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BARTECA RESTAURANTS, LLC WELFARE BENEFIT PLAN 401k Plan overview

Plan NameBARTECA RESTAURANTS, LLC WELFARE BENEFIT PLAN
Plan identification number 501

BARTECA RESTAURANTS, LLC WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

BARETECA RESTAURANTS, LLC has sponsored the creation of one or more 401k plans.

Company Name:BARETECA RESTAURANTS, LLC
Employer identification number (EIN):454613842
NAIC Classification:722511
NAIC Description:Full-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BARTECA RESTAURANTS, LLC WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-09-01LEVI MARTIN2024-03-05
5012021-09-01LEVI MARTIN2023-07-17

Plan Statistics for BARTECA RESTAURANTS, LLC WELFARE BENEFIT PLAN

401k plan membership statisitcs for BARTECA RESTAURANTS, LLC WELFARE BENEFIT PLAN

Measure Date Value
2022: BARTECA RESTAURANTS, LLC WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-09-011,137
Total number of active participants reported on line 7a of the Form 55002022-09-011,176
Number of retired or separated participants receiving benefits2022-09-010
Number of other retired or separated participants entitled to future benefits2022-09-010
Total of all active and inactive participants2022-09-011,176
Number of employers contributing to the scheme2022-09-010
2021: BARTECA RESTAURANTS, LLC WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-09-011,486
Total number of active participants reported on line 7a of the Form 55002021-09-011,137
Number of retired or separated participants receiving benefits2021-09-014
Number of other retired or separated participants entitled to future benefits2021-09-010
Total of all active and inactive participants2021-09-011,141
Number of employers contributing to the scheme2021-09-010

Form 5500 Responses for BARTECA RESTAURANTS, LLC WELFARE BENEFIT PLAN

2022: BARTECA RESTAURANTS, LLC WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-09-01Type of plan entitySingle employer plan
2022-09-01Plan funding arrangement – InsuranceYes
2022-09-01Plan funding arrangement – General assets of the sponsorYes
2022-09-01Plan benefit arrangement – InsuranceYes
2022-09-01Plan benefit arrangement – General assets of the sponsorYes
2021: BARTECA RESTAURANTS, LLC WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-09-01Type of plan entitySingle employer plan
2021-09-01Plan funding arrangement – InsuranceYes
2021-09-01Plan funding arrangement – General assets of the sponsorYes
2021-09-01Plan benefit arrangement – InsuranceYes
2021-09-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number187454
Policy instance 1
Insurance contract or identification number187454
Number of Individuals Covered340
Insurance policy start date2022-09-01
Insurance policy end date2023-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $3,199
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $65,413
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $0
Amount paid for insurance broker fees3199
Additional information about fees paid to insurance broker2022 PINNACLE DENTAL NEW BUSINESS INCENTIVE RISK, INDIRECT COMPENSATION
Insurance broker organization code?3
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30099468
Policy instance 2
Insurance contract or identification number30099468
Number of Individuals Covered181
Insurance policy start date2022-09-01
Insurance policy end date2023-08-31
Total amount of commissions paid to insurance brokerUSD $751
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,058
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $751
Amount paid for insurance broker fees0
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX967458
Policy instance 3
Insurance contract or identification numberFLX967458
Number of Individuals Covered1176
Insurance policy start date2022-09-01
Insurance policy end date2023-08-31
Total amount of commissions paid to insurance brokerUSD $7,902
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT,EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $93,836
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Commission paid to Insurance BrokerUSD $7,902
Amount paid for insurance broker fees0
Insurance broker organization code?3
DELTA DENTAL PLAN OF ARKANSAS (National Association of Insurance Commissioners NAIC id number: 81396 )
Policy contract number21065
Policy instance 1
Insurance contract or identification number21065
Number of Individuals Covered323
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $74,129
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 39616 )
Policy contract number30099468
Policy instance 2
Insurance contract or identification number30099468
Number of Individuals Covered168
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $716
Total amount of fees paid to insurance companyUSD $0
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,403
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $716
Amount paid for insurance broker fees0
Insurance broker organization code?3
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX967458
Policy instance 3
Insurance contract or identification numberFLX967458
Number of Individuals Covered1137
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $15,364
Total amount of fees paid to insurance companyUSD $11
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT,EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $147,166
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,906
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerOVERRIDE

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