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EMPLOYEE HEALTH PLAN OF EXTRA PICKLES 401k Plan overview

Plan NameEMPLOYEE HEALTH PLAN OF EXTRA PICKLES
Plan identification number 501

EMPLOYEE HEALTH PLAN OF EXTRA PICKLES Benefits

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

401k Sponsoring company profile

EXTRA PICKLES has sponsored the creation of one or more 401k plans.

Company Name:EXTRA PICKLES
Employer identification number (EIN):842499296
NAIC Classification:722513
NAIC Description:Limited-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE HEALTH PLAN OF EXTRA PICKLES

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-05-01
5012022-05-01
5012021-12-01

Plan Statistics for EMPLOYEE HEALTH PLAN OF EXTRA PICKLES

401k plan membership statisitcs for EMPLOYEE HEALTH PLAN OF EXTRA PICKLES

Measure Date Value
2023: EMPLOYEE HEALTH PLAN OF EXTRA PICKLES 2023 401k membership
Total participants, beginning-of-year2023-05-018
Total number of active participants reported on line 7a of the Form 55002023-05-015
Number of retired or separated participants receiving benefits2023-05-010
Number of other retired or separated participants entitled to future benefits2023-05-010
Total of all active and inactive participants2023-05-015
2022: EMPLOYEE HEALTH PLAN OF EXTRA PICKLES 2022 401k membership
Total participants, beginning-of-year2022-05-018
Total number of active participants reported on line 7a of the Form 55002022-05-018
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 participants2022-05-018
2021: EMPLOYEE HEALTH PLAN OF EXTRA PICKLES 2021 401k membership
Total participants, beginning-of-year2021-12-014
Total number of active participants reported on line 7a of the Form 55002021-12-015
Number of retired or separated participants receiving benefits2021-12-010
Number of other retired or separated participants entitled to future benefits2021-12-010
Total of all active and inactive participants2021-12-015

Financial Data on EMPLOYEE HEALTH PLAN OF EXTRA PICKLES

Measure Date Value
2024 : EMPLOYEE HEALTH PLAN OF EXTRA PICKLES 2024 401k financial data
Total income from all sources2024-04-30$21,351
Expenses. Total of all expenses incurred2024-04-30$21,351
Benefits paid (including direct rollovers)2024-04-30$9,109
Value of fidelity bond covering the plan2024-04-30$2,000
Expenses. Other expenses not covered elsewhere2024-04-30$12,242
Net income (gross income less expenses)2024-04-30$0
Net plan assets at end of year (total assets less liabilities)2024-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2024-04-30$0
Total contributions received or receivable from employer(s)2024-04-30$21,351
2023 : EMPLOYEE HEALTH PLAN OF EXTRA PICKLES 2023 401k financial data
Total income from all sources2023-04-30$26,876
Expenses. Total of all expenses incurred2023-04-30$29,275
Benefits paid (including direct rollovers)2023-04-30$13,820
Total plan assets at beginning of year2023-04-30$2,399
Value of fidelity bond covering the plan2023-04-30$2,000
Expenses. Other expenses not covered elsewhere2023-04-30$15,455
Net income (gross income less expenses)2023-04-30$-2,399
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$2,399
Total contributions received or receivable from employer(s)2023-04-30$26,876
2022 : EMPLOYEE HEALTH PLAN OF EXTRA PICKLES 2022 401k financial data
Total income from all sources2022-04-30$10,700
Expenses. Total of all expenses incurred2022-04-30$8,301
Benefits paid (including direct rollovers)2022-04-30$2,639
Total plan assets at end of year2022-04-30$2,399
Value of fidelity bond covering the plan2022-04-30$1,000
Expenses. Other expenses not covered elsewhere2022-04-30$5,662
Net income (gross income less expenses)2022-04-30$2,399
Net plan assets at end of year (total assets less liabilities)2022-04-30$2,399
Net plan assets at beginning of year (total assets less liabilities)2022-04-30$0
Total contributions received or receivable from employer(s)2022-04-30$10,700

Form 5500 Responses for EMPLOYEE HEALTH PLAN OF EXTRA PICKLES

2023: EMPLOYEE HEALTH PLAN OF EXTRA PICKLES 2023 form 5500 responses
2023-05-01Type of plan entitySingle employer plan
2023-05-01Submission has been amendedNo
2023-05-01This submission is the final filingNo
2023-05-01This return/report is a short plan year return/report (less than 12 months)No
2023-05-01Plan is a collectively bargained planNo
2023-05-01Plan funding arrangement – InsuranceYes
2023-05-01Plan funding arrangement – TrustYes
2023-05-01Plan benefit arrangement – InsuranceYes
2023-05-01Plan benefit arrangement - TrustYes
2022: EMPLOYEE HEALTH PLAN OF EXTRA PICKLES 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 EXTRA PICKLES 2021 form 5500 responses
2021-12-01Type of plan entitySingle employer plan
2021-12-01First time form 5500 has been submittedYes
2021-12-01Submission has been amendedNo
2021-12-01This submission is the final filingNo
2021-12-01This return/report is a short plan year return/report (less than 12 months)Yes
2021-12-01Plan is a collectively bargained planNo
2021-12-01Plan funding arrangement – InsuranceYes
2021-12-01Plan funding arrangement – TrustYes
2021-12-01Plan benefit arrangement – InsuranceYes
2021-12-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number70500 NFA 0879
Policy instance 1
Insurance contract or identification number70500 NFA 0879
Number of Individuals Covered5
Insurance policy start date2023-12-01
Insurance policy end date2024-04-30
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 $8,090
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 number70500 NFA 0879
Policy instance 1
Insurance contract or identification number70500 NFA 0879
Number of Individuals Covered9
Insurance policy start date2022-12-01
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 $10,318
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 number70500 NFA 0879
Policy instance 1
Insurance contract or identification number70500 NFA 0879
Number of Individuals Covered12
Insurance policy start date2021-12-01
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 $4,296
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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