401k Plan data: FIC RESTAURANTS, INC. LONG TERM DISABILITY PLAN plan

FIC RESTAURANTS, INC. LONG TERM DISABILITY PLAN 401k Plan overview

Plan Name	FIC RESTAURANTS, INC. LONG TERM DISABILITY PLAN
Plan identification number	502

FIC RESTAURANTS, INC. LONG TERM DISABILITY PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Long-term disability cover

401k Sponsoring company profile

FIC RESTAURANTS, INC. has sponsored the creation of one or more 401k plans.

Company Name: FIC RESTAURANTS, INC.

Employer identification number (EIN): 463931388

NAIC Classification: 722511
NAIC Description: Full-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FIC RESTAURANTS, INC. LONG TERM DISABILITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2020-01-01 T. TODD SCHWENDENMANN 2021-05-21
502 2019-01-01
502 2018-01-01 CONNIE LENNICK
502 2017-01-01 CONNIE LENNICK
502 2016-01-01 CONNIE LENNICK

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
502	2020-01-01	T. TODD SCHWENDENMANN	2021-05-21
502	2019-01-01
502	2018-01-01	CONNIE LENNICK
502	2017-01-01	CONNIE LENNICK
502	2016-01-01	CONNIE LENNICK

Plan Statistics for FIC RESTAURANTS, INC. LONG TERM DISABILITY PLAN

401k plan membership statisitcs for FIC RESTAURANTS, INC. LONG TERM DISABILITY PLAN

Measure Date Value
2020: FIC RESTAURANTS, INC. LONG TERM DISABILITY PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 115
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 0
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 0
Number of employers contributing to the scheme 2020-01-01 0
2019: FIC RESTAURANTS, INC. LONG TERM DISABILITY PLAN 2019 401k membership
Total participants, beginning-of-year 2019-01-01 162
Total number of active participants reported on line 7a of the Form 5500 2019-01-01 115
Total of all active and inactive participants 2019-01-01 115
Total participants 2019-01-01 115
2018: FIC RESTAURANTS, INC. LONG TERM DISABILITY PLAN 2018 401k membership
Total participants, beginning-of-year 2018-01-01 175
Total number of active participants reported on line 7a of the Form 5500 2018-01-01 162
Total of all active and inactive participants 2018-01-01 162
Total participants 2018-01-01 162
2017: FIC RESTAURANTS, INC. LONG TERM DISABILITY PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 182
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 175
Total of all active and inactive participants 2017-01-01 175
Total participants 2017-01-01 175
2016: FIC RESTAURANTS, INC. LONG TERM DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 303
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 182
Total of all active and inactive participants 2016-01-01 182
Total participants 2016-01-01 182

Measure	Date	Value
2020: FIC RESTAURANTS, INC. LONG TERM DISABILITY PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	115
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	0
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	0
Number of employers contributing to the scheme	2020-01-01	0
2019: FIC RESTAURANTS, INC. LONG TERM DISABILITY PLAN 2019 401k membership
Total participants, beginning-of-year	2019-01-01	162
Total number of active participants reported on line 7a of the Form 5500	2019-01-01	115
Total of all active and inactive participants	2019-01-01	115
Total participants	2019-01-01	115
2018: FIC RESTAURANTS, INC. LONG TERM DISABILITY PLAN 2018 401k membership
Total participants, beginning-of-year	2018-01-01	175
Total number of active participants reported on line 7a of the Form 5500	2018-01-01	162
Total of all active and inactive participants	2018-01-01	162
Total participants	2018-01-01	162
2017: FIC RESTAURANTS, INC. LONG TERM DISABILITY PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	182
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	175
Total of all active and inactive participants	2017-01-01	175
Total participants	2017-01-01	175
2016: FIC RESTAURANTS, INC. LONG TERM DISABILITY PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	303
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	182
Total of all active and inactive participants	2016-01-01	182
Total participants	2016-01-01	182

Form 5500 Responses for FIC RESTAURANTS, INC. LONG TERM DISABILITY PLAN

2020: FIC RESTAURANTS, INC. LONG TERM DISABILITY PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	This submission is the final filing	Yes
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes
2019: FIC RESTAURANTS, INC. LONG TERM DISABILITY PLAN 2019 form 5500 responses
2019-01-01	Type of plan entity	Single employer plan
2019-01-01	Submission has been amended	No
2019-01-01	This submission is the final filing	No
2019-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-01-01	Plan is a collectively bargained plan	No
2019-01-01	Plan funding arrangement – Insurance	Yes
2019-01-01	Plan benefit arrangement – Insurance	Yes
2018: FIC RESTAURANTS, INC. LONG TERM DISABILITY PLAN 2018 form 5500 responses
2018-01-01	Type of plan entity	Single employer plan
2018-01-01	Submission has been amended	No
2018-01-01	This submission is the final filing	No
2018-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2018-01-01	Plan is a collectively bargained plan	No
2018-01-01	Plan funding arrangement – Insurance	Yes
2018-01-01	Plan benefit arrangement – Insurance	Yes
2017: FIC RESTAURANTS, INC. LONG TERM DISABILITY PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	No
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2016: FIC RESTAURANTS, INC. LONG TERM DISABILITY PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	First time form 5500 has been submitted	Yes
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

LK963265

Policy instance

Insurance contract or identification number	LK963265
Number of Individuals Covered	115
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $2,213
Total amount of fees paid to insurance company	USD $903
Long Term Disability Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $36,875
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $1,106
Amount paid for insurance broker fees	903
Additional information about fees paid to insurance broker	OVERRIDE
Insurance broker organization code?	3

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

LK963265

Policy instance

Insurance contract or identification number	LK963265
Number of Individuals Covered	115
Insurance policy start date	2019-01-01
Insurance policy end date	2019-12-31
Total amount of commissions paid to insurance broker	USD $2,234
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
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	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
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 $37,233
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,117
Amount paid for insurance broker fees	0
Insurance broker organization code?	7

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

LK 963265

Policy instance

Insurance contract or identification number	LK 963265
Number of Individuals Covered	162
Insurance policy start date	2018-01-01
Insurance policy end date	2018-12-31
Total amount of commissions paid to insurance broker	USD $2,816
Total amount of fees paid to insurance company	USD $0
Are there contracts with allocated funds for individual policies?	0
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	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
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 $46,787
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $436
Amount paid for insurance broker fees	0
Insurance broker organization code?	7

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

LK 963265

Policy instance

Insurance contract or identification number	LK 963265
Number of Individuals Covered	175
Insurance policy start date	2017-01-01
Insurance policy end date	2017-12-31
Total amount of commissions paid to insurance broker	USD $2,840
Total amount of fees paid to insurance company	USD $1,296
Are there contracts with allocated funds for individual policies?	0
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	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
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 $47,395
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $1,420
Amount paid for insurance broker fees	1296
Additional information about fees paid to insurance broker	OVERRIDE
Insurance broker organization code?	7
Insurance broker name	WELLS FARGO INSURANCE SER

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Company Name:	FIC RESTAURANTS, INC.
Employer identification number (EIN):	463931388
NAIC Classification:	722511
NAIC Description:	Full-Service Restaurants