401k Plan data: BARETECA RESTAURANTS, LLC plan

BARETECA RESTAURANTS, LLC 401k Plan overview

Plan Name	BARETECA RESTAURANTS, LLC
Plan identification number	502

BARETECA RESTAURANTS, LLC Benefits

401k Plan Type	Welfare 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)

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 BARETECA RESTAURANTS, LLC

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2018-05-01 JENNIFER SIMMONS 2019-10-10
502 2017-05-01
502 2016-05-01
502 2015-05-01 MATTHEW WILBER

Plan Statistics for BARETECA RESTAURANTS, LLC

401k plan membership statisitcs for BARETECA RESTAURANTS, LLC

Measure Date Value
2018: BARETECA RESTAURANTS, LLC 2018 401k membership
Total participants, beginning-of-year 2018-05-01 174
Total number of active participants reported on line 7a of the Form 5500 2018-05-01 0
Number of retired or separated participants receiving benefits 2018-05-01 0
Number of other retired or separated participants entitled to future benefits 2018-05-01 0
Total of all active and inactive participants 2018-05-01 0
Number of employers contributing to the scheme 2018-05-01 0
2017: BARETECA RESTAURANTS, LLC 2017 401k membership
Total participants, beginning-of-year 2017-05-01 263
Total number of active participants reported on line 7a of the Form 5500 2017-05-01 174
Number of retired or separated participants receiving benefits 2017-05-01 5
Number of other retired or separated participants entitled to future benefits 2017-05-01 0
Total of all active and inactive participants 2017-05-01 179
2016: BARETECA RESTAURANTS, LLC 2016 401k membership
Total participants, beginning-of-year 2016-05-01 242
Total number of active participants reported on line 7a of the Form 5500 2016-05-01 263
Number of retired or separated participants receiving benefits 2016-05-01 11
Number of other retired or separated participants entitled to future benefits 2016-05-01 0
Total of all active and inactive participants 2016-05-01 274
2015: BARETECA RESTAURANTS, LLC 2015 401k membership
Total participants, beginning-of-year 2015-05-01 242
Total number of active participants reported on line 7a of the Form 5500 2015-05-01 242
Number of retired or separated participants receiving benefits 2015-05-01 0
Number of other retired or separated participants entitled to future benefits 2015-05-01 0
Total of all active and inactive participants 2015-05-01 242

Measure	Date	Value
2018: BARETECA RESTAURANTS, LLC 2018 401k membership
Total participants, beginning-of-year	2018-05-01	174
Total number of active participants reported on line 7a of the Form 5500	2018-05-01	0
Number of retired or separated participants receiving benefits	2018-05-01	0
Number of other retired or separated participants entitled to future benefits	2018-05-01	0
Total of all active and inactive participants	2018-05-01	0
Number of employers contributing to the scheme	2018-05-01	0
2017: BARETECA RESTAURANTS, LLC 2017 401k membership
Total participants, beginning-of-year	2017-05-01	263
Total number of active participants reported on line 7a of the Form 5500	2017-05-01	174
Number of retired or separated participants receiving benefits	2017-05-01	5
Number of other retired or separated participants entitled to future benefits	2017-05-01	0
Total of all active and inactive participants	2017-05-01	179
2016: BARETECA RESTAURANTS, LLC 2016 401k membership
Total participants, beginning-of-year	2016-05-01	242
Total number of active participants reported on line 7a of the Form 5500	2016-05-01	263
Number of retired or separated participants receiving benefits	2016-05-01	11
Number of other retired or separated participants entitled to future benefits	2016-05-01	0
Total of all active and inactive participants	2016-05-01	274
2015: BARETECA RESTAURANTS, LLC 2015 401k membership
Total participants, beginning-of-year	2015-05-01	242
Total number of active participants reported on line 7a of the Form 5500	2015-05-01	242
Number of retired or separated participants receiving benefits	2015-05-01	0
Number of other retired or separated participants entitled to future benefits	2015-05-01	0
Total of all active and inactive participants	2015-05-01	242

Form 5500 Responses for BARETECA RESTAURANTS, LLC

2018: BARETECA RESTAURANTS, LLC 2018 form 5500 responses
2018-05-01	Type of plan entity	Single employer plan
2018-05-01	This submission is the final filing	Yes
2018-05-01	Plan funding arrangement – Insurance	Yes
2018-05-01	Plan benefit arrangement – Insurance	Yes
2017: BARETECA RESTAURANTS, LLC 2017 form 5500 responses
2017-05-01	Type of plan entity	Single employer plan
2017-05-01	Plan funding arrangement – Insurance	Yes
2017-05-01	Plan benefit arrangement – Insurance	Yes
2016: BARETECA RESTAURANTS, LLC 2016 form 5500 responses
2016-05-01	Type of plan entity	Single employer plan
2016-05-01	Submission has been amended	No
2016-05-01	This submission is the final filing	No
2016-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-05-01	Plan is a collectively bargained plan	No
2016-05-01	Plan funding arrangement – Insurance	Yes
2016-05-01	Plan benefit arrangement – Insurance	Yes
2015: BARETECA RESTAURANTS, LLC 2015 form 5500 responses
2015-05-01	Type of plan entity	Single employer plan
2015-05-01	First time form 5500 has been submitted	Yes
2015-05-01	Submission has been amended	No
2015-05-01	This submission is the final filing	No
2015-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-05-01	Plan is a collectively bargained plan	No
2015-05-01	Plan funding arrangement – Insurance	Yes
2015-05-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

101920-SHORT

Policy instance

Insurance contract or identification number	101920-SHORT
Number of Individuals Covered	415
Insurance policy start date	2018-05-01
Insurance policy end date	2019-03-31
Total amount of commissions paid to insurance broker	USD $86,626
Total amount of fees paid to insurance company	USD $88
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $2,314,731
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $53,680
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	INDIRECT COMPENSATION

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10228427

Policy instance

Insurance contract or identification number	10228427
Number of Individuals Covered	46
Insurance policy start date	2018-05-01
Insurance policy end date	2019-04-30
Total amount of commissions paid to insurance broker	USD $4,138
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $33,071
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,082
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

101920

Policy instance

Insurance contract or identification number	101920
Number of Individuals Covered	506
Insurance policy start date	2017-05-01
Insurance policy end date	2018-04-30
Total amount of commissions paid to insurance broker	USD $113,957
Total amount of fees paid to insurance company	USD $12,373
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $2,601,939
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $113,957
Amount paid for insurance broker fees	12373
Additional information about fees paid to insurance broker	2017 LOCAL MARKET INCENTIVE PAYMENT INDIRECT COMPENSATION
Insurance broker organization code?	3
Insurance broker name	LOCKTON COMPANIES, LLC

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010228427

Policy instance

Insurance contract or identification number	000010228427
Number of Individuals Covered	52
Insurance policy start date	2017-05-01
Insurance policy end date	2018-04-30
Total amount of commissions paid to insurance broker	USD $4,741
Total amount of fees paid to insurance company	USD $1,795
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $39,776
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,741
Amount paid for insurance broker fees	1795
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3
Insurance broker name	LOCKTON COMPANIES, LLC

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )

Policy contract number

905091

Policy instance

Insurance contract or identification number	905091
Number of Individuals Covered	242
Insurance policy start date	2015-05-01
Insurance policy end date	2016-04-30
Total amount of commissions paid to insurance broker	USD $4,868
Total amount of fees paid to insurance company	USD $0
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $92,348
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,868
Amount paid for insurance broker fees	0
Additional information about fees paid to insurance broker	COMMISSION
Insurance broker organization code?	3
Insurance broker name	BENEFIT PLANNING SERVICES, LLC

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

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
502	2018-05-01	JENNIFER SIMMONS	2019-10-10
502	2017-05-01
502	2016-05-01
502	2015-05-01	MATTHEW WILBER