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EMPLOYEE HEALTH PLAN OF RACKSON RESTAURANTS, LLC 401k Plan overview

Plan NameEMPLOYEE HEALTH PLAN OF RACKSON RESTAURANTS, LLC
Plan identification number 501

EMPLOYEE HEALTH PLAN OF RACKSON RESTAURANTS, LLC Benefits

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

401k Sponsoring company profile

RACKSON RESTAURANTS, LLC has sponsored the creation of one or more 401k plans.

Company Name:RACKSON RESTAURANTS, LLC
Employer identification number (EIN):812076912
NAIC Classification:722511
NAIC Description:Full-Service Restaurants

Additional information about RACKSON RESTAURANTS, LLC

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 6004775

More information about RACKSON RESTAURANTS, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE HEALTH PLAN OF RACKSON RESTAURANTS, LLC

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012020-05-01
5012019-05-01
5012019-04-01

Plan Statistics for EMPLOYEE HEALTH PLAN OF RACKSON RESTAURANTS, LLC

401k plan membership statisitcs for EMPLOYEE HEALTH PLAN OF RACKSON RESTAURANTS, LLC

Measure Date Value
2020: EMPLOYEE HEALTH PLAN OF RACKSON RESTAURANTS, LLC 2020 401k membership
Total participants, beginning-of-year2020-05-0169
Total number of active participants reported on line 7a of the Form 55002020-05-0166
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 participants2020-05-0166
2019: EMPLOYEE HEALTH PLAN OF RACKSON RESTAURANTS, LLC 2019 401k membership
Total participants, beginning-of-year2019-05-0172
Total number of active participants reported on line 7a of the Form 55002019-05-0165
Number of retired or separated participants receiving benefits2019-05-010
Number of other retired or separated participants entitled to future benefits2019-05-010
Total of all active and inactive participants2019-05-0165
Total participants, beginning-of-year2019-04-0170
Total number of active participants reported on line 7a of the Form 55002019-04-010
Number of retired or separated participants receiving benefits2019-04-010
Number of other retired or separated participants entitled to future benefits2019-04-010
Total of all active and inactive participants2019-04-010

Financial Data on EMPLOYEE HEALTH PLAN OF RACKSON RESTAURANTS, LLC

Measure Date Value
2021 : EMPLOYEE HEALTH PLAN OF RACKSON RESTAURANTS, LLC 2021 401k financial data
Total plan liabilities at beginning of year2021-04-30$0
Total income from all sources2021-04-30$664,614
Expenses. Total of all expenses incurred2021-04-30$719,204
Benefits paid (including direct rollovers)2021-04-30$379,721
Total plan assets at beginning of year2021-04-30$54,590
Value of fidelity bond covering the plan2021-04-30$75,000
Expenses. Other expenses not covered elsewhere2021-04-30$339,483
Net income (gross income less expenses)2021-04-30$-54,590
Net plan assets at end of year (total assets less liabilities)2021-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2021-04-30$54,590
Total contributions received or receivable from employer(s)2021-04-30$664,614
2020 : EMPLOYEE HEALTH PLAN OF RACKSON RESTAURANTS, LLC 2020 401k financial data
Total plan liabilities at end of year2020-04-30$0
Total plan liabilities at beginning of year2020-04-30$0
Total income from all sources2020-04-30$729,305
Expenses. Total of all expenses incurred2020-04-30$695,358
Benefits paid (including direct rollovers)2020-04-30$325,093
Total plan assets at end of year2020-04-30$54,590
Total plan assets at beginning of year2020-04-30$20,643
Value of fidelity bond covering the plan2020-04-30$75,000
Expenses. Other expenses not covered elsewhere2020-04-30$370,265
Net income (gross income less expenses)2020-04-30$33,947
Net plan assets at end of year (total assets less liabilities)2020-04-30$54,590
Net plan assets at beginning of year (total assets less liabilities)2020-04-30$20,643
Total contributions received or receivable from employer(s)2020-04-30$729,305
2019 : EMPLOYEE HEALTH PLAN OF RACKSON RESTAURANTS, LLC 2019 401k financial data
Total plan liabilities at end of year2019-04-30$0
Total plan liabilities at beginning of year2019-04-30$0
Total income from all sources2019-04-30$30,360
Expenses. Total of all expenses incurred2019-04-30$9,717
Benefits paid (including direct rollovers)2019-04-30$0
Total plan assets at end of year2019-04-30$20,643
Total plan assets at beginning of year2019-04-30$0
Value of fidelity bond covering the plan2019-04-30$75,000
Expenses. Other expenses not covered elsewhere2019-04-30$9,717
Net income (gross income less expenses)2019-04-30$20,643
Net plan assets at end of year (total assets less liabilities)2019-04-30$20,643
Net plan assets at beginning of year (total assets less liabilities)2019-04-30$0
Total contributions received or receivable from employer(s)2019-04-30$30,360

Form 5500 Responses for EMPLOYEE HEALTH PLAN OF RACKSON RESTAURANTS, LLC

2020: EMPLOYEE HEALTH PLAN OF RACKSON RESTAURANTS, 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
2019: EMPLOYEE HEALTH PLAN OF RACKSON RESTAURANTS, LLC 2019 form 5500 responses
2019-05-01Type of plan entitySingle employer plan
2019-05-01Submission has been amendedNo
2019-05-01This submission is the final filingNo
2019-05-01This return/report is a short plan year return/report (less than 12 months)No
2019-05-01Plan is a collectively bargained planNo
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan funding arrangement – TrustYes
2019-05-01Plan benefit arrangement – InsuranceYes
2019-05-01Plan benefit arrangement - TrustYes
2019-04-01Type of plan entitySingle employer plan
2019-04-01First time form 5500 has been submittedYes
2019-04-01Submission has been amendedNo
2019-04-01This submission is the final filingNo
2019-04-01This return/report is a short plan year return/report (less than 12 months)Yes
2019-04-01Plan is a collectively bargained planNo
2019-04-01Plan funding arrangement – InsuranceYes
2019-04-01Plan funding arrangement – TrustYes
2019-04-01Plan benefit arrangement – InsuranceYes
2019-04-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number14474 NFA 0743
Policy instance 1
Insurance contract or identification number14474 NFA 0743
Number of Individuals Covered102
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 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 $274,686
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 number14474 NFA 0743
Policy instance 1
Insurance contract or identification number14474 NFA 0743
Number of Individuals Covered92
Insurance policy start date2019-05-01
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 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 $303,762
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 number14474 NFA 0743
Policy instance 1
Insurance contract or identification number14474 NFA 0743
Number of Individuals Covered101
Insurance policy start date2019-04-01
Insurance policy end date2019-04-30
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 $7,524
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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