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| Plan Name | HOOD RIVER INN GROUP LIFE AND DISABILITY PLAN |
| Plan identification number | 503 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | COLUMBIA ROOM INC |
| Employer identification number (EIN): | 931006125 |
| NAIC Classification: | 721110 |
| NAIC Description: | Hotels (except Casino Hotels) and Motels |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 503 | 2019-01-01 | JULIE L JOHANSON | 2020-07-08 | ||
| 503 | 2019-01-01 | JULIE L. JOHANSON | 2021-05-05 | ||
| 503 | 2018-01-01 | JULIE L. JOHANSON | 2019-10-02 | ||
| 503 | 2011-01-01 | DEBBIE RINGHOFFER | DEBBIE RINGHOFFER | 2012-06-29 | |
| 503 | 2009-01-01 | DEBBIE RINGHOFFER | DEBBIE RINGHOFFER | 2010-07-27 |
| Measure | Date | Value |
|---|---|---|
| 2019: HOOD RIVER INN GROUP LIFE AND DISABILITY PLAN 2019 401k membership | ||
| Total participants, beginning-of-year | 2019-01-01 | 112 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-01-01 | 106 |
| Number of retired or separated participants receiving benefits | 2019-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-01-01 | 0 |
| Total of all active and inactive participants | 2019-01-01 | 106 |
| 2018: HOOD RIVER INN GROUP LIFE AND DISABILITY PLAN 2018 401k membership | ||
| Total participants, beginning-of-year | 2018-01-01 | 127 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 108 |
| Number of retired or separated participants receiving benefits | 2018-01-01 | 3 |
| Number of other retired or separated participants entitled to future benefits | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 111 |
| 2011: HOOD RIVER INN GROUP LIFE AND DISABILITY PLAN 2011 401k membership | ||
| Total participants, beginning-of-year | 2011-01-01 | 116 |
| Total number of active participants reported on line 7a of the Form 5500 | 2011-01-01 | 98 |
| Total of all active and inactive participants | 2011-01-01 | 98 |
| 2009: HOOD RIVER INN GROUP LIFE AND DISABILITY PLAN 2009 401k membership | ||
| Total participants, beginning-of-year | 2009-01-01 | 104 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-01-01 | 88 |
| Number of retired or separated participants receiving benefits | 2009-01-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-01-01 | 0 |
| Total of all active and inactive participants | 2009-01-01 | 88 |
| 2019: HOOD RIVER INN GROUP LIFE AND DISABILITY PLAN 2019 form 5500 responses | ||
|---|---|---|
| 2019-01-01 | Type of plan entity | Single employer plan |
| 2019-01-01 | Submission has been amended | No |
| 2019-01-01 | This submission is the final filing | No |
| 2019-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-01-01 | Plan is a collectively bargained plan | No |
| 2019-01-01 | Plan funding arrangement – Insurance | Yes |
| 2019-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: HOOD RIVER INN GROUP LIFE AND DISABILITY PLAN 2018 form 5500 responses | ||
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | First time form 5500 has been submitted | Yes |
| 2018-01-01 | Submission has been amended | No |
| 2018-01-01 | This submission is the final filing | No |
| 2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-01-01 | Plan is a collectively bargained plan | No |
| 2018-01-01 | Plan funding arrangement – Insurance | Yes |
| 2018-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2011: HOOD RIVER INN GROUP LIFE AND DISABILITY PLAN 2011 form 5500 responses | ||
| 2011-01-01 | Type of plan entity | Single employer plan |
| 2011-01-01 | Submission has been amended | No |
| 2011-01-01 | This submission is the final filing | No |
| 2011-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2011-01-01 | Plan is a collectively bargained plan | No |
| 2011-01-01 | Plan funding arrangement – Insurance | Yes |
| 2011-01-01 | Plan benefit arrangement – Insurance | Yes |
| 2009: HOOD RIVER INN GROUP LIFE AND DISABILITY PLAN 2009 form 5500 responses | ||
| 2009-01-01 | Type of plan entity | Single employer plan |
| 2009-01-01 | First time form 5500 has been submitted | Yes |
| 2009-01-01 | Submission has been amended | No |
| 2009-01-01 | This submission is the final filing | No |
| 2009-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2009-01-01 | Plan is a collectively bargained plan | No |
| 2009-01-01 | Plan funding arrangement – Insurance | Yes |
| 2009-01-01 | Plan benefit arrangement – Insurance | Yes |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 00453499 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 00453499 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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