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GULF COAST HOTEL MANAGEMENT GROUP HEALTH AND WELFARE BENEFIT PLAN 401k Plan overview

Plan NameGULF COAST HOTEL MANAGEMENT GROUP HEALTH AND WELFARE BENEFIT PLAN
Plan identification number 501

GULF COAST HOTEL MANAGEMENT GROUP HEALTH AND WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Other welfare benefit cover
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

GULF COAST HOTEL MANAGEMENT, INC has sponsored the creation of one or more 401k plans.

Company Name:GULF COAST HOTEL MANAGEMENT, INC
Employer identification number (EIN):813097661
NAIC Classification:721110
NAIC Description:Hotels (except Casino Hotels) and Motels

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GULF COAST HOTEL MANAGEMENT GROUP HEALTH AND WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-09-01
5012021-09-01

Plan Statistics for GULF COAST HOTEL MANAGEMENT GROUP HEALTH AND WELFARE BENEFIT PLAN

401k plan membership statisitcs for GULF COAST HOTEL MANAGEMENT GROUP HEALTH AND WELFARE BENEFIT PLAN

Measure Date Value
2021: GULF COAST HOTEL MANAGEMENT GROUP HEALTH AND WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-09-01105
Total number of active participants reported on line 7a of the Form 55002021-09-01169
Number of retired or separated participants receiving benefits2021-09-010
Number of other retired or separated participants entitled to future benefits2021-09-010
Total of all active and inactive participants2021-09-01169

Form 5500 Responses for GULF COAST HOTEL MANAGEMENT GROUP HEALTH AND WELFARE BENEFIT PLAN

2021: GULF COAST HOTEL MANAGEMENT GROUP HEALTH AND WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-09-01Type of plan entitySingle employer plan
2021-09-01First time form 5500 has been submittedYes
2021-09-01Submission has been amendedYes
2021-09-01Plan funding arrangement – InsuranceYes
2021-09-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number147561
Policy instance 1
Insurance contract or identification number147561
Number of Individuals Covered169
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $17,328
Total amount of fees paid to insurance companyUSD $900
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $984,990
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,328
Insurance broker organization code?3
Amount paid for insurance broker fees900
Additional information about fees paid to insurance brokerSPECIAL PROGRAMS
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5391229
Policy instance 2
Insurance contract or identification number5391229
Number of Individuals Covered257
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $9,105
Total amount of fees paid to insurance companyUSD $1,599
Dental Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $81,078
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,105
Amount paid for insurance broker fees1599
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION NON-MONETARY COMPENSATION
Insurance broker organization code?3

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