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US WAFFLE COMPANY LONG TERM DISABILITY PLAN 401k Plan overview

Plan NameUS WAFFLE COMPANY LONG TERM DISABILITY PLAN
Plan identification number 504

US WAFFLE COMPANY LONG TERM DISABILITY PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Long-term disability cover

401k Sponsoring company profile

US WAFFLE COMPANY, INC has sponsored the creation of one or more 401k plans.

Company Name:US WAFFLE COMPANY, INC
Employer identification number (EIN):463048574
NAIC Classification:311800
NAIC Description: Bakeries and Tortilla Manufacturing

Form 5500 Filing Information

Submission information for form 5500 for 401k plan US WAFFLE COMPANY LONG TERM DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042017-09-01MARK J. DION2019-04-01

Plan Statistics for US WAFFLE COMPANY LONG TERM DISABILITY PLAN

401k plan membership statisitcs for US WAFFLE COMPANY LONG TERM DISABILITY PLAN

Measure Date Value
2017: US WAFFLE COMPANY LONG TERM DISABILITY PLAN 2017 401k membership
Total participants, beginning-of-year2017-09-01105
Total number of active participants reported on line 7a of the Form 55002017-09-010
Number of retired or separated participants receiving benefits2017-09-010
Number of other retired or separated participants entitled to future benefits2017-09-010
Total of all active and inactive participants2017-09-010
Number of employers contributing to the scheme2017-09-010

Form 5500 Responses for US WAFFLE COMPANY LONG TERM DISABILITY PLAN

2017: US WAFFLE COMPANY LONG TERM DISABILITY PLAN 2017 form 5500 responses
2017-09-01Type of plan entitySingle employer plan
2017-09-01First time form 5500 has been submittedYes
2017-09-01This submission is the final filingYes
2017-09-01Plan funding arrangement – InsuranceYes
2017-09-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGLTD0B37N
Policy instance 1
Insurance contract or identification numberGLTD0B37N
Number of Individuals Covered103
Insurance policy start date2017-09-01
Insurance policy end date2018-08-31
Total amount of commissions paid to insurance brokerUSD $2,142
Total amount of fees paid to insurance companyUSD $339
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $14,283
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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