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| Plan Name | XPERIENCE MANAGEMENT GROUP LLC MEDICAL PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | XPERIENCE MANAGEMENT GROUP LLC |
| Employer identification number (EIN): | 471335785 |
| NAIC Classification: | 713900 |
Additional information about XPERIENCE MANAGEMENT GROUP LLC
| Jurisdiction of Incorporation: | Nevada Department of State |
| Incorporation Date: | 2013-09-18 |
| Company Identification Number: | 20131552807 |
| Legal Registered Office Address: |
2005 CEDAR HILLS ST LAS VEGAS United States of America (USA) 89128 |
More information about XPERIENCE MANAGEMENT GROUP LLC
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2019-11-01 | ||||
| 501 | 2018-11-01 | ||||
| 501 | 2017-11-01 | ||||
| 501 | 2016-11-01 | DENA BARTON | DENA BARTON | 2018-07-09 |
| Measure | Date | Value |
|---|---|---|
| 2019: XPERIENCE MANAGEMENT GROUP LLC MEDICAL PLAN 2019 401k membership | ||
| Total participants, beginning-of-year | 2019-11-01 | 84 |
| Total number of active participants reported on line 7a of the Form 5500 | 2019-11-01 | 51 |
| Number of retired or separated participants receiving benefits | 2019-11-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2019-11-01 | 0 |
| Total of all active and inactive participants | 2019-11-01 | 51 |
| 2018: XPERIENCE MANAGEMENT GROUP LLC MEDICAL PLAN 2018 401k membership | ||
| Total participants, beginning-of-year | 2018-11-01 | 91 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-11-01 | 84 |
| Total of all active and inactive participants | 2018-11-01 | 84 |
| 2017: XPERIENCE MANAGEMENT GROUP LLC MEDICAL PLAN 2017 401k membership | ||
| Total participants, beginning-of-year | 2017-11-01 | 101 |
| Total number of active participants reported on line 7a of the Form 5500 | 2017-11-01 | 91 |
| Number of retired or separated participants receiving benefits | 2017-11-01 | 1 |
| Number of other retired or separated participants entitled to future benefits | 2017-11-01 | 0 |
| Total of all active and inactive participants | 2017-11-01 | 92 |
| Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2017-11-01 | 0 |
| 2016: XPERIENCE MANAGEMENT GROUP LLC MEDICAL PLAN 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-11-01 | 103 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-11-01 | 99 |
| Number of retired or separated participants receiving benefits | 2016-11-01 | 3 |
| Total of all active and inactive participants | 2016-11-01 | 102 |
| 2019: XPERIENCE MANAGEMENT GROUP LLC MEDICAL PLAN 2019 form 5500 responses | ||
|---|---|---|
| 2019-11-01 | Type of plan entity | Single employer plan |
| 2019-11-01 | Submission has been amended | No |
| 2019-11-01 | This submission is the final filing | No |
| 2019-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2019-11-01 | Plan is a collectively bargained plan | No |
| 2019-11-01 | Plan funding arrangement – Insurance | Yes |
| 2019-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: XPERIENCE MANAGEMENT GROUP LLC MEDICAL PLAN 2018 form 5500 responses | ||
| 2018-11-01 | Type of plan entity | Single employer plan |
| 2018-11-01 | Submission has been amended | No |
| 2018-11-01 | This submission is the final filing | No |
| 2018-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-11-01 | Plan is a collectively bargained plan | No |
| 2018-11-01 | Plan funding arrangement – Insurance | Yes |
| 2018-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2017: XPERIENCE MANAGEMENT GROUP LLC MEDICAL PLAN 2017 form 5500 responses | ||
| 2017-11-01 | Type of plan entity | Single employer plan |
| 2017-11-01 | Submission has been amended | No |
| 2017-11-01 | This submission is the final filing | No |
| 2017-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2017-11-01 | Plan is a collectively bargained plan | No |
| 2017-11-01 | Plan funding arrangement – Insurance | Yes |
| 2017-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2016: XPERIENCE MANAGEMENT GROUP LLC MEDICAL PLAN 2016 form 5500 responses | ||
| 2016-11-01 | Type of plan entity | Single employer plan |
| 2016-11-01 | First time form 5500 has been submitted | Yes |
| 2016-11-01 | Submission has been amended | No |
| 2016-11-01 | This submission is the final filing | No |
| 2016-11-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-11-01 | Plan is a collectively bargained plan | No |
| 2016-11-01 | Plan funding arrangement – Insurance | Yes |
| 2016-11-01 | Plan benefit arrangement – Insurance | Yes |
| HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 95342 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 774304 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 95342 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 774304 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||
| HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE CO. (National Association of Insurance Commissioners NAIC id number: 95342 ) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy contract number | 774304 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
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