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EMPLOYEE HEALTH PLAN OF ULTRO GROUP, LLC 401k Plan overview

Plan NameEMPLOYEE HEALTH PLAN OF ULTRO GROUP, LLC
Plan identification number 501

EMPLOYEE HEALTH PLAN OF ULTRO GROUP, LLC Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental

401k Sponsoring company profile

ULTRO GROUP, LLC has sponsored the creation of one or more 401k plans.

Company Name:ULTRO GROUP, LLC
Employer identification number (EIN):465445886
NAIC Classification:722511
NAIC Description:Full-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE HEALTH PLAN OF ULTRO GROUP, LLC

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-05-01
5012021-05-01
5012020-05-01
5012020-03-01

Plan Statistics for EMPLOYEE HEALTH PLAN OF ULTRO GROUP, LLC

401k plan membership statisitcs for EMPLOYEE HEALTH PLAN OF ULTRO GROUP, LLC

Measure Date Value
2022: EMPLOYEE HEALTH PLAN OF ULTRO GROUP, LLC 2022 401k membership
Total participants, beginning-of-year2022-05-013
Total number of active participants reported on line 7a of the Form 55002022-05-013
Number of retired or separated participants receiving benefits2022-05-010
Number of other retired or separated participants entitled to future benefits2022-05-010
Total of all active and inactive participants2022-05-013
2021: EMPLOYEE HEALTH PLAN OF ULTRO GROUP, LLC 2021 401k membership
Total participants, beginning-of-year2021-05-017
Total number of active participants reported on line 7a of the Form 55002021-05-017
Number of retired or separated participants receiving benefits2021-05-010
Number of other retired or separated participants entitled to future benefits2021-05-010
Total of all active and inactive participants2021-05-017
2020: EMPLOYEE HEALTH PLAN OF ULTRO GROUP, LLC 2020 401k membership
Total participants, beginning-of-year2020-05-015
Total number of active participants reported on line 7a of the Form 55002020-05-017
Number of retired or separated participants receiving benefits2020-05-010
Number of other retired or separated participants entitled to future benefits2020-05-010
Total of all active and inactive participants2020-05-017
Total participants, beginning-of-year2020-03-016
Total number of active participants reported on line 7a of the Form 55002020-03-016
Number of retired or separated participants receiving benefits2020-03-010
Number of other retired or separated participants entitled to future benefits2020-03-010
Total of all active and inactive participants2020-03-016

Financial Data on EMPLOYEE HEALTH PLAN OF ULTRO GROUP, LLC

Measure Date Value
2023 : EMPLOYEE HEALTH PLAN OF ULTRO GROUP, LLC 2023 401k financial data
Total income from all sources2023-04-30$30,797
Expenses. Total of all expenses incurred2023-04-30$30,797
Benefits paid (including direct rollovers)2023-04-30$13,192
Value of fidelity bond covering the plan2023-04-30$8,000
Expenses. Other expenses not covered elsewhere2023-04-30$17,605
Net income (gross income less expenses)2023-04-30$0
Net plan assets at end of year (total assets less liabilities)2023-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2023-04-30$0
Total contributions received or receivable from employer(s)2023-04-30$30,797
2022 : EMPLOYEE HEALTH PLAN OF ULTRO GROUP, LLC 2022 401k financial data
Total income from all sources2022-04-30$30,858
Expenses. Total of all expenses incurred2022-04-30$34,028
Benefits paid (including direct rollovers)2022-04-30$15,438
Total plan assets at beginning of year2022-04-30$3,170
Value of fidelity bond covering the plan2022-04-30$1,000
Expenses. Other expenses not covered elsewhere2022-04-30$18,590
Net income (gross income less expenses)2022-04-30$-3,170
Net plan assets at end of year (total assets less liabilities)2022-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2022-04-30$3,170
Total contributions received or receivable from employer(s)2022-04-30$30,858
2021 : EMPLOYEE HEALTH PLAN OF ULTRO GROUP, LLC 2021 401k financial data
Total plan liabilities at beginning of year2021-04-30$0
Total income from all sources2021-04-30$26,863
Expenses. Total of all expenses incurred2021-04-30$25,085
Benefits paid (including direct rollovers)2021-04-30$9,010
Total plan assets at end of year2021-04-30$3,170
Total plan assets at beginning of year2021-04-30$1,392
Value of fidelity bond covering the plan2021-04-30$5,000
Expenses. Other expenses not covered elsewhere2021-04-30$16,075
Net income (gross income less expenses)2021-04-30$1,778
Net plan assets at end of year (total assets less liabilities)2021-04-30$3,170
Net plan assets at beginning of year (total assets less liabilities)2021-04-30$1,392
Total contributions received or receivable from employer(s)2021-04-30$26,863
2020 : EMPLOYEE HEALTH PLAN OF ULTRO GROUP, LLC 2020 401k financial data
Total plan liabilities at end of year2020-04-30$0
Total income from all sources2020-04-30$4,067
Expenses. Total of all expenses incurred2020-04-30$2,675
Total plan assets at end of year2020-04-30$1,392
Value of fidelity bond covering the plan2020-04-30$5,000
Expenses. Other expenses not covered elsewhere2020-04-30$2,675
Net income (gross income less expenses)2020-04-30$1,392
Net plan assets at end of year (total assets less liabilities)2020-04-30$1,392
Net plan assets at beginning of year (total assets less liabilities)2020-04-30$0
Total contributions received or receivable from employer(s)2020-04-30$4,067

Form 5500 Responses for EMPLOYEE HEALTH PLAN OF ULTRO GROUP, LLC

2022: EMPLOYEE HEALTH PLAN OF ULTRO GROUP, LLC 2022 form 5500 responses
2022-05-01Type of plan entitySingle employer plan
2022-05-01Submission has been amendedNo
2022-05-01This submission is the final filingNo
2022-05-01This return/report is a short plan year return/report (less than 12 months)No
2022-05-01Plan is a collectively bargained planNo
2022-05-01Plan funding arrangement – InsuranceYes
2022-05-01Plan funding arrangement – TrustYes
2022-05-01Plan benefit arrangement – InsuranceYes
2022-05-01Plan benefit arrangement - TrustYes
2021: EMPLOYEE HEALTH PLAN OF ULTRO GROUP, LLC 2021 form 5500 responses
2021-05-01Type of plan entitySingle employer plan
2021-05-01Submission has been amendedNo
2021-05-01This submission is the final filingNo
2021-05-01This return/report is a short plan year return/report (less than 12 months)No
2021-05-01Plan is a collectively bargained planNo
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan funding arrangement – TrustYes
2021-05-01Plan benefit arrangement – InsuranceYes
2021-05-01Plan benefit arrangement - TrustYes
2020: EMPLOYEE HEALTH PLAN OF ULTRO GROUP, LLC 2020 form 5500 responses
2020-05-01Type of plan entitySingle employer plan
2020-05-01Submission has been amendedNo
2020-05-01This submission is the final filingNo
2020-05-01This return/report is a short plan year return/report (less than 12 months)No
2020-05-01Plan is a collectively bargained planNo
2020-05-01Plan funding arrangement – InsuranceYes
2020-05-01Plan funding arrangement – TrustYes
2020-05-01Plan benefit arrangement – InsuranceYes
2020-05-01Plan benefit arrangement - TrustYes
2020-03-01Type of plan entitySingle employer plan
2020-03-01First time form 5500 has been submittedYes
2020-03-01Submission has been amendedNo
2020-03-01This submission is the final filingNo
2020-03-01This return/report is a short plan year return/report (less than 12 months)Yes
2020-03-01Plan is a collectively bargained planNo
2020-03-01Plan funding arrangement – InsuranceYes
2020-03-01Plan funding arrangement – TrustYes
2020-03-01Plan benefit arrangement – InsuranceYes
2020-03-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number60026 NFA 0780
Policy instance 1
Insurance contract or identification number60026 NFA 0780
Number of Individuals Covered3
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Are there contracts with allocated funds for individual policies?0
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 BenefitYes
Dental Insurance Welfare BenefitYes
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 $12,966
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: 0 )
Policy contract number60026 NFA 0780
Policy instance 1
Insurance contract or identification number60026 NFA 0780
Number of Individuals Covered7
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Are there contracts with allocated funds for individual policies?0
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 BenefitYes
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 $12,722
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: 0 )
Policy contract number27035 NFA 0597
Policy instance 1
Insurance contract or identification number27035 NFA 0597
Number of Individuals Covered7
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Are there contracts with allocated funds for individual policies?0
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 BenefitYes
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 $10,582
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: 0 )
Policy contract number27035 NFA 0597
Policy instance 1
Insurance contract or identification number27035 NFA 0597
Number of Individuals Covered6
Insurance policy start date2020-03-01
Insurance policy end date2020-04-30
Are there contracts with allocated funds for individual policies?0
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 BenefitYes
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 $1,596
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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