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EMPLOYEE HEALTH PLAN OF RJS ENTERPRISES OF WAUPACA, INC 401k Plan overview

Plan NameEMPLOYEE HEALTH PLAN OF RJS ENTERPRISES OF WAUPACA, INC
Plan identification number 502

EMPLOYEE HEALTH PLAN OF RJS ENTERPRISES OF WAUPACA, INC Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Dental

401k Sponsoring company profile

RJS ENTERPRISES OF WAUPACA, INC has sponsored the creation of one or more 401k plans.

Company Name:RJS ENTERPRISES OF WAUPACA, INC
Employer identification number (EIN):391362748
NAIC Classification:722513
NAIC Description:Limited-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE HEALTH PLAN OF RJS ENTERPRISES OF WAUPACA, INC

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022014-05-01BOB PRESLEY
5022013-05-01BOB PRESLEY
5022012-05-01BOB PRESLEY
5022011-05-01BOB PRESLEY
5022010-05-01BOB PRESLEY

Plan Statistics for EMPLOYEE HEALTH PLAN OF RJS ENTERPRISES OF WAUPACA, INC

401k plan membership statisitcs for EMPLOYEE HEALTH PLAN OF RJS ENTERPRISES OF WAUPACA, INC

Measure Date Value
2014: EMPLOYEE HEALTH PLAN OF RJS ENTERPRISES OF WAUPACA, INC 2014 401k membership
Total participants, beginning-of-year2014-05-013
Total number of active participants reported on line 7a of the Form 55002014-05-013
Number of retired or separated participants receiving benefits2014-05-010
Number of other retired or separated participants entitled to future benefits2014-05-010
Total of all active and inactive participants2014-05-013
2013: EMPLOYEE HEALTH PLAN OF RJS ENTERPRISES OF WAUPACA, INC 2013 401k membership
Total participants, beginning-of-year2013-05-015
Total number of active participants reported on line 7a of the Form 55002013-05-013
Number of retired or separated participants receiving benefits2013-05-010
Number of other retired or separated participants entitled to future benefits2013-05-010
Total of all active and inactive participants2013-05-013
2012: EMPLOYEE HEALTH PLAN OF RJS ENTERPRISES OF WAUPACA, INC 2012 401k membership
Total participants, beginning-of-year2012-05-013
Total number of active participants reported on line 7a of the Form 55002012-05-015
Number of retired or separated participants receiving benefits2012-05-010
Number of other retired or separated participants entitled to future benefits2012-05-010
Total of all active and inactive participants2012-05-015
2011: EMPLOYEE HEALTH PLAN OF RJS ENTERPRISES OF WAUPACA, INC 2011 401k membership
Total participants, beginning-of-year2011-05-013
Total number of active participants reported on line 7a of the Form 55002011-05-013
Number of retired or separated participants receiving benefits2011-05-010
Number of other retired or separated participants entitled to future benefits2011-05-010
Total of all active and inactive participants2011-05-013
2010: EMPLOYEE HEALTH PLAN OF RJS ENTERPRISES OF WAUPACA, INC 2010 401k membership
Total participants, beginning-of-year2010-05-013
Total number of active participants reported on line 7a of the Form 55002010-05-013
Number of retired or separated participants receiving benefits2010-05-010
Number of other retired or separated participants entitled to future benefits2010-05-010
Total of all active and inactive participants2010-05-013

Financial Data on EMPLOYEE HEALTH PLAN OF RJS ENTERPRISES OF WAUPACA, INC

Measure Date Value
2015 : EMPLOYEE HEALTH PLAN OF RJS ENTERPRISES OF WAUPACA, INC 2015 401k financial data
Total plan liabilities at end of year2015-04-30$0
Total plan liabilities at beginning of year2015-04-30$36
Total income from all sources2015-04-30$2,052
Expenses. Total of all expenses incurred2015-04-30$2,052
Benefits paid (including direct rollovers)2015-04-30$1,209
Total plan assets at end of year2015-04-30$0
Total plan assets at beginning of year2015-04-30$36
Value of fidelity bond covering the plan2015-04-30$1,000
Expenses. Other expenses not covered elsewhere2015-04-30$843
Net income (gross income less expenses)2015-04-30$0
Net plan assets at end of year (total assets less liabilities)2015-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2015-04-30$0
Total contributions received or receivable from employer(s)2015-04-30$2,052
2014 : EMPLOYEE HEALTH PLAN OF RJS ENTERPRISES OF WAUPACA, INC 2014 401k financial data
Total plan liabilities at end of year2014-04-30$36
Total plan liabilities at beginning of year2014-04-30$109
Total income from all sources2014-04-30$2,047
Expenses. Total of all expenses incurred2014-04-30$2,265
Benefits paid (including direct rollovers)2014-04-30$1,467
Total plan assets at end of year2014-04-30$36
Total plan assets at beginning of year2014-04-30$327
Value of fidelity bond covering the plan2014-04-30$1,000
Expenses. Other expenses not covered elsewhere2014-04-30$798
Net income (gross income less expenses)2014-04-30$-218
Net plan assets at end of year (total assets less liabilities)2014-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2014-04-30$218
Total contributions received or receivable from employer(s)2014-04-30$2,047
2013 : EMPLOYEE HEALTH PLAN OF RJS ENTERPRISES OF WAUPACA, INC 2013 401k financial data
Total plan liabilities at end of year2013-04-30$109
Total plan liabilities at beginning of year2013-04-30$84
Total income from all sources2013-04-30$2,742
Expenses. Total of all expenses incurred2013-04-30$2,524
Benefits paid (including direct rollovers)2013-04-30$1,624
Total plan assets at end of year2013-04-30$327
Total plan assets at beginning of year2013-04-30$84
Expenses. Other expenses not covered elsewhere2013-04-30$900
Net income (gross income less expenses)2013-04-30$218
Net plan assets at end of year (total assets less liabilities)2013-04-30$218
Net plan assets at beginning of year (total assets less liabilities)2013-04-30$0
Total contributions received or receivable from employer(s)2013-04-30$2,742
2012 : EMPLOYEE HEALTH PLAN OF RJS ENTERPRISES OF WAUPACA, INC 2012 401k financial data
Total plan liabilities at end of year2012-04-30$84
Total plan liabilities at beginning of year2012-04-30$0
Total income from all sources2012-04-30$1,842
Expenses. Total of all expenses incurred2012-04-30$2,327
Benefits paid (including direct rollovers)2012-04-30$1,700
Total plan assets at end of year2012-04-30$84
Total plan assets at beginning of year2012-04-30$485
Expenses. Other expenses not covered elsewhere2012-04-30$627
Net income (gross income less expenses)2012-04-30$-485
Net plan assets at end of year (total assets less liabilities)2012-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2012-04-30$485
Total contributions received or receivable from employer(s)2012-04-30$1,842
2011 : EMPLOYEE HEALTH PLAN OF RJS ENTERPRISES OF WAUPACA, INC 2011 401k financial data
Total plan liabilities at end of year2011-04-30$0
Total plan liabilities at beginning of year2011-04-30$0
Total income from all sources2011-04-30$1,602
Expenses. Total of all expenses incurred2011-04-30$1,117
Benefits paid (including direct rollovers)2011-04-30$516
Total plan assets at end of year2011-04-30$485
Total plan assets at beginning of year2011-04-30$0
Expenses. Other expenses not covered elsewhere2011-04-30$601
Net income (gross income less expenses)2011-04-30$485
Net plan assets at end of year (total assets less liabilities)2011-04-30$485
Net plan assets at beginning of year (total assets less liabilities)2011-04-30$0
Total contributions received or receivable from employer(s)2011-04-30$1,602

Form 5500 Responses for EMPLOYEE HEALTH PLAN OF RJS ENTERPRISES OF WAUPACA, INC

2014: EMPLOYEE HEALTH PLAN OF RJS ENTERPRISES OF WAUPACA, INC 2014 form 5500 responses
2014-05-01Type of plan entitySingle employer plan
2014-05-01Submission has been amendedNo
2014-05-01This submission is the final filingNo
2014-05-01This return/report is a short plan year return/report (less than 12 months)No
2014-05-01Plan is a collectively bargained planNo
2014-05-01Plan funding arrangement – InsuranceYes
2014-05-01Plan funding arrangement – TrustYes
2014-05-01Plan benefit arrangement – InsuranceYes
2014-05-01Plan benefit arrangement - TrustYes
2013: EMPLOYEE HEALTH PLAN OF RJS ENTERPRISES OF WAUPACA, INC 2013 form 5500 responses
2013-05-01Type of plan entitySingle employer plan
2013-05-01Submission has been amendedNo
2013-05-01This submission is the final filingNo
2013-05-01This return/report is a short plan year return/report (less than 12 months)No
2013-05-01Plan is a collectively bargained planNo
2013-05-01Plan funding arrangement – InsuranceYes
2013-05-01Plan funding arrangement – TrustYes
2013-05-01Plan benefit arrangement – InsuranceYes
2013-05-01Plan benefit arrangement - TrustYes
2012: EMPLOYEE HEALTH PLAN OF RJS ENTERPRISES OF WAUPACA, INC 2012 form 5500 responses
2012-05-01Type of plan entitySingle employer plan
2012-05-01Submission has been amendedNo
2012-05-01This submission is the final filingNo
2012-05-01This return/report is a short plan year return/report (less than 12 months)No
2012-05-01Plan is a collectively bargained planNo
2012-05-01Plan funding arrangement – InsuranceYes
2012-05-01Plan funding arrangement – TrustYes
2012-05-01Plan benefit arrangement – InsuranceYes
2012-05-01Plan benefit arrangement - TrustYes
2011: EMPLOYEE HEALTH PLAN OF RJS ENTERPRISES OF WAUPACA, INC 2011 form 5500 responses
2011-05-01Type of plan entitySingle employer plan
2011-05-01Submission has been amendedNo
2011-05-01This submission is the final filingNo
2011-05-01This return/report is a short plan year return/report (less than 12 months)No
2011-05-01Plan is a collectively bargained planNo
2011-05-01Plan funding arrangement – InsuranceYes
2011-05-01Plan funding arrangement – TrustYes
2011-05-01Plan benefit arrangement – InsuranceYes
2011-05-01Plan benefit arrangement - TrustYes
2010: EMPLOYEE HEALTH PLAN OF RJS ENTERPRISES OF WAUPACA, INC 2010 form 5500 responses
2010-05-01Type of plan entitySingle employer plan
2010-05-01First time form 5500 has been submittedYes
2010-05-01Submission has been amendedNo
2010-05-01This submission is the final filingNo
2010-05-01This return/report is a short plan year return/report (less than 12 months)No
2010-05-01Plan is a collectively bargained planNo
2010-05-01Plan funding arrangement – InsuranceYes
2010-05-01Plan funding arrangement – TrustYes
2010-05-01Plan benefit arrangement – InsuranceYes
2010-05-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number29005 NFA 0297
Policy instance 1
Insurance contract or identification number29005 NFA 0297
Number of Individuals Covered5
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $594
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number29005 NFA 0297
Policy instance 1
Insurance contract or identification number29005 NFA 0297
Number of Individuals Covered5
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $607
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number29005 NFA 0297
Policy instance 1
Insurance contract or identification number29005 NFA 0297
Number of Individuals Covered7
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $624
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number29005 NFA 0297
Policy instance 1
Insurance contract or identification number29005 NFA 0297
Number of Individuals Covered5
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $460
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number29005 NFA 0297
Policy instance 1
Insurance contract or identification number29005 NFA 0297
Number of Individuals Covered5
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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?No
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $459
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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