amortization installment 2017-09-30 0
Total funding amount beforereflecting carryover/prefunding balances 2017-09-30 0
Carryover balance elected to use to offset funding requirement 2017-09-30 0
Prefunding balance elected to use to offset funding requirement 2017-09-30 0
Additional cash requirement 2017-09-30 0
Contributions allocatedtoward minimum required contributions for current year 2017-09-30 29,600
Unpaid minimum required contributions for current year 2017-09-30 0
Unpaid minimum required contributions for all years 2017-09-30 0

Measure	Date	Value
2020: SOUTH SOUND DENTAL CARE CASH BALANCE PLAN 2020 401k membership
Market value of plan assets	2020-09-30	309,486
Acturial value of plan assets	2020-09-30	309,486
Funding target for retired participants and beneficiaries receiving payment	2020-09-30	0
Number of terminated vested participants	2020-09-30	2
Fundng target for terminated vested participants	2020-09-30	6,357
Active participant vested funding target	2020-09-30	322,160
Number of active participants	2020-09-30	7
Total funding liabilities for active participants	2020-09-30	322,160
Total participant count	2020-09-30	9
Total funding target for all participants	2020-09-30	328,517
Balance at beginning of prior year after applicable adjustments	2020-09-30	0
Prefunding balance at beginning of prior year after applicable adjustments	2020-09-30	0
Carryover balanced portion elected for use to offset prior years funding requirement	2020-09-30	0
Prefunding balanced used to offset prior years funding requirement	2020-09-30	0
Amount remaining of carryover balance	2020-09-30	0
Amount remaining of prefunding balance	2020-09-30	0
Present value of excess contributions	2020-09-30	861
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2020-09-30	861
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2020-09-30	0
Reductions in caryover balances due to elections or deemed elections	2020-09-30	0
Reductions in prefunding balances due to elections or deemed elections	2020-09-30	0
Balance of carryovers at beginning of current year	2020-09-30	0
Balance of prefunding at beginning of current year	2020-09-30	0
Total employer contributions	2020-09-30	10,500
Total employee contributions	2020-09-30	0
Contributions allocated toward unpaid minimum require contributions from prior years	2020-09-30	0
Contributions made to avoid restrictions adjusted to valuation date	2020-09-30	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2020-09-30	10,899
Unpaid minimum required contributions for all prior years	2020-09-30	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2020-09-30	0
Remaining amount of unpaid minimum required contributions	2020-09-30	0
Minimum required contributions for current year target normal cost	2020-09-30	0
Net shortfall amortization installment of oustanding balance	2020-09-30	19,031
Waiver amortization installment	2020-09-30	0
Total funding amount beforereflecting carryover/prefunding balances	2020-09-30	2,577
Carryover balance elected to use to offset funding requirement	2020-09-30	0
Prefunding balance elected to use to offset funding requirement	2020-09-30	0
Additional cash requirement	2020-09-30	2,577
Contributions allocatedtoward minimum required contributions for current year	2020-09-30	10,899
Unpaid minimum required contributions for current year	2020-09-30	0
Unpaid minimum required contributions for all years	2020-09-30	0
2019: SOUTH SOUND DENTAL CARE CASH BALANCE PLAN 2019 401k membership
Market value of plan assets	2019-09-30	285,615
Acturial value of plan assets	2019-09-30	285,615
Funding target for retired participants and beneficiaries receiving payment	2019-09-30	0
Number of terminated vested participants	2019-09-30	0
Fundng target for terminated vested participants	2019-09-30	0
Active participant vested funding target	2019-09-30	250,656
Number of active participants	2019-09-30	9
Total funding liabilities for active participants	2019-09-30	250,656
Total participant count	2019-09-30	9
Total funding target for all participants	2019-09-30	250,656
Balance at beginning of prior year after applicable adjustments	2019-09-30	0
Prefunding balance at beginning of prior year after applicable adjustments	2019-09-30	0
Carryover balanced portion elected for use to offset prior years funding requirement	2019-09-30	0
Prefunding balanced used to offset prior years funding requirement	2019-09-30	0
Amount remaining of carryover balance	2019-09-30	0
Amount remaining of prefunding balance	2019-09-30	0
Present value of excess contributions	2019-09-30	23,863
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2019-09-30	23,863
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2019-09-30	0
Reductions in caryover balances due to elections or deemed elections	2019-09-30	0
Reductions in prefunding balances due to elections or deemed elections	2019-09-30	0
Balance of carryovers at beginning of current year	2019-09-30	0
Balance of prefunding at beginning of current year	2019-09-30	0
Total employer contributions	2019-09-30	10,500
Total employee contributions	2019-09-30	0
Contributions allocated toward unpaid minimum require contributions from prior years	2019-09-30	0
Contributions made to avoid restrictions adjusted to valuation date	2019-09-30	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2019-09-30	10,526
Unpaid minimum required contributions for all prior years	2019-09-30	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2019-09-30	0
Remaining amount of unpaid minimum required contributions	2019-09-30	0
Minimum required contributions for current year target normal cost	2019-09-30	44,623
Net shortfall amortization installment of oustanding balance	2019-09-30	0
Waiver amortization installment	2019-09-30	0
Total funding amount beforereflecting carryover/prefunding balances	2019-09-30	9,665
Carryover balance elected to use to offset funding requirement	2019-09-30	0
Prefunding balance elected to use to offset funding requirement	2019-09-30	0
Additional cash requirement	2019-09-30	9,665
Contributions allocatedtoward minimum required contributions for current year	2019-09-30	10,526
Unpaid minimum required contributions for current year	2019-09-30	0
Unpaid minimum required contributions for all years	2019-09-30	0
2018: SOUTH SOUND DENTAL CARE CASH BALANCE PLAN 2018 401k membership
Market value of plan assets	2018-09-30	250,436
Acturial value of plan assets	2018-09-30	250,436
Funding target for retired participants and beneficiaries receiving payment	2018-09-30	0
Number of terminated vested participants	2018-09-30	0
Fundng target for terminated vested participants	2018-09-30	0
Active participant vested funding target	2018-09-30	203,258
Number of active participants	2018-09-30	9
Total funding liabilities for active participants	2018-09-30	204,753
Total participant count	2018-09-30	9
Total funding target for all participants	2018-09-30	204,753
Balance at beginning of prior year after applicable adjustments	2018-09-30	0
Prefunding balance at beginning of prior year after applicable adjustments	2018-09-30	0
Carryover balanced portion elected for use to offset prior years funding requirement	2018-09-30	0
Prefunding balanced used to offset prior years funding requirement	2018-09-30	0
Amount remaining of carryover balance	2018-09-30	0
Amount remaining of prefunding balance	2018-09-30	0
Present value of excess contributions	2018-09-30	29,600
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2018-09-30	29,600
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2018-09-30	0
Reductions in caryover balances due to elections or deemed elections	2018-09-30	0
Reductions in prefunding balances due to elections or deemed elections	2018-09-30	0
Balance of carryovers at beginning of current year	2018-09-30	0
Balance of prefunding at beginning of current year	2018-09-30	0
Total employer contributions	2018-09-30	25,000
Total employee contributions	2018-09-30	0
Contributions allocated toward unpaid minimum require contributions from prior years	2018-09-30	0
Contributions made to avoid restrictions adjusted to valuation date	2018-09-30	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2018-09-30	24,143
Unpaid minimum required contributions for all prior years	2018-09-30	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2018-09-30	0
Remaining amount of unpaid minimum required contributions	2018-09-30	0
Minimum required contributions for current year target normal cost	2018-09-30	45,963
Net shortfall amortization installment of oustanding balance	2018-09-30	0
Waiver amortization installment	2018-09-30	0
Total funding amount beforereflecting carryover/prefunding balances	2018-09-30	280
Carryover balance elected to use to offset funding requirement	2018-09-30	0
Prefunding balance elected to use to offset funding requirement	2018-09-30	0
Additional cash requirement	2018-09-30	280
Contributions allocatedtoward minimum required contributions for current year	2018-09-30	24,143
Unpaid minimum required contributions for current year	2018-09-30	0
Unpaid minimum required contributions for all years	2018-09-30	0
2017: SOUTH SOUND DENTAL CARE CASH BALANCE PLAN 2017 401k membership
Market value of plan assets	2017-09-30	207,268
Acturial value of plan assets	2017-09-30	207,268
Funding target for retired participants and beneficiaries receiving payment	2017-09-30	0
Number of terminated vested participants	2017-09-30	0
Fundng target for terminated vested participants	2017-09-30	0
Active participant vested funding target	2017-09-30	141,346
Number of active participants	2017-09-30	7
Total funding liabilities for active participants	2017-09-30	141,346
Total participant count	2017-09-30	7
Total funding target for all participants	2017-09-30	141,346
Balance at beginning of prior year after applicable adjustments	2017-09-30	0
Prefunding balance at beginning of prior year after applicable adjustments	2017-09-30	0
Carryover balanced portion elected for use to offset prior years funding requirement	2017-09-30	0
Prefunding balanced used to offset prior years funding requirement	2017-09-30	0
Amount remaining of carryover balance	2017-09-30	0
Amount remaining of prefunding balance	2017-09-30	0
Present value of excess contributions	2017-09-30	49,048
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2017-09-30	49,048
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2017-09-30	0
Reductions in caryover balances due to elections or deemed elections	2017-09-30	0
Reductions in prefunding balances due to elections or deemed elections	2017-09-30	0
Balance of carryovers at beginning of current year	2017-09-30	0
Balance of prefunding at beginning of current year	2017-09-30	0
Total employer contributions	2017-09-30	30,000
Total employee contributions	2017-09-30	0
Contributions allocated toward unpaid minimum require contributions from prior years	2017-09-30	0
Contributions made to avoid restrictions adjusted to valuation date	2017-09-30	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2017-09-30	29,600
Unpaid minimum required contributions for all prior years	2017-09-30	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2017-09-30	0
Remaining amount of unpaid minimum required contributions	2017-09-30	0
Minimum required contributions for current year target normal cost	2017-09-30	43,226
Net shortfall amortization installment of oustanding balance	2017-09-30	0
Waiver amortization installment	2017-09-30	0
Total funding amount beforereflecting carryover/prefunding balances	2017-09-30	0
Carryover balance elected to use to offset funding requirement	2017-09-30	0
Prefunding balance elected to use to offset funding requirement	2017-09-30	0
Additional cash requirement	2017-09-30	0
Contributions allocatedtoward minimum required contributions for current year	2017-09-30	29,600
Unpaid minimum required contributions for current year	2017-09-30	0
Unpaid minimum required contributions for all years	2017-09-30	0

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Company Name:	MOONA KHAN, DDS, PS DBA SOUTH SOUND DENTAL CENTER
Employer identification number (EIN):	461676836
NAIC Classification:	621210
NAIC Description:	Offices of Dentists

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
002	2020-10-01
002	2019-10-01
002	2018-10-01
002	2017-10-01
002	2016-10-01
002	2015-10-01
002	2014-10-01
002	2013-10-01	RUSSELL SNOW, EA, CPC, MSPA	2015-06-30