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CAFE CONCEPTS, INC. LIFE AND AD&D BENEFIT PLAN 401k Plan overview

Plan NameCAFE CONCEPTS, INC. LIFE AND AD&D BENEFIT PLAN
Plan identification number 502

CAFE CONCEPTS, INC. LIFE AND AD&D BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Death benefits (include travel accident but not life insurance)
  • 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

THE FIREMAN GROUP CAFE CONCEPTS, INC. has sponsored the creation of one or more 401k plans.

Company Name:THE FIREMAN GROUP CAFE CONCEPTS, INC.
Employer identification number (EIN):133835919
NAIC Classification:111100
NAIC Description:Oilseed and Grain Farming

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CAFE CONCEPTS, INC. LIFE AND AD&D BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022020-01-01
5022019-01-01
5022018-01-01MARK HAMWI CFO
5022017-01-01STEVE WEISSMAN
5022016-01-01STEVE WEISSMAN
5022015-01-01STEVE WEISSMAN

Plan Statistics for CAFE CONCEPTS, INC. LIFE AND AD&D BENEFIT PLAN

401k plan membership statisitcs for CAFE CONCEPTS, INC. LIFE AND AD&D BENEFIT PLAN

Measure Date Value
2020: CAFE CONCEPTS, INC. LIFE AND AD&D BENEFIT PLAN 2020 401k membership
Total participants, beginning-of-year2020-01-0170
Total number of active participants reported on line 7a of the Form 55002020-01-0120
Total of all active and inactive participants2020-01-0120
2019: CAFE CONCEPTS, INC. LIFE AND AD&D BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01106
Total number of active participants reported on line 7a of the Form 55002019-01-01105
Total of all active and inactive participants2019-01-01105
2018: CAFE CONCEPTS, INC. LIFE AND AD&D BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-01-01116
Total number of active participants reported on line 7a of the Form 55002018-01-01107
Total of all active and inactive participants2018-01-01107
2017: CAFE CONCEPTS, INC. LIFE AND AD&D BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-01111
Total number of active participants reported on line 7a of the Form 55002017-01-01116
Total of all active and inactive participants2017-01-01116
Total participants2017-01-01116
2016: CAFE CONCEPTS, INC. LIFE AND AD&D BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01114
Total number of active participants reported on line 7a of the Form 55002016-01-01111
Total of all active and inactive participants2016-01-01111
Total participants2016-01-01111
2015: CAFE CONCEPTS, INC. LIFE AND AD&D BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01140
Total number of active participants reported on line 7a of the Form 55002015-01-01114
Total of all active and inactive participants2015-01-01114
Total participants2015-01-01114

Form 5500 Responses for CAFE CONCEPTS, INC. LIFE AND AD&D BENEFIT PLAN

2020: CAFE CONCEPTS, INC. LIFE AND AD&D BENEFIT PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: CAFE CONCEPTS, INC. LIFE AND AD&D BENEFIT PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: CAFE CONCEPTS, INC. LIFE AND AD&D BENEFIT PLAN 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes
2017: CAFE CONCEPTS, INC. LIFE AND AD&D BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entitySingle employer plan
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – InsuranceYes
2016: CAFE CONCEPTS, INC. LIFE AND AD&D BENEFIT PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: CAFE CONCEPTS, INC. LIFE AND AD&D BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberSGN600807
Policy instance 1
Insurance contract or identification numberSGN600807
Number of Individuals Covered20
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $209
Total amount of fees paid to insurance companyUSD $638
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $2,082
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $209
Amount paid for insurance broker fees638
Additional information about fees paid to insurance brokerOVERRIDE
Insurance broker organization code?3
CIGNA GROUP INSURANCE (National Association of Insurance Commissioners NAIC id number: 64548 )
Policy contract numberSGN600807
Policy instance 1
Insurance contract or identification numberSGN600807
Number of Individuals Covered105
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $1,692
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $16,919
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,692
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number386392
Policy instance 1
Insurance contract or identification number386392
Number of Individuals Covered107
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $2,536
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $22,660
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,536
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number386392
Policy instance 1
Insurance contract or identification number386392
Number of Individuals Covered116
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $2,589
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $23,402
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,589
Insurance broker organization code?3
Insurance broker nameKINLOCH CONSULTING GROUP, INC.

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