401k Plan data: PELHAM LINKS FAMILY & COSMETIC DENTISTRY, P.A. PROFIT SHARING 401(K) PLAN plan

PELHAM LINKS FAMILY & COSMETIC DENTISTRY, P.A. PROFIT SHARING 401(K) PLAN 401k Plan overview

Plan Name	PELHAM LINKS FAMILY & COSMETIC DENTISTRY, P.A. PROFIT SHARING 401(K) PLAN
Plan identification number	001

PELHAM LINKS FAMILY & COSMETIC DENTISTRY, P.A. 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.
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.
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

PELHAM LINKS FAMILY & COSMETIC DENTISTRY, P.A. has sponsored the creation of one or more 401k plans.

Company Name: PELHAM LINKS FAMILY & COSMETIC DENTISTRY, P.A.

Employer identification number (EIN): 570788902

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PELHAM LINKS FAMILY & COSMETIC DENTISTRY, P.A. PROFIT SHARING 401(K) PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2021-01-01 SHANNON HUDSON 2021-06-22
001 2020-01-01 SHANNON HUDSON 2021-03-19
001 2019-01-01 SHANNON HUDSON 2020-09-24
001 2018-01-01 SHANNON HUDSON 2019-10-02
001 2017-01-01 SHANNON HUDSON 2018-09-13
001 2016-01-01
001 2015-01-01
001 2014-01-01 SHANNON C. HUDSON 2015-10-09
001 2014-01-01
001 2013-01-01 SHANNON C. HUDSON 2015-10-09
001 2012-01-01 SHANNON C. HUDSON 2015-10-09
001 2011-01-01 JESSE RENAUD
001 2009-01-01 JESSE RENAUD JESSE RENAUD 2010-10-08
001 2009-01-01 SHANNON HUDSON JESSE RENAUD 2010-10-12
001 2009-01-01 JESSE RENAUD
001 2009-01-01 JESSE RENAUD
001 2009-01-01 2010-10-12
001 2009-01-01 JESSE RENAUD JESSE RENAUD 2010-10-12
001 2009-01-01 SHANNON HUDSON SHANNON HUDSON 2010-10-12

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
001	2021-01-01	SHANNON HUDSON	2021-06-22
001	2020-01-01	SHANNON HUDSON	2021-03-19
001	2019-01-01	SHANNON HUDSON	2020-09-24
001	2018-01-01	SHANNON HUDSON	2019-10-02
001	2017-01-01	SHANNON HUDSON	2018-09-13
001	2016-01-01
001	2015-01-01
001	2014-01-01	SHANNON C. HUDSON	2015-10-09
001	2014-01-01
001	2013-01-01	SHANNON C. HUDSON	2015-10-09
001	2012-01-01	SHANNON C. HUDSON	2015-10-09
001	2011-01-01	JESSE RENAUD
001	2009-01-01	JESSE RENAUD		JESSE RENAUD	2010-10-08
001	2009-01-01	SHANNON HUDSON		JESSE RENAUD	2010-10-12
001	2009-01-01	JESSE RENAUD
001	2009-01-01	JESSE RENAUD
001	2009-01-01		2010-10-12
001	2009-01-01	JESSE RENAUD		JESSE RENAUD	2010-10-12
001	2009-01-01	SHANNON HUDSON		SHANNON HUDSON	2010-10-12

Plan Statistics for PELHAM LINKS FAMILY & COSMETIC DENTISTRY, P.A. PROFIT SHARING 401(K) PLAN

401k plan membership statisitcs for PELHAM LINKS FAMILY & COSMETIC DENTISTRY, P.A. PROFIT SHARING 401(K) PLAN

Measure Date Value
2011: PELHAM LINKS FAMILY & COSMETIC DENTISTRY, P.A. PROFIT SHARING 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year 2011-01-01 41
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 37
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 5
Total of all active and inactive participants 2011-01-01 42
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 42
Number of participants with account balances 2011-01-01 42
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 0
2009: PELHAM LINKS FAMILY & COSMETIC DENTISTRY, P.A. PROFIT SHARING 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 37
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 38
Number of retired or separated participants receiving benefits 2009-01-01 0
Number of other retired or separated participants entitled to future benefits 2009-01-01 4
Total of all active and inactive participants 2009-01-01 42
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2009-01-01 0
Total participants 2009-01-01 42
Number of participants with account balances 2009-01-01 36
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2009-01-01 0

Measure	Date	Value
2011: PELHAM LINKS FAMILY & COSMETIC DENTISTRY, P.A. PROFIT SHARING 401(K) PLAN 2011 401k membership
Total participants, beginning-of-year	2011-01-01	41
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	37
Number of retired or separated participants receiving benefits	2011-01-01	0
Number of other retired or separated participants entitled to future benefits	2011-01-01	5
Total of all active and inactive participants	2011-01-01	42
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	42
Number of participants with account balances	2011-01-01	42
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	0
2009: PELHAM LINKS FAMILY & COSMETIC DENTISTRY, P.A. PROFIT SHARING 401(K) PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	37
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	38
Number of retired or separated participants receiving benefits	2009-01-01	0
Number of other retired or separated participants entitled to future benefits	2009-01-01	4
Total of all active and inactive participants	2009-01-01	42
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2009-01-01	0
Total participants	2009-01-01	42
Number of participants with account balances	2009-01-01	36
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2009-01-01	0

Financial Data on PELHAM LINKS FAMILY & COSMETIC DENTISTRY, P.A. PROFIT SHARING 401(K) PLAN

Measure	Date	Value
2011 : PELHAM LINKS FAMILY & COSMETIC DENTISTRY, P.A. PROFIT SHARING 401(K) PLAN 2011 401k financial data
Transfers to/from the plan	2011-12-31	$0
Total income from all sources	2011-12-31	$253,005
Expenses. Total of all expenses incurred	2011-12-31	$14,786
Benefits paid (including direct rollovers)	2011-12-31	$14,716
Total plan assets at end of year	2011-12-31	$2,316,498
Total plan assets at beginning of year	2011-12-31	$2,078,279
Value of fidelity bond covering the plan	2011-12-31	$250,000
Total contributions received or receivable from participants	2011-12-31	$161,294
Expenses. Other expenses not covered elsewhere	2011-12-31	$70
Contributions received from other sources (not participants or employers)	2011-12-31	$0
Other income received	2011-12-31	$-63,660
Net income (gross income less expenses)	2011-12-31	$238,219
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$2,316,498
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$2,078,279
Assets. Value of participant loans	2011-12-31	$60,752
Total contributions received or receivable from employer(s)	2011-12-31	$155,371
Value of certain deemed distributions of participant loans	2011-12-31	$0
Value of corrective distributions	2011-12-31	$0
Funding deficiency by the employer to the plan for this plan year	2011-12-31	$0
Minimum employer required contribution for this plan year	2011-12-31	$0
Amount contributed by the employer to the plan for this plan year	2011-12-31	$0
2010 : PELHAM LINKS FAMILY & COSMETIC DENTISTRY, P.A. PROFIT SHARING 401(K) PLAN 2010 401k financial data
Transfers to/from the plan	2010-12-31	$0
Total income from all sources	2010-12-31	$502,470
Expenses. Total of all expenses incurred	2010-12-31	$196,832
Benefits paid (including direct rollovers)	2010-12-31	$187,758
Total plan assets at end of year	2010-12-31	$2,078,279
Total plan assets at beginning of year	2010-12-31	$1,772,641
Value of fidelity bond covering the plan	2010-12-31	$250,000
Total contributions received or receivable from participants	2010-12-31	$134,904
Expenses. Other expenses not covered elsewhere	2010-12-31	$70
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$246,667
Net income (gross income less expenses)	2010-12-31	$305,638
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$2,078,279
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$1,772,641
Assets. Value of participant loans	2010-12-31	$72,821
Total contributions received or receivable from employer(s)	2010-12-31	$120,899
Value of certain deemed distributions of participant loans	2010-12-31	$0
Value of corrective distributions	2010-12-31	$9,004
Funding deficiency by the employer to the plan for this plan year	2010-12-31	$0
Minimum employer required contribution for this plan year	2010-12-31	$0
Amount contributed by the employer to the plan for this plan year	2010-12-31	$0
2009 : PELHAM LINKS FAMILY & COSMETIC DENTISTRY, P.A. PROFIT SHARING 401(K) PLAN 2009 401k financial data
Funding deficiency by the employer to the plan for this plan year	2009-12-31	$0
Minimum employer required contribution for this plan year	2009-12-31	$0
Amount contributed by the employer to the plan for this plan year	2009-12-31	$0
2008 : PELHAM LINKS FAMILY & COSMETIC DENTISTRY, P.A. PROFIT SHARING 401(K) PLAN 2008 401k financial data
Total income from all sources	2008-12-31	$-307,767
Expenses. Total of all expenses incurred	2008-12-31	$98,440
Benefits paid (including direct rollovers)	2008-12-31	$98,440
Total plan assets at end of year	2008-12-31	$1,315,769
Total plan assets at beginning of year	2008-12-31	$1,721,976
Value of fidelity bond covering the plan	2008-12-31	$250,000
Total contributions received or receivable from participants	2008-12-31	$129,554
Other income received	2008-12-31	$-561,014
Net income (gross income less expenses)	2008-12-31	$-406,207
Net plan assets at end of year (total assets less liabilities)	2008-12-31	$1,315,769
Net plan assets at beginning of year (total assets less liabilities)	2008-12-31	$1,721,976
Assets. Value of participant loans	2008-12-31	$54,739
Total contributions received or receivable from employer(s)	2008-12-31	$123,693

Form 5500 Responses for PELHAM LINKS FAMILY & COSMETIC DENTISTRY, P.A. PROFIT SHARING 401(K) PLAN

2011: PELHAM LINKS FAMILY & COSMETIC DENTISTRY, P.A. PROFIT SHARING 401(K) PLAN 2011 form 5500 responses
2011-01-01	Type of plan entity	Single employer plan
2011-01-01	Submission has been amended	No
2011-01-01	This submission is the final filing	No
2011-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2011-01-01	Plan is a collectively bargained plan	No
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2009: PELHAM LINKS FAMILY & COSMETIC DENTISTRY, P.A. PROFIT SHARING 401(K) PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	Yes
2009-01-01	This submission is the final filing	No
2009-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2009-01-01	Plan is a collectively bargained plan	No
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-019325

Policy instance

Insurance contract or identification number	GA-019325
Number of Individuals Covered	42
Insurance policy start date	2011-01-01
Insurance policy end date	2011-12-31
Total amount of commissions paid to insurance broker	USD $6,225
Total amount of fees paid to insurance company	USD $1,732
Are there contracts with allocated funds for individual policies?	No
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?	Yes
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

HARTFORD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88072 )

Policy contract number

GA-019325

Policy instance

Insurance contract or identification number	GA-019325
Number of Individuals Covered	31
Insurance policy start date	2008-01-01
Insurance policy end date	2008-12-31
Total amount of commissions paid to insurance broker	USD $4,850
Total amount of fees paid to insurance company	USD $1,620
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	1620
Additional information about fees paid to insurance broker	SALES AND MARKETING
Insurance broker organization code?	3
Are there contracts with allocated funds for individual policies?	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
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
Insurance broker name	EDWARDS JONES AND INSURANCE SERVI

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Company Name:	PELHAM LINKS FAMILY & COSMETIC DENTISTRY, P.A.
Employer identification number (EIN):	570788902
NAIC Classification:	621210
NAIC Description:	Offices of Dentists