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GROUP LIFE INSURANCE AND ADD INSURANCE PLAN 401k Plan overview

Plan NameGROUP LIFE INSURANCE AND ADD INSURANCE PLAN
Plan identification number 503

GROUP LIFE INSURANCE AND ADD INSURANCE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance

401k Sponsoring company profile

ROBERT'S HAWAII, INC. has sponsored the creation of one or more 401k plans.

Company Name:ROBERT'S HAWAII, INC.
Employer identification number (EIN):990185478
NAIC Classification:485990

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GROUP LIFE INSURANCE AND ADD INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032019-01-01
5032018-04-01
5032017-04-01ROY PFUND
5032016-04-01ROY PFUND
5032015-04-01ROY PFUND ROY PFUND2016-10-31
5032014-04-01SHARI KOMO
5032012-04-01SHARI KOMO
5032011-04-01ROY PFUND
5032010-04-01ROY PFUND
5032009-04-01ROY PFUND

Plan Statistics for GROUP LIFE INSURANCE AND ADD INSURANCE PLAN

401k plan membership statisitcs for GROUP LIFE INSURANCE AND ADD INSURANCE PLAN

Measure Date Value
2019: GROUP LIFE INSURANCE AND ADD INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01561
Total number of active participants reported on line 7a of the Form 55002019-01-01616
Total of all active and inactive participants2019-01-01616
Total participants2019-01-01616
2018: GROUP LIFE INSURANCE AND ADD INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-04-01605
Total number of active participants reported on line 7a of the Form 55002018-04-01561
Total of all active and inactive participants2018-04-01561
Total participants2018-04-01561
2017: GROUP LIFE INSURANCE AND ADD INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-04-01543
Total number of active participants reported on line 7a of the Form 55002017-04-01605
Total of all active and inactive participants2017-04-01605
Total participants2017-04-01605
2016: GROUP LIFE INSURANCE AND ADD INSURANCE PLAN 2016 401k membership
Total participants, beginning-of-year2016-04-01543
Total number of active participants reported on line 7a of the Form 55002016-04-01562
Total of all active and inactive participants2016-04-01562
Total participants2016-04-01562
2015: GROUP LIFE INSURANCE AND ADD INSURANCE PLAN 2015 401k membership
Total participants, beginning-of-year2015-04-01509
Total number of active participants reported on line 7a of the Form 55002015-04-01543
Total of all active and inactive participants2015-04-01543
Total participants2015-04-01543
2014: GROUP LIFE INSURANCE AND ADD INSURANCE PLAN 2014 401k membership
Total participants, beginning-of-year2014-04-0195
Total number of active participants reported on line 7a of the Form 55002014-04-01509
Number of retired or separated participants receiving benefits2014-04-010
Total of all active and inactive participants2014-04-01509
Total participants2014-04-01509
2012: GROUP LIFE INSURANCE AND ADD INSURANCE PLAN 2012 401k membership
Total participants, beginning-of-year2012-04-01320
Total number of active participants reported on line 7a of the Form 55002012-04-01395
Total of all active and inactive participants2012-04-01395
Total participants2012-04-01395
2011: GROUP LIFE INSURANCE AND ADD INSURANCE PLAN 2011 401k membership
Total participants, beginning-of-year2011-04-01336
Total number of active participants reported on line 7a of the Form 55002011-04-01320
Total of all active and inactive participants2011-04-01320
Total participants2011-04-01320
2010: GROUP LIFE INSURANCE AND ADD INSURANCE PLAN 2010 401k membership
Total participants, beginning-of-year2010-04-01379
Total number of active participants reported on line 7a of the Form 55002010-04-01336
Number of retired or separated participants receiving benefits2010-04-010
Number of other retired or separated participants entitled to future benefits2010-04-010
Total of all active and inactive participants2010-04-01336
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2010-04-010
Total participants2010-04-01336
2009: GROUP LIFE INSURANCE AND ADD INSURANCE PLAN 2009 401k membership
Total participants, beginning-of-year2009-04-01295
Total number of active participants reported on line 7a of the Form 55002009-04-01379
Number of retired or separated participants receiving benefits2009-04-010
Number of other retired or separated participants entitled to future benefits2009-04-010
Total of all active and inactive participants2009-04-01379
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits2009-04-010
Total participants2009-04-01379

Form 5500 Responses for GROUP LIFE INSURANCE AND ADD INSURANCE PLAN

2019: GROUP LIFE INSURANCE AND ADD INSURANCE PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Submission has been amendedNo
2019-01-01This submission is the final filingNo
2019-01-01This return/report is a short plan year return/report (less than 12 months)No
2019-01-01Plan is a collectively bargained planNo
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: GROUP LIFE INSURANCE AND ADD INSURANCE PLAN 2018 form 5500 responses
2018-04-01Type of plan entitySingle employer plan
2018-04-01Submission has been amendedNo
2018-04-01This submission is the final filingNo
2018-04-01This return/report is a short plan year return/report (less than 12 months)Yes
2018-04-01Plan is a collectively bargained planNo
2018-04-01Plan funding arrangement – InsuranceYes
2018-04-01Plan benefit arrangement – InsuranceYes
2017: GROUP LIFE INSURANCE AND ADD INSURANCE PLAN 2017 form 5500 responses
2017-04-01Type of plan entitySingle employer plan
2017-04-01Submission has been amendedNo
2017-04-01This submission is the final filingNo
2017-04-01This return/report is a short plan year return/report (less than 12 months)No
2017-04-01Plan is a collectively bargained planNo
2017-04-01Plan funding arrangement – InsuranceYes
2017-04-01Plan benefit arrangement – InsuranceYes
2016: GROUP LIFE INSURANCE AND ADD INSURANCE PLAN 2016 form 5500 responses
2016-04-01Type of plan entitySingle employer plan
2016-04-01Submission has been amendedNo
2016-04-01This submission is the final filingNo
2016-04-01This return/report is a short plan year return/report (less than 12 months)No
2016-04-01Plan is a collectively bargained planNo
2016-04-01Plan funding arrangement – InsuranceYes
2016-04-01Plan benefit arrangement – InsuranceYes
2015: GROUP LIFE INSURANCE AND ADD INSURANCE PLAN 2015 form 5500 responses
2015-04-01Type of plan entitySingle employer plan
2015-04-01Submission has been amendedNo
2015-04-01This submission is the final filingNo
2015-04-01This return/report is a short plan year return/report (less than 12 months)No
2015-04-01Plan is a collectively bargained planNo
2015-04-01Plan funding arrangement – InsuranceYes
2015-04-01Plan benefit arrangement – InsuranceYes
2014: GROUP LIFE INSURANCE AND ADD INSURANCE PLAN 2014 form 5500 responses
2014-04-01Type of plan entitySingle employer plan
2014-04-01Submission has been amendedNo
2014-04-01This submission is the final filingNo
2014-04-01This return/report is a short plan year return/report (less than 12 months)No
2014-04-01Plan is a collectively bargained planNo
2014-04-01Plan funding arrangement – InsuranceYes
2014-04-01Plan benefit arrangement – InsuranceYes
2012: GROUP LIFE INSURANCE AND ADD INSURANCE PLAN 2012 form 5500 responses
2012-04-01Type of plan entitySingle employer plan
2012-04-01Submission has been amendedNo
2012-04-01This submission is the final filingNo
2012-04-01This return/report is a short plan year return/report (less than 12 months)No
2012-04-01Plan is a collectively bargained planNo
2012-04-01Plan funding arrangement – InsuranceYes
2012-04-01Plan benefit arrangement – InsuranceYes
2011: GROUP LIFE INSURANCE AND ADD INSURANCE PLAN 2011 form 5500 responses
2011-04-01Type of plan entitySingle employer plan
2011-04-01Submission has been amendedNo
2011-04-01This submission is the final filingNo
2011-04-01This return/report is a short plan year return/report (less than 12 months)No
2011-04-01Plan is a collectively bargained planNo
2011-04-01Plan funding arrangement – InsuranceYes
2011-04-01Plan benefit arrangement – InsuranceYes
2010: GROUP LIFE INSURANCE AND ADD INSURANCE PLAN 2010 form 5500 responses
2010-04-01Type of plan entitySingle employer plan
2010-04-01Submission has been amendedNo
2010-04-01This submission is the final filingNo
2010-04-01This return/report is a short plan year return/report (less than 12 months)No
2010-04-01Plan is a collectively bargained planNo
2010-04-01Plan funding arrangement – InsuranceYes
2010-04-01Plan benefit arrangement – InsuranceYes
2009: GROUP LIFE INSURANCE AND ADD INSURANCE PLAN 2009 form 5500 responses
2009-04-01Type of plan entitySingle employer plan
2009-04-01Submission has been amendedNo
2009-04-01This submission is the final filingNo
2009-04-01This return/report is a short plan year return/report (less than 12 months)No
2009-04-01Plan is a collectively bargained planNo
2009-04-01Plan funding arrangement – InsuranceYes
2009-04-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLUG0BHS3
Policy instance 1
Insurance contract or identification numberGLUG0BHS3
Number of Individuals Covered616
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $1,028
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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 $10,280
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,028
Additional information about fees paid to insurance brokerBROKER OF RECORD
Insurance broker organization code?3
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number0409041
Policy instance 1
Insurance contract or identification number0409041
Number of Individuals Covered561
Insurance policy start date2018-04-01
Insurance policy end date2018-12-31
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
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 $15,696
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 )
Policy contract number409041
Policy instance 1
Insurance contract or identification number409041
Number of Individuals Covered543
Insurance policy start date2015-04-01
Insurance policy end date2016-03-31
Total amount of commissions paid to insurance brokerUSD $1,762
Are there contracts with allocated funds for individual policies?No
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE
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 $17,615
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,762
Insurance broker nameCOLIN D FUKAMI
PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. (National Association of Insurance Commissioners NAIC id number: 64343 )
Policy contract number70519
Policy instance 1
Insurance contract or identification number70519
Number of Individuals Covered509
Insurance policy start date2014-04-01
Insurance policy end date2015-03-31
Are there contracts with allocated funds for individual policies?No
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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 $18,865
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. (National Association of Insurance Commissioners NAIC id number: 64343 )
Policy contract number70519
Policy instance 1
Insurance contract or identification number70519
Number of Individuals Covered395
Insurance policy start date2012-04-01
Insurance policy end date2013-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,190
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. (National Association of Insurance Commissioners NAIC id number: 64343 )
Policy contract number70519
Policy instance 1
Insurance contract or identification number70519
Insurance policy start date2011-04-01
Insurance policy end date2012-03-31
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $9,884
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PACIFIC GUARDIAN LIFE INSURANCE COMPANY, LTD. (National Association of Insurance Commissioners NAIC id number: 64343 )
Policy contract number70519
Policy instance 1
Insurance contract or identification number70519
Number of Individuals Covered336
Insurance policy start date2010-04-01
Insurance policy end date2011-03-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,745
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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