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EMPLOYEE HEALTH PLAN OF ADAMS RESTAURANT GROUP, INC 401k Plan overview

Plan NameEMPLOYEE HEALTH PLAN OF ADAMS RESTAURANT GROUP, INC
Plan identification number 501

EMPLOYEE HEALTH PLAN OF ADAMS RESTAURANT GROUP, INC Benefits

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

401k Sponsoring company profile

ADAMS RESTAURANT GROUP, INC has sponsored the creation of one or more 401k plans.

Company Name:ADAMS RESTAURANT GROUP, INC
Employer identification number (EIN):204618472
NAIC Classification:722513
NAIC Description:Limited-Service Restaurants

Additional information about ADAMS RESTAURANT GROUP, INC

Jurisdiction of Incorporation: Arizona Corporation Commission
Incorporation Date:
Company Identification Number: 12732414

More information about ADAMS RESTAURANT GROUP, INC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE HEALTH PLAN OF ADAMS RESTAURANT GROUP, INC

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012020-05-01
5012019-05-01
5012018-05-01
5012017-05-01ADAMS RESTAURANT GROUP INC
5012016-05-01GREGORY A. ADAMS
5012016-03-01GREGORY A. ADAMS

Plan Statistics for EMPLOYEE HEALTH PLAN OF ADAMS RESTAURANT GROUP, INC

401k plan membership statisitcs for EMPLOYEE HEALTH PLAN OF ADAMS RESTAURANT GROUP, INC

Measure Date Value
2020: EMPLOYEE HEALTH PLAN OF ADAMS RESTAURANT GROUP, INC 2020 401k membership
Total participants, beginning-of-year2020-05-012
Total number of active participants reported on line 7a of the Form 55002020-05-010
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 participants2020-05-010
2019: EMPLOYEE HEALTH PLAN OF ADAMS RESTAURANT GROUP, INC 2019 401k membership
Total participants, beginning-of-year2019-05-012
Total number of active participants reported on line 7a of the Form 55002019-05-012
Number of retired or separated participants receiving benefits2019-05-010
Number of other retired or separated participants entitled to future benefits2019-05-010
Total of all active and inactive participants2019-05-012
2018: EMPLOYEE HEALTH PLAN OF ADAMS RESTAURANT GROUP, INC 2018 401k membership
Total participants, beginning-of-year2018-05-013
Total number of active participants reported on line 7a of the Form 55002018-05-012
Number of retired or separated participants receiving benefits2018-05-010
Number of other retired or separated participants entitled to future benefits2018-05-010
Total of all active and inactive participants2018-05-012
2017: EMPLOYEE HEALTH PLAN OF ADAMS RESTAURANT GROUP, INC 2017 401k membership
Total participants, beginning-of-year2017-05-015
Total number of active participants reported on line 7a of the Form 55002017-05-015
Number of retired or separated participants receiving benefits2017-05-010
Number of other retired or separated participants entitled to future benefits2017-05-010
Total of all active and inactive participants2017-05-015
2016: EMPLOYEE HEALTH PLAN OF ADAMS RESTAURANT GROUP, INC 2016 401k membership
Total participants, beginning-of-year2016-05-015
Total number of active participants reported on line 7a of the Form 55002016-05-015
Number of retired or separated participants receiving benefits2016-05-010
Number of other retired or separated participants entitled to future benefits2016-05-010
Total of all active and inactive participants2016-05-015
Total participants, beginning-of-year2016-03-015
Total number of active participants reported on line 7a of the Form 55002016-03-015
Number of retired or separated participants receiving benefits2016-03-010
Number of other retired or separated participants entitled to future benefits2016-03-010
Total of all active and inactive participants2016-03-015

Financial Data on EMPLOYEE HEALTH PLAN OF ADAMS RESTAURANT GROUP, INC

Measure Date Value
2021 : EMPLOYEE HEALTH PLAN OF ADAMS RESTAURANT GROUP, INC 2021 401k financial data
Total plan liabilities at beginning of year2021-04-30$0
Total income from all sources2021-04-30$1,201
Expenses. Total of all expenses incurred2021-04-30$1,472
Benefits paid (including direct rollovers)2021-04-30$461
Total plan assets at end of year2021-04-30$115
Total plan assets at beginning of year2021-04-30$386
Value of fidelity bond covering the plan2021-04-30$1,000
Expenses. Other expenses not covered elsewhere2021-04-30$1,011
Net income (gross income less expenses)2021-04-30$-271
Net plan assets at end of year (total assets less liabilities)2021-04-30$115
Net plan assets at beginning of year (total assets less liabilities)2021-04-30$386
Total contributions received or receivable from employer(s)2021-04-30$1,201
2020 : EMPLOYEE HEALTH PLAN OF ADAMS RESTAURANT GROUP, INC 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$1,603
Expenses. Total of all expenses incurred2020-04-30$1,658
Benefits paid (including direct rollovers)2020-04-30$428
Total plan assets at end of year2020-04-30$386
Total plan assets at beginning of year2020-04-30$441
Value of fidelity bond covering the plan2020-04-30$1,000
Expenses. Other expenses not covered elsewhere2020-04-30$1,230
Net income (gross income less expenses)2020-04-30$-55
Net plan assets at end of year (total assets less liabilities)2020-04-30$386
Net plan assets at beginning of year (total assets less liabilities)2020-04-30$441
Total contributions received or receivable from employer(s)2020-04-30$1,603
2019 : EMPLOYEE HEALTH PLAN OF ADAMS RESTAURANT GROUP, INC 2019 401k financial data
Total plan liabilities at end of year2019-04-30$0
Total plan liabilities at beginning of year2019-04-30$0
Total income from all sources2019-04-30$1,892
Expenses. Total of all expenses incurred2019-04-30$2,122
Benefits paid (including direct rollovers)2019-04-30$673
Total plan assets at end of year2019-04-30$441
Total plan assets at beginning of year2019-04-30$671
Value of fidelity bond covering the plan2019-04-30$1,000
Expenses. Other expenses not covered elsewhere2019-04-30$1,449
Net income (gross income less expenses)2019-04-30$-230
Net plan assets at end of year (total assets less liabilities)2019-04-30$441
Net plan assets at beginning of year (total assets less liabilities)2019-04-30$671
Total contributions received or receivable from employer(s)2019-04-30$1,892
2018 : EMPLOYEE HEALTH PLAN OF ADAMS RESTAURANT GROUP, INC 2018 401k financial data
Total plan liabilities at end of year2018-04-30$0
Total plan liabilities at beginning of year2018-04-30$0
Total income from all sources2018-04-30$3,401
Expenses. Total of all expenses incurred2018-04-30$3,146
Benefits paid (including direct rollovers)2018-04-30$602
Total plan assets at end of year2018-04-30$671
Total plan assets at beginning of year2018-04-30$416
Value of fidelity bond covering the plan2018-04-30$1,000
Expenses. Other expenses not covered elsewhere2018-04-30$2,544
Net income (gross income less expenses)2018-04-30$255
Net plan assets at end of year (total assets less liabilities)2018-04-30$671
Net plan assets at beginning of year (total assets less liabilities)2018-04-30$416
Total contributions received or receivable from employer(s)2018-04-30$3,401
2017 : EMPLOYEE HEALTH PLAN OF ADAMS RESTAURANT GROUP, INC 2017 401k financial data
Total plan liabilities at end of year2017-04-30$0
Total plan liabilities at beginning of year2017-04-30$0
Total income from all sources2017-04-30$2,639
Expenses. Total of all expenses incurred2017-04-30$2,333
Benefits paid (including direct rollovers)2017-04-30$394
Total plan assets at end of year2017-04-30$416
Total plan assets at beginning of year2017-04-30$110
Value of fidelity bond covering the plan2017-04-30$1,000
Expenses. Other expenses not covered elsewhere2017-04-30$1,939
Net income (gross income less expenses)2017-04-30$306
Net plan assets at end of year (total assets less liabilities)2017-04-30$416
Net plan assets at beginning of year (total assets less liabilities)2017-04-30$110
Total contributions received or receivable from employer(s)2017-04-30$2,639
2016 : EMPLOYEE HEALTH PLAN OF ADAMS RESTAURANT GROUP, INC 2016 401k financial data
Total income from all sources2016-04-30$540
Expenses. Total of all expenses incurred2016-04-30$430
Total plan assets at end of year2016-04-30$110
Value of fidelity bond covering the plan2016-04-30$1,000
Expenses. Other expenses not covered elsewhere2016-04-30$430
Net income (gross income less expenses)2016-04-30$110
Net plan assets at end of year (total assets less liabilities)2016-04-30$110
Net plan assets at beginning of year (total assets less liabilities)2016-04-30$0
Total contributions received or receivable from employer(s)2016-04-30$540

Form 5500 Responses for EMPLOYEE HEALTH PLAN OF ADAMS RESTAURANT GROUP, INC

2020: EMPLOYEE HEALTH PLAN OF ADAMS RESTAURANT GROUP, INC 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 ADAMS RESTAURANT GROUP, INC 2019 form 5500 responses
2019-05-01Type of plan entitySingle employer plan
2019-05-01Submission has been amendedNo
2019-05-01This submission is the final filingNo
2019-05-01This return/report is a short plan year return/report (less than 12 months)No
2019-05-01Plan is a collectively bargained planNo
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan funding arrangement – TrustYes
2019-05-01Plan benefit arrangement – InsuranceYes
2019-05-01Plan benefit arrangement - TrustYes
2018: EMPLOYEE HEALTH PLAN OF ADAMS RESTAURANT GROUP, INC 2018 form 5500 responses
2018-05-01Type of plan entitySingle employer plan
2018-05-01Submission has been amendedNo
2018-05-01This submission is the final filingNo
2018-05-01This return/report is a short plan year return/report (less than 12 months)No
2018-05-01Plan is a collectively bargained planNo
2018-05-01Plan funding arrangement – InsuranceYes
2018-05-01Plan funding arrangement – TrustYes
2018-05-01Plan benefit arrangement – InsuranceYes
2018-05-01Plan benefit arrangement - TrustYes
2017: EMPLOYEE HEALTH PLAN OF ADAMS RESTAURANT GROUP, INC 2017 form 5500 responses
2017-05-01Type of plan entitySingle employer plan
2017-05-01Submission has been amendedNo
2017-05-01This submission is the final filingNo
2017-05-01This return/report is a short plan year return/report (less than 12 months)No
2017-05-01Plan is a collectively bargained planNo
2017-05-01Plan funding arrangement – InsuranceYes
2017-05-01Plan funding arrangement – TrustYes
2017-05-01Plan benefit arrangement – InsuranceYes
2017-05-01Plan benefit arrangement - TrustYes
2016: EMPLOYEE HEALTH PLAN OF ADAMS RESTAURANT GROUP, INC 2016 form 5500 responses
2016-05-01Type of plan entitySingle employer plan
2016-05-01Submission has been amendedNo
2016-05-01This submission is the final filingNo
2016-05-01This return/report is a short plan year return/report (less than 12 months)No
2016-05-01Plan is a collectively bargained planNo
2016-05-01Plan funding arrangement – InsuranceYes
2016-05-01Plan funding arrangement – TrustYes
2016-05-01Plan benefit arrangement – InsuranceYes
2016-05-01Plan benefit arrangement - TrustYes
2016-03-01Type of plan entitySingle employer plan
2016-03-01First time form 5500 has been submittedYes
2016-03-01Submission has been amendedNo
2016-03-01This submission is the final filingNo
2016-03-01This return/report is a short plan year return/report (less than 12 months)Yes
2016-03-01Plan is a collectively bargained planNo
2016-03-01Plan funding arrangement – InsuranceYes
2016-03-01Plan funding arrangement – TrustYes
2016-03-01Plan benefit arrangement – InsuranceYes
2016-03-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number50008 NFA 0633
Policy instance 1
Insurance contract or identification number50008 NFA 0633
Number of Individuals Covered0
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 $421
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 number50008 NFA 0633
Policy instance 1
Insurance contract or identification number50008 NFA 0633
Number of Individuals Covered2
Insurance policy start date2019-05-01
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 $537
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 number50008 NFA 0633
Policy instance 1
Insurance contract or identification number50008 NFA 0633
Number of Individuals Covered2
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
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 $617
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 number50008 NFA 0633
Policy instance 1
Insurance contract or identification number50008 NFA 0633
Number of Individuals Covered5
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
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 BenefitNo
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 $1,057
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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