401k Plan data: COAST DENTAL SERVICES, INC. 401(K) PROFIT SHARING PLAN #2 plan

COAST DENTAL SERVICES, INC. 401(K) PROFIT SHARING PLAN #2 401k Plan overview

Plan Name	COAST DENTAL SERVICES, INC. 401(K) PROFIT SHARING PLAN #2
Plan identification number	002

COAST DENTAL SERVICES, INC. 401(K) PROFIT SHARING PLAN #2 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.
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

INTELIDENT SOLUTIONS, LLC DBA has sponsored the creation of one or more 401k plans.

Company Name: INTELIDENT SOLUTIONS, LLC DBA

Employer identification number (EIN): 593136131

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Additional information about INTELIDENT SOLUTIONS, LLC DBA

Jurisdiction of Incorporation: Florida Department of State Division of Corporations

Incorporation Date: 2002-08-29

Company Identification Number: P02000094204

Legal Registered Office Address: 1200 South Pine Island Road

Plantation

33324

More information about INTELIDENT SOLUTIONS, LLC DBA

Form 5500 Filing Information

Submission information for form 5500 for 401k plan COAST DENTAL SERVICES, INC. 401(K) PROFIT SHARING PLAN #2

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2012-01-01 DON KELLY
002 2011-01-01 DON KELLY

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2012-01-01	DON KELLY
002	2011-01-01	DON KELLY

Plan Statistics for COAST DENTAL SERVICES, INC. 401(K) PROFIT SHARING PLAN #2

401k plan membership statisitcs for COAST DENTAL SERVICES, INC. 401(K) PROFIT SHARING PLAN #2

Measure Date Value
2012: COAST DENTAL SERVICES, INC. 401(K) PROFIT SHARING PLAN #2 2012 401k membership
Total participants, beginning-of-year 2012-01-01 676
Total number of active participants reported on line 7a of the Form 5500 2012-01-01 0
Number of retired or separated participants receiving benefits 2012-01-01 0
Number of other retired or separated participants entitled to future benefits 2012-01-01 0
Total of all active and inactive participants 2012-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2012-01-01 0
Total participants 2012-01-01 0
Number of participants with account balances 2012-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2012-01-01 0
2011: COAST DENTAL SERVICES, INC. 401(K) PROFIT SHARING PLAN #2 2011 401k membership
Total participants, beginning-of-year 2011-01-01 817
Total number of active participants reported on line 7a of the Form 5500 2011-01-01 574
Number of retired or separated participants receiving benefits 2011-01-01 0
Number of other retired or separated participants entitled to future benefits 2011-01-01 102
Total of all active and inactive participants 2011-01-01 676
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2011-01-01 0
Total participants 2011-01-01 676
Number of participants with account balances 2011-01-01 168
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2011-01-01 9

Measure	Date	Value
2012: COAST DENTAL SERVICES, INC. 401(K) PROFIT SHARING PLAN #2 2012 401k membership
Total participants, beginning-of-year	2012-01-01	676
Total number of active participants reported on line 7a of the Form 5500	2012-01-01	0
Number of retired or separated participants receiving benefits	2012-01-01	0
Number of other retired or separated participants entitled to future benefits	2012-01-01	0
Total of all active and inactive participants	2012-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2012-01-01	0
Total participants	2012-01-01	0
Number of participants with account balances	2012-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2012-01-01	0
2011: COAST DENTAL SERVICES, INC. 401(K) PROFIT SHARING PLAN #2 2011 401k membership
Total participants, beginning-of-year	2011-01-01	817
Total number of active participants reported on line 7a of the Form 5500	2011-01-01	574
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	102
Total of all active and inactive participants	2011-01-01	676
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2011-01-01	0
Total participants	2011-01-01	676
Number of participants with account balances	2011-01-01	168
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2011-01-01	9

Financial Data on COAST DENTAL SERVICES, INC. 401(K) PROFIT SHARING PLAN #2

Measure	Date	Value
2012 : COAST DENTAL SERVICES, INC. 401(K) PROFIT SHARING PLAN #2 2012 401k financial data
Total unrealized appreciation/depreciation of assets	2012-02-21	$0
Total transfer of assets from this plan	2012-02-21	$3,899,451
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-02-21	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2012-02-21	$16,271
Total income from all sources (including contributions)	2012-02-21	$278,993
Total loss/gain on sale of assets	2012-02-21	$0
Total of all expenses incurred	2012-02-21	$113,190
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2012-02-21	$84,853
Value of total corrective distributions	2012-02-21	$26,421
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2012-02-21	$21,886
Value of total assets at end of year	2012-02-21	$0
Value of total assets at beginning of year	2012-02-21	$3,749,919
Total of administrative expenses incurred including professional, contract, advisory and management fees	2012-02-21	$1,916
Total interest from all sources	2012-02-21	$1,247
Total dividends received (eg from common stock, registered investment company shares)	2012-02-21	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2012-02-21	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2012-02-21	$0
Was this plan covered by a fidelity bond	2012-02-21	Yes
Value of fidelity bond cover	2012-02-21	$500,000
If this is an individual account plan, was there a blackout period	2012-02-21	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-02-21	$0
Were there any nonexempt tranactions with any party-in-interest	2012-02-21	No
Contributions received from participants	2012-02-21	$21,886
Participant contributions at end of year	2012-02-21	$0
Participant contributions at beginning of year	2012-02-21	$71,348
Participant contributions at end of year	2012-02-21	$0
Participant contributions at beginning of year	2012-02-21	$29,377
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2012-02-21	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2012-02-21	$16,271
Total non interest bearing cash at end of year	2012-02-21	$0
Total non interest bearing cash at beginning of year	2012-02-21	$132
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-02-21	No
Value of net income/loss	2012-02-21	$165,803
Value of net assets at end of year (total assets less liabilities)	2012-02-21	$0
Value of net assets at beginning of year (total assets less liabilities)	2012-02-21	$3,733,648
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2012-02-21	No
Were any loans by the plan or fixed income obligations due to the plan in default	2012-02-21	No
Were any leases to which the plan was party in default or uncollectible	2012-02-21	No
Value of interest in pooled separate accounts at end of year	2012-02-21	$0
Value of interest in pooled separate accounts at beginning of year	2012-02-21	$3,443,820
Interest on participant loans	2012-02-21	$423
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2012-02-21	$824
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2012-02-21	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2012-02-21	$205,242
Net investment gain/loss from pooled separate accounts	2012-02-21	$255,860
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2012-02-21	No
Was there a failure to transmit to the plan any participant contributions	2012-02-21	No
Has the plan failed to provide any benefit when due under the plan	2012-02-21	No
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2012-02-21	$84,853
Contract administrator fees	2012-02-21	$1,916
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2012-02-21	Yes
Did the plan have assets held for investment	2012-02-21	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2012-02-21	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2012-02-21	Yes
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2012-02-21	Yes
Opinion of an independent qualified public accountant for this plan	2012-02-21	Disclaimer
Accountancy firm name	2012-02-21	MAYER HOFFMAN MCCANN P.C.
Accountancy firm EIN	2012-02-21	431947695
2011 : COAST DENTAL SERVICES, INC. 401(K) PROFIT SHARING PLAN #2 2011 401k financial data
Total unrealized appreciation/depreciation of assets	2011-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$16,271
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2011-12-31	$16,680
Total income from all sources (including contributions)	2011-12-31	$351,186
Total loss/gain on sale of assets	2011-12-31	$0
Total of all expenses incurred	2011-12-31	$579,376
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2011-12-31	$532,642
Expenses. Certain deemed distributions of participant loans	2011-12-31	$6,500
Value of total corrective distributions	2011-12-31	$16,271
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2011-12-31	$410,521
Value of total assets at end of year	2011-12-31	$3,749,919
Value of total assets at beginning of year	2011-12-31	$3,978,518
Total of administrative expenses incurred including professional, contract, advisory and management fees	2011-12-31	$23,963
Total interest from all sources	2011-12-31	$9,641
Total dividends received (eg from common stock, registered investment company shares)	2011-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2011-12-31	No
Was this plan covered by a fidelity bond	2011-12-31	Yes
Value of fidelity bond cover	2011-12-31	$500,000
If this is an individual account plan, was there a blackout period	2011-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2011-12-31	No
Contributions received from participants	2011-12-31	$410,521
Participant contributions at end of year	2011-12-31	$71,348
Participant contributions at beginning of year	2011-12-31	$101,595
Participant contributions at end of year	2011-12-31	$29,377
Income. Received or receivable in cash from other sources (including rollovers)	2011-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2011-12-31	$16,271
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2011-12-31	$16,680
Total non interest bearing cash at end of year	2011-12-31	$132
Total non interest bearing cash at beginning of year	2011-12-31	$131
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Income. Non cash contributions	2011-12-31	$0
Value of net income/loss	2011-12-31	$-228,190
Value of net assets at end of year (total assets less liabilities)	2011-12-31	$3,733,648
Value of net assets at beginning of year (total assets less liabilities)	2011-12-31	$3,961,838
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2011-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2011-12-31	No
Were any leases to which the plan was party in default or uncollectible	2011-12-31	No
Value of interest in registered invesment companies (eg mutual funds) at end of year	2011-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2011-12-31	$0
Value of interest in pooled separate accounts at end of year	2011-12-31	$3,443,820
Value of interest in pooled separate accounts at beginning of year	2011-12-31	$3,643,089
Interest on participant loans	2011-12-31	$3,781
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2011-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2011-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2011-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2011-12-31	$5,860
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2011-12-31	$205,242
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2011-12-31	$233,703
Net investment gain/loss from pooled separate accounts	2011-12-31	$-68,976
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2011-12-31	No
Was there a failure to transmit to the plan any participant contributions	2011-12-31	Yes
Has the plan failed to provide any benefit when due under the plan	2011-12-31	No
Contributions received in cash from employer	2011-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2011-12-31	$532,642
Contract administrator fees	2011-12-31	$23,963
Did the plan have assets held for investment	2011-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2011-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2011-12-31	No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2011-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2011-12-31	Disclaimer
Accountancy firm name	2011-12-31	MAYER HOFFMAN MCCANN P.C.
Accountancy firm EIN	2011-12-31	431947695

Form 5500 Responses for COAST DENTAL SERVICES, INC. 401(K) PROFIT SHARING PLAN #2

2012: COAST DENTAL SERVICES, INC. 401(K) PROFIT SHARING PLAN #2 2012 form 5500 responses
2012-01-01	Type of plan entity	Single employer plan
2012-01-01	Submission has been amended	No
2012-01-01	This submission is the final filing	Yes
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2012-01-01	Plan is a collectively bargained plan	Yes
2012-01-01	Plan funding arrangement – Insurance	Yes
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement – Insurance	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: COAST DENTAL SERVICES, INC. 401(K) PROFIT SHARING PLAN #2 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	Yes
2011-01-01	Plan funding arrangement – Insurance	Yes
2011-01-01	Plan funding arrangement – Trust	Yes
2011-01-01	Plan benefit arrangement – Insurance	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes

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Company Name:	INTELIDENT SOLUTIONS, LLC DBA
Employer identification number (EIN):	593136131
NAIC Classification:	621210
NAIC Description:	Offices of Dentists

Jurisdiction of Incorporation:	Florida Department of State Division of Corporations
Incorporation Date:	2002-08-29
Company Identification Number:	P02000094204
Legal Registered Office Address:	1200 South Pine Island Road Plantation 33324