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PIZZA HUT OF SOUTHERN WISCONSIN, INC. SECTION 125 CAFETERIA PLAN 401k Plan overview

Plan NamePIZZA HUT OF SOUTHERN WISCONSIN, INC. SECTION 125 CAFETERIA PLAN
Plan identification number 503

PIZZA HUT OF SOUTHERN WISCONSIN, INC. SECTION 125 CAFETERIA PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Long-term disability cover
  • Other welfare benefit cover
  • 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

PIZZA HUT OF SOUTHERN WISCONSIN INC has sponsored the creation of one or more 401k plans.

Company Name:PIZZA HUT OF SOUTHERN WISCONSIN INC
Employer identification number (EIN):391133143
NAIC Classification:722513
NAIC Description:Limited-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PIZZA HUT OF SOUTHERN WISCONSIN, INC. SECTION 125 CAFETERIA PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032016-01-01NANCY BORELLI
5032015-01-01NANCY BORELLI
5032014-01-01NANCY BORELLI
5032013-01-01NANCY BORELLI
5032012-01-01NANCY BORELLI
5032011-01-01NANCY BORELLI
5032010-01-01NANCY BORELLI
5032009-01-01NANCY BORELLI

Plan Statistics for PIZZA HUT OF SOUTHERN WISCONSIN, INC. SECTION 125 CAFETERIA PLAN

401k plan membership statisitcs for PIZZA HUT OF SOUTHERN WISCONSIN, INC. SECTION 125 CAFETERIA PLAN

Measure Date Value
2016: PIZZA HUT OF SOUTHERN WISCONSIN, INC. SECTION 125 CAFETERIA PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0171
Total number of active participants reported on line 7a of the Form 55002016-01-0160
Number of retired or separated participants receiving benefits2016-01-011
Total of all active and inactive participants2016-01-0161
2015: PIZZA HUT OF SOUTHERN WISCONSIN, INC. SECTION 125 CAFETERIA PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-0170
Total number of active participants reported on line 7a of the Form 55002015-01-0166
Total of all active and inactive participants2015-01-0166
2014: PIZZA HUT OF SOUTHERN WISCONSIN, INC. SECTION 125 CAFETERIA PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-0166
Total number of active participants reported on line 7a of the Form 55002014-01-0160
Total of all active and inactive participants2014-01-0160
2013: PIZZA HUT OF SOUTHERN WISCONSIN, INC. SECTION 125 CAFETERIA PLAN 2013 401k membership
Total participants, beginning-of-year2013-01-0166
Total number of active participants reported on line 7a of the Form 55002013-01-0161
Number of retired or separated participants receiving benefits2013-01-011
Total of all active and inactive participants2013-01-0162
2012: PIZZA HUT OF SOUTHERN WISCONSIN, INC. SECTION 125 CAFETERIA PLAN 2012 401k membership
Total participants, beginning-of-year2012-01-0179
Total number of active participants reported on line 7a of the Form 55002012-01-0169
Number of retired or separated participants receiving benefits2012-01-012
Total of all active and inactive participants2012-01-0171
2011: PIZZA HUT OF SOUTHERN WISCONSIN, INC. SECTION 125 CAFETERIA PLAN 2011 401k membership
Total participants, beginning-of-year2011-01-01107
Total number of active participants reported on line 7a of the Form 55002011-01-0195
Number of retired or separated participants receiving benefits2011-01-012
Total of all active and inactive participants2011-01-0197
2010: PIZZA HUT OF SOUTHERN WISCONSIN, INC. SECTION 125 CAFETERIA PLAN 2010 401k membership
Total participants, beginning-of-year2010-01-01122
Total number of active participants reported on line 7a of the Form 55002010-01-01104
Number of retired or separated participants receiving benefits2010-01-012
Number of other retired or separated participants entitled to future benefits2010-01-010
Total of all active and inactive participants2010-01-01106
2009: PIZZA HUT OF SOUTHERN WISCONSIN, INC. SECTION 125 CAFETERIA PLAN 2009 401k membership
Total participants, beginning-of-year2009-01-01151
Total number of active participants reported on line 7a of the Form 55002009-01-01125
Number of retired or separated participants receiving benefits2009-01-018
Number of other retired or separated participants entitled to future benefits2009-01-010
Total of all active and inactive participants2009-01-01133
Total participants2009-01-010

Form 5500 Responses for PIZZA HUT OF SOUTHERN WISCONSIN, INC. SECTION 125 CAFETERIA PLAN

2016: PIZZA HUT OF SOUTHERN WISCONSIN, INC. SECTION 125 CAFETERIA PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: PIZZA HUT OF SOUTHERN WISCONSIN, INC. SECTION 125 CAFETERIA PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: PIZZA HUT OF SOUTHERN WISCONSIN, INC. SECTION 125 CAFETERIA PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: PIZZA HUT OF SOUTHERN WISCONSIN, INC. SECTION 125 CAFETERIA PLAN 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Submission has been amendedNo
2013-01-01This submission is the final filingNo
2013-01-01This return/report is a short plan year return/report (less than 12 months)No
2013-01-01Plan is a collectively bargained planNo
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: PIZZA HUT OF SOUTHERN WISCONSIN, INC. SECTION 125 CAFETERIA PLAN 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Submission has been amendedNo
2012-01-01This submission is the final filingNo
2012-01-01This return/report is a short plan year return/report (less than 12 months)No
2012-01-01Plan is a collectively bargained planNo
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: PIZZA HUT OF SOUTHERN WISCONSIN, INC. SECTION 125 CAFETERIA PLAN 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Submission has been amendedNo
2011-01-01This submission is the final filingNo
2011-01-01This return/report is a short plan year return/report (less than 12 months)No
2011-01-01Plan is a collectively bargained planNo
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2010: PIZZA HUT OF SOUTHERN WISCONSIN, INC. SECTION 125 CAFETERIA PLAN 2010 form 5500 responses
2010-01-01Type of plan entitySingle employer plan
2010-01-01Submission has been amendedNo
2010-01-01This submission is the final filingNo
2010-01-01This return/report is a short plan year return/report (less than 12 months)No
2010-01-01Plan is a collectively bargained planNo
2010-01-01Plan funding arrangement – InsuranceYes
2010-01-01Plan funding arrangement – General assets of the sponsorYes
2010-01-01Plan benefit arrangement – InsuranceYes
2010-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: PIZZA HUT OF SOUTHERN WISCONSIN, INC. SECTION 125 CAFETERIA PLAN 2009 form 5500 responses
2009-01-01Type of plan entitySingle employer plan
2009-01-01Submission has been amendedNo
2009-01-01This submission is the final filingNo
2009-01-01This return/report is a short plan year return/report (less than 12 months)No
2009-01-01Plan is a collectively bargained planNo
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

DEAN HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 96156 )
Policy contract number3279
Policy instance 1
Insurance contract or identification number3279
Number of Individuals Covered58
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $12,209
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $414,456
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,209
Insurance broker organization code?3
Insurance broker nameM3 INSURANCE SOLUTIONS, INC
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number53706
Policy instance 2
Insurance contract or identification number53706
Number of Individuals Covered66
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $1,415
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $9,867
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,415
Insurance broker organization code?3
Insurance broker nameM3 INSURANCE SOLUTIONS, INC.
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number53706
Policy instance 1
Insurance contract or identification number53706
Number of Individuals Covered60
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $1,569
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $11,038
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,569
Insurance broker organization code?3
Insurance broker nameM3 INSURANCE SOLUTIONS, INC.
DEAN HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 96156 )
Policy contract number3279
Policy instance 2
Insurance contract or identification number3279
Number of Individuals Covered51
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $11,044
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $379,170
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $11,044
Insurance broker organization code?3
Insurance broker nameM3 INSURANCE SOLUTIONS, INC
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number53706
Policy instance 1
Insurance contract or identification number53706
Number of Individuals Covered62
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $1,579
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $10,965
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,579
Insurance broker organization code?3
Insurance broker nameM3 INSURANCE SOLUTIONS, INC.
DEAN HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 96156 )
Policy contract number3279
Policy instance 2
Insurance contract or identification number3279
Number of Individuals Covered57
Insurance policy start date2013-01-01
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $12,740
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $395,224
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,740
Insurance broker organization code?3
Insurance broker nameM3 INSURANCE SOLUTIONS, INC
DEAN HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 96156 )
Policy contract number32790-32795Y
Policy instance 1
Insurance contract or identification number32790-32795Y
Number of Individuals Covered54
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $13,311
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $400,671
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,311
Insurance broker organization code?3
Insurance broker nameM3 INSURANCE SOLUTIONS, INC
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number53706
Policy instance 2
Insurance contract or identification number53706
Number of Individuals Covered71
Insurance policy start date2012-01-01
Insurance policy end date2012-12-31
Total amount of commissions paid to insurance brokerUSD $1,426
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $9,971
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,426
Insurance broker organization code?3
Insurance broker nameM3 INSURANCE SOLUTIONS, INC.
DEAN HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 96156 )
Policy contract number32790-32795Y
Policy instance 1
Insurance contract or identification number32790-32795Y
Number of Individuals Covered66
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $16,283
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $453,860
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number53706
Policy instance 2
Insurance contract or identification number53706
Number of Individuals Covered40
Insurance policy start date2011-01-01
Insurance policy end date2011-12-31
Total amount of commissions paid to insurance brokerUSD $1,787
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $12,761
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
PRUDENTIAL ANNUITIES SERVICE (National Association of Insurance Commissioners NAIC id number: 68241 )
Policy contract number53706
Policy instance 1
Insurance contract or identification number53706
Number of Individuals Covered67
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $1,878
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH & DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $13,959
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,878
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameM3 INSURANCE SOLUTIONS, INC.
DEAN HEALTH PLAN (National Association of Insurance Commissioners NAIC id number: 96156 )
Policy contract number32790-32795Y
Policy instance 2
Insurance contract or identification number32790-32795Y
Number of Individuals Covered169
Insurance policy start date2010-01-01
Insurance policy end date2010-12-31
Total amount of commissions paid to insurance brokerUSD $17,071
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $531,407
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $17,071
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameM3 INSURANCE SOLUTIONS, INC

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