401k Plan data: M. LEWIS GRUBBS, D.D.S. RETIREMENT PLAN plan

M. LEWIS GRUBBS, D.D.S. RETIREMENT PLAN 401k Plan overview

Plan Name	M. LEWIS GRUBBS, D.D.S. RETIREMENT PLAN
Plan identification number	001

M. LEWIS GRUBBS, D.D.S. RETIREMENT 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.
Participant-directed brokerage accounts provided as an investment option under the plan.
Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
Plan covering Self-Employed individuals.
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

M. LEWIS GRUBBS, D.D.S. has sponsored the creation of one or more 401k plans.

Company Name: M. LEWIS GRUBBS, D.D.S.

Employer identification number (EIN): 640679895

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan M. LEWIS GRUBBS, D.D.S. RETIREMENT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
001 2019-01-01 WILL UMPHLETT 2020-10-15
001 2018-01-01 M. LEWIS GRUBBS 2019-10-11
001 2017-01-01
001 2016-01-01 M. LEWIS GRUBBS, D.M.D.
001 2015-01-01 M. LEWIS GRUBBS, D.M.D.
001 2014-01-01 M. LEWIS GRUBBS, D.M.D.
001 2013-01-01 M. LEWIS GRUBBS, D.M.D.
001 2012-01-01 M. LEWIS GRUBBS, D.M.D.
001 2011-01-01 M. LEWIS GRUBBS, D.M.D.
001 2009-01-01 M. LEWIS GRUBBS, D.M.D.

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
001	2019-01-01	WILL UMPHLETT	2020-10-15
001	2018-01-01	M. LEWIS GRUBBS	2019-10-11
001	2017-01-01
001	2016-01-01	M. LEWIS GRUBBS, D.M.D.
001	2015-01-01	M. LEWIS GRUBBS, D.M.D.
001	2014-01-01	M. LEWIS GRUBBS, D.M.D.
001	2013-01-01	M. LEWIS GRUBBS, D.M.D.
001	2012-01-01	M. LEWIS GRUBBS, D.M.D.
001	2011-01-01	M. LEWIS GRUBBS, D.M.D.
001	2009-01-01	M. LEWIS GRUBBS, D.M.D.

Financial Data on M. LEWIS GRUBBS, D.D.S. RETIREMENT PLAN

Measure	Date	Value
2019 : M. LEWIS GRUBBS, D.D.S. RETIREMENT PLAN 2019 401k financial data
Total income from all sources	2019-12-31	$40,582
Expenses. Total of all expenses incurred	2019-12-31	$125,000
Benefits paid (including direct rollovers)	2019-12-31	$125,000
Total plan assets at end of year	2019-12-31	$294,975
Total plan assets at beginning of year	2019-12-31	$379,393
Value of fidelity bond covering the plan	2019-12-31	$200,000
Total contributions received or receivable from participants	2019-12-31	$6,288
Other income received	2019-12-31	$29,166
Net income (gross income less expenses)	2019-12-31	$-84,418
Net plan assets at end of year (total assets less liabilities)	2019-12-31	$294,975
Net plan assets at beginning of year (total assets less liabilities)	2019-12-31	$379,393
Assets. Value of assets in partnership/joint-venture interests	2019-12-31	$0
Total contributions received or receivable from employer(s)	2019-12-31	$5,128
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2019-12-31	$125,000
2018 : M. LEWIS GRUBBS, D.D.S. RETIREMENT PLAN 2018 401k financial data
Total income from all sources	2018-12-31	$13,022
Expenses. Total of all expenses incurred	2018-12-31	$5,090
Benefits paid (including direct rollovers)	2018-12-31	$5,000
Total plan assets at end of year	2018-12-31	$379,393
Total plan assets at beginning of year	2018-12-31	$371,461
Value of fidelity bond covering the plan	2018-12-31	$200,000
Total contributions received or receivable from participants	2018-12-31	$5,955
Other income received	2018-12-31	$2,167
Net income (gross income less expenses)	2018-12-31	$7,932
Net plan assets at end of year (total assets less liabilities)	2018-12-31	$379,393
Net plan assets at beginning of year (total assets less liabilities)	2018-12-31	$371,461
Assets. Value of assets in partnership/joint-venture interests	2018-12-31	$125,000
Total contributions received or receivable from employer(s)	2018-12-31	$4,900
Expenses. Administrative service providers (salaries,fees and commissions)	2018-12-31	$90
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2018-12-31	$0
2017 : M. LEWIS GRUBBS, D.D.S. RETIREMENT PLAN 2017 401k financial data
Total income from all sources	2017-12-31	$44,106
Expenses. Total of all expenses incurred	2017-12-31	$15,696
Total plan assets at end of year	2017-12-31	$371,461
Total plan assets at beginning of year	2017-12-31	$343,051
Value of fidelity bond covering the plan	2017-12-31	$200,000
Total contributions received or receivable from participants	2017-12-31	$14,238
Expenses. Other expenses not covered elsewhere	2017-12-31	$15,696
Other income received	2017-12-31	$16,665
Net income (gross income less expenses)	2017-12-31	$28,410
Net plan assets at end of year (total assets less liabilities)	2017-12-31	$371,461
Net plan assets at beginning of year (total assets less liabilities)	2017-12-31	$343,051
Assets. Value of assets in partnership/joint-venture interests	2017-12-31	$125,000
Total contributions received or receivable from employer(s)	2017-12-31	$13,203
2016 : M. LEWIS GRUBBS, D.D.S. RETIREMENT PLAN 2016 401k financial data
Total income from all sources	2016-12-31	$51,239
Expenses. Total of all expenses incurred	2016-12-31	$150,203
Benefits paid (including direct rollovers)	2016-12-31	$125,622
Total plan assets at end of year	2016-12-31	$343,051
Total plan assets at beginning of year	2016-12-31	$442,015
Value of fidelity bond covering the plan	2016-12-31	$200,000
Total contributions received or receivable from participants	2016-12-31	$20,051
Expenses. Other expenses not covered elsewhere	2016-12-31	$24,581
Other income received	2016-12-31	$15,656
Net income (gross income less expenses)	2016-12-31	$-98,964
Net plan assets at end of year (total assets less liabilities)	2016-12-31	$343,051
Net plan assets at beginning of year (total assets less liabilities)	2016-12-31	$442,015
Assets. Value of assets in partnership/joint-venture interests	2016-12-31	$125,000
Total contributions received or receivable from employer(s)	2016-12-31	$15,532
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
2015 : M. LEWIS GRUBBS, D.D.S. RETIREMENT PLAN 2015 401k financial data
Total income from all sources	2015-12-31	$33,260
Expenses. Total of all expenses incurred	2015-12-31	$40,797
Benefits paid (including direct rollovers)	2015-12-31	$21,288
Total plan assets at end of year	2015-12-31	$442,015
Total plan assets at beginning of year	2015-12-31	$449,552
Value of fidelity bond covering the plan	2015-12-31	$200,000
Total contributions received or receivable from participants	2015-12-31	$15,758
Expenses. Other expenses not covered elsewhere	2015-12-31	$19,509
Other income received	2015-12-31	$2,943
Net income (gross income less expenses)	2015-12-31	$-7,537
Net plan assets at end of year (total assets less liabilities)	2015-12-31	$442,015
Net plan assets at beginning of year (total assets less liabilities)	2015-12-31	$449,552
Assets. Value of assets in partnership/joint-venture interests	2015-12-31	$125,000
Total contributions received or receivable from employer(s)	2015-12-31	$14,559
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
2014 : M. LEWIS GRUBBS, D.D.S. RETIREMENT PLAN 2014 401k financial data
Total income from all sources	2014-12-31	$35,710
Expenses. Total of all expenses incurred	2014-12-31	$93,858
Benefits paid (including direct rollovers)	2014-12-31	$90,045
Total plan assets at end of year	2014-12-31	$449,552
Total plan assets at beginning of year	2014-12-31	$507,700
Value of fidelity bond covering the plan	2014-12-31	$200,000
Total contributions received or receivable from participants	2014-12-31	$7,814
Expenses. Other expenses not covered elsewhere	2014-12-31	$3,813
Other income received	2014-12-31	$21,287
Net income (gross income less expenses)	2014-12-31	$-58,148
Net plan assets at end of year (total assets less liabilities)	2014-12-31	$449,552
Net plan assets at beginning of year (total assets less liabilities)	2014-12-31	$507,700
Assets. Value of assets in partnership/joint-venture interests	2014-12-31	$125,000
Total contributions received or receivable from employer(s)	2014-12-31	$6,609
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
2013 : M. LEWIS GRUBBS, D.D.S. RETIREMENT PLAN 2013 401k financial data
Total income from all sources	2013-12-31	$48,230
Expenses. Total of all expenses incurred	2013-12-31	$3,813
Total plan assets at end of year	2013-12-31	$507,700
Total plan assets at beginning of year	2013-12-31	$463,283
Value of fidelity bond covering the plan	2013-12-31	$200,000
Total contributions received or receivable from participants	2013-12-31	$17,877
Expenses. Other expenses not covered elsewhere	2013-12-31	$3,813
Other income received	2013-12-31	$15,501
Net income (gross income less expenses)	2013-12-31	$44,417
Net plan assets at end of year (total assets less liabilities)	2013-12-31	$507,700
Net plan assets at beginning of year (total assets less liabilities)	2013-12-31	$463,283
Assets. Value of assets in partnership/joint-venture interests	2013-12-31	$125,000
Total contributions received or receivable from employer(s)	2013-12-31	$14,852
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
2012 : M. LEWIS GRUBBS, D.D.S. RETIREMENT PLAN 2012 401k financial data
Total income from all sources	2012-12-31	$43,250
Expenses. Total of all expenses incurred	2012-12-31	$3,813
Total plan assets at end of year	2012-12-31	$463,283
Total plan assets at beginning of year	2012-12-31	$423,846
Value of fidelity bond covering the plan	2012-12-31	$200,000
Total contributions received or receivable from participants	2012-12-31	$14,518
Expenses. Other expenses not covered elsewhere	2012-12-31	$3,813
Other income received	2012-12-31	$15,214
Net income (gross income less expenses)	2012-12-31	$39,437
Net plan assets at end of year (total assets less liabilities)	2012-12-31	$463,283
Net plan assets at beginning of year (total assets less liabilities)	2012-12-31	$423,846
Assets. Value of assets in partnership/joint-venture interests	2012-12-31	$125,000
Value of participant contributions where there was a failure to transmit these to the plan within the time period described in 29 CFR 2510.3-102	2012-12-31	$1,530
Total contributions received or receivable from employer(s)	2012-12-31	$13,518
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2012-12-31	$0
2011 : M. LEWIS GRUBBS, D.D.S. RETIREMENT PLAN 2011 401k financial data
Total income from all sources	2011-12-31	$101,800
Expenses. Total of all expenses incurred	2011-12-31	$59,078
Benefits paid (including direct rollovers)	2011-12-31	$55,878
Total plan assets at end of year	2011-12-31	$423,846
Total plan assets at beginning of year	2011-12-31	$381,124
Value of fidelity bond covering the plan	2011-12-31	$200,000
Total contributions received or receivable from participants	2011-12-31	$10,652
Expenses. Other expenses not covered elsewhere	2011-12-31	$3,200
Contributions received from other sources (not participants or employers)	2011-12-31	$75,526
Other income received	2011-12-31	$5,675
Net income (gross income less expenses)	2011-12-31	$42,722
Net plan assets at end of year (total assets less liabilities)	2011-12-31	$423,846
Net plan assets at beginning of year (total assets less liabilities)	2011-12-31	$381,124
Assets. Value of assets in partnership/joint-venture interests	2011-12-31	$125,000
Total contributions received or receivable from employer(s)	2011-12-31	$9,947
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2011-12-31	$0
2010 : M. LEWIS GRUBBS, D.D.S. RETIREMENT PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$43,113
Expenses. Total of all expenses incurred	2010-12-31	$0
Total plan assets at end of year	2010-12-31	$381,124
Total plan assets at beginning of year	2010-12-31	$338,011
Value of fidelity bond covering the plan	2010-12-31	$200,000
Total contributions received or receivable from participants	2010-12-31	$9,902
Contributions received from other sources (not participants or employers)	2010-12-31	$10
Other income received	2010-12-31	$24,235
Net income (gross income less expenses)	2010-12-31	$43,113
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$381,124
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$338,011
Assets. Value of assets in partnership/joint-venture interests	2010-12-31	$125,000
Total contributions received or receivable from employer(s)	2010-12-31	$8,966
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0
2009 : M. LEWIS GRUBBS, D.D.S. RETIREMENT PLAN 2009 401k financial data
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2009-12-31	$0

Form 5500 Responses for M. LEWIS GRUBBS, D.D.S. RETIREMENT PLAN

2019: M. LEWIS GRUBBS, D.D.S. RETIREMENT PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan funding arrangement – Trust	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement - Trust	Yes
2018: M. LEWIS GRUBBS, D.D.S. RETIREMENT PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
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: M. LEWIS GRUBBS, D.D.S. RETIREMENT 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 – 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
2016: M. LEWIS GRUBBS, D.D.S. RETIREMENT PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
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 – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: M. LEWIS GRUBBS, D.D.S. RETIREMENT PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: M. LEWIS GRUBBS, D.D.S. RETIREMENT PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: M. LEWIS GRUBBS, D.D.S. RETIREMENT PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2012: M. LEWIS GRUBBS, D.D.S. RETIREMENT PLAN 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	No
2012-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2012-01-01	Plan is a collectively bargained plan	No
2012-01-01	Plan funding arrangement – Trust	Yes
2012-01-01	Plan benefit arrangement - Trust	Yes
2011: M. LEWIS GRUBBS, D.D.S. RETIREMENT 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 – Trust	Yes
2011-01-01	Plan benefit arrangement - Trust	Yes
2009: M. LEWIS GRUBBS, D.D.S. RETIREMENT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Submission has been amended	No
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 – Trust	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract number	VF52552570
Policy instance	2
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number	GA-839482
Policy instance	1
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract number	VF52552570
Policy instance	2
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number	GA-839482
Policy instance	1
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract number	VF52552570
Policy instance	2
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number	GA-839482
Policy instance	1
MASSACHUSETTS MUTUAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65935 )
Policy contract number	GA-839482
Policy instance	1
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract number	VF52552570
Policy instance	2
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract number	VF52552570
Policy instance	1
PACIFIC LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67466 )
Policy contract number	VF52552570
Policy instance	1
NEW ENGLAND FINANCIAL (National Association of Insurance Commissioners NAIC id number: 91626 )
Policy contract number	0Z055348
Policy instance	1
NEW ENGLAND FINANCIAL (National Association of Insurance Commissioners NAIC id number: 91626 )
Policy contract number	0Z055348
Policy instance	1
NEW ENGLAND FINANCIAL (National Association of Insurance Commissioners NAIC id number: 91626 )
Policy contract number	0Z055348
Policy instance	1

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Company Name:	M. LEWIS GRUBBS, D.D.S.
Employer identification number (EIN):	640679895
NAIC Classification:	621210
NAIC Description:	Offices of Dentists