401k Plan data: MARILYN R. CALVO, D.D.S. DEFINED BENEFIT PLAN plan

MARILYN R. CALVO, D.D.S. DEFINED BENEFIT PLAN 401k Plan overview

Plan Name	MARILYN R. CALVO, D.D.S. DEFINED BENEFIT PLAN
Plan identification number	002

MARILYN R. CALVO, D.D.S. DEFINED BENEFIT PLAN Benefits

401k Plan Type

Defined Benefit Pension

Plan Features/Benefits

Benefits are primarily pay related
Benefits are primarily flat dollar (includes dollars per year of service)
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

MARILYN R. CALVO, D.D.S., A DENTAL CORPORATION has sponsored the creation of one or more 401k plans.

Company Name: MARILYN R. CALVO, D.D.S., A DENTAL CORPORATION

Employer identification number (EIN): 954049599

NAIC Classification: 621210
NAIC Description: Offices of Dentists

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MARILYN R. CALVO, D.D.S. DEFINED BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2016-01-01 MARILYN R. CALVO, D.D.S. 2017-05-12
002 2015-01-01 MARILYN R. CALVO, D.D.S. 2016-09-08
002 2014-01-01 MARILYN R. CALVO, D.D.S. 2015-10-12
002 2013-01-01 MARILYN CALVO 2014-09-09
002 2012-01-01 MARILYN CALVO 2013-07-30
002 2011-01-01 MARILYN CALVO 2012-09-12
002 2010-01-01 MARILYN CALVO
002 2009-01-01 MARILYN CALVO

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
002	2016-01-01	MARILYN R. CALVO, D.D.S.	2017-05-12
002	2015-01-01	MARILYN R. CALVO, D.D.S.	2016-09-08
002	2014-01-01	MARILYN R. CALVO, D.D.S.	2015-10-12
002	2013-01-01	MARILYN CALVO	2014-09-09
002	2012-01-01	MARILYN CALVO	2013-07-30
002	2011-01-01	MARILYN CALVO	2012-09-12
002	2010-01-01	MARILYN CALVO
002	2009-01-01	MARILYN CALVO

Plan Statistics for MARILYN R. CALVO, D.D.S. DEFINED BENEFIT PLAN

401k plan membership statisitcs for MARILYN R. CALVO, D.D.S. DEFINED BENEFIT PLAN

Measure Date Value
2016: MARILYN R. CALVO, D.D.S. DEFINED BENEFIT PLAN 2016 401k membership
Market value of plan assets 2016-12-31 2,431,880
Acturial value of plan assets 2016-12-31 2,431,880
Funding target for retired participants and beneficiaries receiving payment 2016-12-31 0
Number of terminated vested participants 2016-12-31 4
Fundng target for terminated vested participants 2016-12-31 92,602
Active participant vested funding target 2016-12-31 2,215,446
Number of active participants 2016-12-31 4
Total funding liabilities for active participants 2016-12-31 2,215,446
Total participant count 2016-12-31 8
Total funding target for all participants 2016-12-31 2,308,048
Balance at beginning of prior year after applicable adjustments 2016-12-31 0
Prefunding balance at beginning of prior year after applicable adjustments 2016-12-31 0
Carryover balanced portion elected for use to offset prior years funding requirement 2016-12-31 0
Prefunding balanced used to offset prior years funding requirement 2016-12-31 0
Amount remaining of carryover balance 2016-12-31 0
Amount remaining of prefunding balance 2016-12-31 0
Present value of excess contributions 2016-12-31 139,895
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance 2016-12-31 147,827
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance 2016-12-31 0
Reductions in caryover balances due to elections or deemed elections 2016-12-31 0
Reductions in prefunding balances due to elections or deemed elections 2016-12-31 0
Balance of carryovers at beginning of current year 2016-12-31 0
Balance of prefunding at beginning of current year 2016-12-31 0
Total employer contributions 2016-12-31 0
Total employee contributions 2016-12-31 0
Contributions allocated toward unpaid minimum require contributions from prior years 2016-12-31 0
Contributions made to avoid restrictions adjusted to valuation date 2016-12-31 0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date 2016-12-31 0
Unpaid minimum required contributions for all prior years 2016-12-31 0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years 2016-12-31 0
Remaining amount of unpaid minimum required contributions 2016-12-31 0
Minimum required contributions for current year target normal cost 2016-12-31 0
Net shortfall amortization installment of oustanding balance 2016-12-31 0
Waiver amortization installment 2016-12-31 0
Total funding amount beforereflecting carryover/prefunding balances 2016-12-31 0
Carryover balance elected to use to offset funding requirement 2016-12-31 0
Prefunding balance elected to use to offset funding requirement 2016-12-31 0
Additional cash requirement 2016-12-31 0
Contributions allocatedtoward minimum required contributions for current year 2016-12-31 0
Unpaid minimum required contributions for current year 2016-12-31 0
Unpaid minimum required contributions for all years 2016-12-31 0
2010: MARILYN R. CALVO, D.D.S. DEFINED BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 3
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 3
Total of all active and inactive participants 2010-01-01 6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 6
2009: MARILYN R. CALVO, D.D.S. DEFINED BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year 2009-01-01 6
Total number of active participants reported on line 7a of the Form 5500 2009-01-01 3
Number of other retired or separated participants entitled to future benefits 2009-01-01 3
Total of all active and inactive participants 2009-01-01 6
Total participants 2009-01-01 6

Measure	Date	Value
2016: MARILYN R. CALVO, D.D.S. DEFINED BENEFIT PLAN 2016 401k membership
Market value of plan assets	2016-12-31	2,431,880
Acturial value of plan assets	2016-12-31	2,431,880
Funding target for retired participants and beneficiaries receiving payment	2016-12-31	0
Number of terminated vested participants	2016-12-31	4
Fundng target for terminated vested participants	2016-12-31	92,602
Active participant vested funding target	2016-12-31	2,215,446
Number of active participants	2016-12-31	4
Total funding liabilities for active participants	2016-12-31	2,215,446
Total participant count	2016-12-31	8
Total funding target for all participants	2016-12-31	2,308,048
Balance at beginning of prior year after applicable adjustments	2016-12-31	0
Prefunding balance at beginning of prior year after applicable adjustments	2016-12-31	0
Carryover balanced portion elected for use to offset prior years funding requirement	2016-12-31	0
Prefunding balanced used to offset prior years funding requirement	2016-12-31	0
Amount remaining of carryover balance	2016-12-31	0
Amount remaining of prefunding balance	2016-12-31	0
Present value of excess contributions	2016-12-31	139,895
Total available prior years excess cotributions available at beginning of current plan year to add to prefunding balance	2016-12-31	147,827
Total available prior years excess cotributions added at beginning of current plan year to add to prefunding balance	2016-12-31	0
Reductions in caryover balances due to elections or deemed elections	2016-12-31	0
Reductions in prefunding balances due to elections or deemed elections	2016-12-31	0
Balance of carryovers at beginning of current year	2016-12-31	0
Balance of prefunding at beginning of current year	2016-12-31	0
Total employer contributions	2016-12-31	0
Total employee contributions	2016-12-31	0
Contributions allocated toward unpaid minimum require contributions from prior years	2016-12-31	0
Contributions made to avoid restrictions adjusted to valuation date	2016-12-31	0
Contributions allocated toward minimum required contributions for current year adjusted to valuation date	2016-12-31	0
Unpaid minimum required contributions for all prior years	2016-12-31	0
iDiscounted employer contributions allocated toward unpaid minimum required contributions from prior years	2016-12-31	0
Remaining amount of unpaid minimum required contributions	2016-12-31	0
Minimum required contributions for current year target normal cost	2016-12-31	0
Net shortfall amortization installment of oustanding balance	2016-12-31	0
Waiver amortization installment	2016-12-31	0
Total funding amount beforereflecting carryover/prefunding balances	2016-12-31	0
Carryover balance elected to use to offset funding requirement	2016-12-31	0
Prefunding balance elected to use to offset funding requirement	2016-12-31	0
Additional cash requirement	2016-12-31	0
Contributions allocatedtoward minimum required contributions for current year	2016-12-31	0
Unpaid minimum required contributions for current year	2016-12-31	0
Unpaid minimum required contributions for all years	2016-12-31	0
2010: MARILYN R. CALVO, D.D.S. DEFINED BENEFIT PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	3
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	3
Total of all active and inactive participants	2010-01-01	6
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	6
2009: MARILYN R. CALVO, D.D.S. DEFINED BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year	2009-01-01	6
Total number of active participants reported on line 7a of the Form 5500	2009-01-01	3
Number of other retired or separated participants entitled to future benefits	2009-01-01	3
Total of all active and inactive participants	2009-01-01	6
Total participants	2009-01-01	6

Financial Data on MARILYN R. CALVO, D.D.S. DEFINED BENEFIT PLAN

Measure	Date	Value
2010 : MARILYN R. CALVO, D.D.S. DEFINED BENEFIT PLAN 2010 401k financial data
Transfers to/from the plan	2010-12-31	$0
Total plan liabilities at end of year	2010-12-31	$0
Total plan liabilities at beginning of year	2010-12-31	$0
Total income from all sources	2010-12-31	$155,793
Expenses. Total of all expenses incurred	2010-12-31	$7,635
Benefits paid (including direct rollovers)	2010-12-31	$0
Total plan assets at end of year	2010-12-31	$1,454,681
Total plan assets at beginning of year	2010-12-31	$1,306,523
Total contributions received or receivable from participants	2010-12-31	$0
Expenses. Other expenses not covered elsewhere	2010-12-31	$0
Contributions received from other sources (not participants or employers)	2010-12-31	$0
Other income received	2010-12-31	$43,979
Noncash contributions received	2010-12-31	$0
Net income (gross income less expenses)	2010-12-31	$148,158
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$1,454,681
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$1,306,523
Total contributions received or receivable from employer(s)	2010-12-31	$111,814
Value of certain deemed distributions of participant loans	2010-12-31	$0
Value of corrective distributions	2010-12-31	$0
Expenses. Administrative service providers (salaries,fees and commissions)	2010-12-31	$7,635
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0

Form 5500 Responses for MARILYN R. CALVO, D.D.S. DEFINED BENEFIT PLAN

2010: MARILYN R. CALVO, D.D.S. DEFINED BENEFIT PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	Yes
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes
2010-01-01	Plan benefit arrangement - Trust	Yes
2009: MARILYN R. CALVO, D.D.S. DEFINED BENEFIT PLAN 2009 form 5500 responses
2009-01-01	Type of plan entity	Single employer plan
2009-01-01	Plan funding arrangement – Insurance	Yes
2009-01-01	Plan funding arrangement – Trust	Yes
2009-01-01	Plan benefit arrangement – Insurance	Yes
2009-01-01	Plan benefit arrangement - Trust	Yes

Insurance Providers Used on plan

AVIVA LIFE AND ANNUITY COMPANY (National Association of Insurance Commissioners NAIC id number: 60631 )

Policy contract number

576030

Policy instance

Insurance contract or identification number	576030
Number of Individuals Covered	6
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
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

ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )

Policy contract number

70155640

Policy instance

Insurance contract or identification number	70155640
Number of Individuals Covered	6
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
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

ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )

Policy contract number

21357714

Policy instance

Insurance contract or identification number	21357714
Number of Individuals Covered	6
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
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

ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )

Policy contract number

70830519

Policy instance

Insurance contract or identification number	70830519
Number of Individuals Covered	6
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
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

ALLIANZ LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 90611 )

Policy contract number

411366075

Policy instance

Insurance contract or identification number	411366075
Number of Individuals Covered	6
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Are there contracts with allocated funds for types other than group deferred annuity or individual?	Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Other information about contract	ANNUITY

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Company Name:	MARILYN R. CALVO, D.D.S., A DENTAL CORPORATION
Employer identification number (EIN):	954049599
NAIC Classification:	621210
NAIC Description:	Offices of Dentists