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| Plan Name | PARADISE GRILLS HOLDINGS, INC. HEALTH & WELFARE BENEFIT PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | PARADISE GRILLING SYSTEMS INC. |
| Employer identification number (EIN): | 462489504 |
| NAIC Classification: | 442299 |
| NAIC Description: | All Other Home Furnishings Stores |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2023-05-01 | EMMA HEINS | 2024-10-04 | ||
| 501 | 2022-05-01 | ||||
| 501 | 2022-05-01 | ||||
| 501 | 2022-05-01 | CHARLOTTE MALAVE |
| 2023: PARADISE GRILLS HOLDINGS, INC. HEALTH & WELFARE BENEFIT PLAN 2023 form 5500 responses | ||
|---|---|---|
| 2023-05-01 | Type of plan entity | Single employer plan |
| 2023-05-01 | Plan funding arrangement – Insurance | Yes |
| 2023-05-01 | Plan benefit arrangement – Insurance | Yes |
| 2022: PARADISE GRILLS HOLDINGS, INC. HEALTH & WELFARE BENEFIT PLAN 2022 form 5500 responses | ||
| 2022-05-01 | Type of plan entity | Single employer plan |
| 2022-05-01 | First time form 5500 has been submitted | Yes |
| 2022-05-01 | Submission has been amended | No |
| 2022-05-01 | This submission is the final filing | No |
| 2022-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2022-05-01 | Plan is a collectively bargained plan | No |
| 2022-05-01 | Plan funding arrangement – Insurance | Yes |
| 2022-05-01 | Plan benefit arrangement – Insurance | Yes |
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |||||||||||||||||||||||||||||
| Policy contract number | S8379 | ||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||
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| SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 ) | |||||||||||||||||||||||||||||
| Policy contract number | 960070 | ||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||
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| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95089 ) | |||||||||||||||||||||||||||||
| Policy contract number | S8379 | ||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |||||||||||||||||||||||||||||
| Policy contract number | S8379 | ||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||
| HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 ) | |||||||||||||||||||||||||||||
| Policy contract number | 897309G | ||||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||||
| FLORIDA COMBINED LIFE INSURANCE COMPANY, INC. (National Association of Insurance Commissioners NAIC id number: 76031 ) | |||||||||||||||||||||||||||||
| Policy contract number | Y1585-4T5E89 | ||||||||||||||||||||||||||||
| Policy instance | 4 | ||||||||||||||||||||||||||||
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |||||||||||||||||||||||||||||
| Policy contract number | S8379 | ||||||||||||||||||||||||||||
| Policy instance | 5 | ||||||||||||||||||||||||||||
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 95089 ) | |||||||||||||||||||||||||||||
| Policy contract number | S8379 | ||||||||||||||||||||||||||||
| Policy instance | 6 | ||||||||||||||||||||||||||||
| BLUE CROSS BLUE SHIELD OF FLORIDA (National Association of Insurance Commissioners NAIC id number: 98167 ) | |||||||||||||||||||||||||||||
| Policy contract number | S8379 | ||||||||||||||||||||||||||||
| Policy instance | 7 | ||||||||||||||||||||||||||||
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