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EMPLOYEE HEALTH PLAN OF 413 HAGERSTOWN 401k Plan overview

Plan NameEMPLOYEE HEALTH PLAN OF 413 HAGERSTOWN
Plan identification number 501

EMPLOYEE HEALTH PLAN OF 413 HAGERSTOWN Benefits

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

401k Sponsoring company profile

413 HAGERSTOWN has sponsored the creation of one or more 401k plans.

Company Name:413 HAGERSTOWN
Employer identification number (EIN):831386022
NAIC Classification:722511
NAIC Description:Full-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE HEALTH PLAN OF 413 HAGERSTOWN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012021-05-01
5012020-05-01
5012020-05-01
5012019-07-01

Plan Statistics for EMPLOYEE HEALTH PLAN OF 413 HAGERSTOWN

401k plan membership statisitcs for EMPLOYEE HEALTH PLAN OF 413 HAGERSTOWN

Measure Date Value
2021: EMPLOYEE HEALTH PLAN OF 413 HAGERSTOWN 2021 401k membership
Total participants, beginning-of-year2021-05-012
Total number of active participants reported on line 7a of the Form 55002021-05-011
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 participants2021-05-011
2020: EMPLOYEE HEALTH PLAN OF 413 HAGERSTOWN 2020 401k membership
Total participants, beginning-of-year2020-05-015
Total number of active participants reported on line 7a of the Form 55002020-05-013
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 participants2020-05-013
2019: EMPLOYEE HEALTH PLAN OF 413 HAGERSTOWN 2019 401k membership
Total participants, beginning-of-year2019-07-011
Total number of active participants reported on line 7a of the Form 55002019-07-013
Number of retired or separated participants receiving benefits2019-07-010
Number of other retired or separated participants entitled to future benefits2019-07-010
Total of all active and inactive participants2019-07-013

Financial Data on EMPLOYEE HEALTH PLAN OF 413 HAGERSTOWN

Measure Date Value
2022 : EMPLOYEE HEALTH PLAN OF 413 HAGERSTOWN 2022 401k financial data
Total income from all sources2022-04-30$5,581
Expenses. Total of all expenses incurred2022-04-30$10,307
Benefits paid (including direct rollovers)2022-04-30$7,003
Total plan assets at end of year2022-04-30$6,606
Total plan assets at beginning of year2022-04-30$11,332
Value of fidelity bond covering the plan2022-04-30$2,000
Expenses. Other expenses not covered elsewhere2022-04-30$3,304
Net income (gross income less expenses)2022-04-30$-4,726
Net plan assets at end of year (total assets less liabilities)2022-04-30$6,606
Net plan assets at beginning of year (total assets less liabilities)2022-04-30$11,332
Total contributions received or receivable from employer(s)2022-04-30$5,581
2021 : EMPLOYEE HEALTH PLAN OF 413 HAGERSTOWN 2021 401k financial data
Total plan liabilities at beginning of year2021-04-30$0
Total income from all sources2021-04-30$20,796
Expenses. Total of all expenses incurred2021-04-30$14,142
Benefits paid (including direct rollovers)2021-04-30$1,951
Total plan assets at end of year2021-04-30$11,332
Total plan assets at beginning of year2021-04-30$4,678
Value of fidelity bond covering the plan2021-04-30$5,000
Expenses. Other expenses not covered elsewhere2021-04-30$12,191
Net income (gross income less expenses)2021-04-30$6,654
Net plan assets at end of year (total assets less liabilities)2021-04-30$11,332
Net plan assets at beginning of year (total assets less liabilities)2021-04-30$4,678
Total contributions received or receivable from employer(s)2021-04-30$20,796
2020 : EMPLOYEE HEALTH PLAN OF 413 HAGERSTOWN 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$11,912
Expenses. Total of all expenses incurred2020-04-30$7,234
Benefits paid (including direct rollovers)2020-04-30$549
Total plan assets at end of year2020-04-30$4,678
Total plan assets at beginning of year2020-04-30$0
Value of fidelity bond covering the plan2020-04-30$5,000
Expenses. Other expenses not covered elsewhere2020-04-30$6,685
Net income (gross income less expenses)2020-04-30$4,678
Net plan assets at end of year (total assets less liabilities)2020-04-30$4,678
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$11,912

Form 5500 Responses for EMPLOYEE HEALTH PLAN OF 413 HAGERSTOWN

2021: EMPLOYEE HEALTH PLAN OF 413 HAGERSTOWN 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 413 HAGERSTOWN 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 413 HAGERSTOWN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01First time form 5500 has been submittedYes
2019-07-01Submission has been amendedNo
2019-07-01This submission is the final filingNo
2019-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2019-07-01Plan is a collectively bargained planNo
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan funding arrangement – TrustYes
2019-07-01Plan benefit arrangement – InsuranceYes
2019-07-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number40243 NFA 0752
Policy instance 1
Insurance contract or identification number40243 NFA 0752
Number of Individuals Covered1
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 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 $2,281
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 number46001 NFA 0717
Policy instance 1
Insurance contract or identification number46001 NFA 0717
Number of Individuals Covered2
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 $8,345
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 number46001 NFA 0717
Policy instance 1
Insurance contract or identification number46001 NFA 0717
Number of Individuals Covered7
Insurance policy start date2019-07-01
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 $4,722
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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