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JERSEY PIZZA LLC EMPLOYER HEALTH & WELFARE PLAN 401k Plan overview

Plan NameJERSEY PIZZA LLC EMPLOYER HEALTH & WELFARE PLAN
Plan identification number 553

JERSEY PIZZA LLC EMPLOYER HEALTH & WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental

401k Sponsoring company profile

JERSEY PIZZA LLC has sponsored the creation of one or more 401k plans.

Company Name:JERSEY PIZZA LLC
Employer identification number (EIN):471666814
NAIC Classification:722511
NAIC Description:Full-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan JERSEY PIZZA LLC EMPLOYER HEALTH & WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5532016-07-01
5532015-07-01PATRICIA PITPITAN

Plan Statistics for JERSEY PIZZA LLC EMPLOYER HEALTH & WELFARE PLAN

401k plan membership statisitcs for JERSEY PIZZA LLC EMPLOYER HEALTH & WELFARE PLAN

Measure Date Value
2016: JERSEY PIZZA LLC EMPLOYER HEALTH & WELFARE PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-0110
Total number of active participants reported on line 7a of the Form 55002016-07-0110
Number of retired or separated participants receiving benefits2016-07-010
Number of other retired or separated participants entitled to future benefits2016-07-010
Total of all active and inactive participants2016-07-0110
2015: JERSEY PIZZA LLC EMPLOYER HEALTH & WELFARE PLAN 2015 401k membership
Total participants, beginning-of-year2015-07-0114
Total number of active participants reported on line 7a of the Form 55002015-07-0110
Number of retired or separated participants receiving benefits2015-07-010
Number of other retired or separated participants entitled to future benefits2015-07-010
Total of all active and inactive participants2015-07-0110

Financial Data on JERSEY PIZZA LLC EMPLOYER HEALTH & WELFARE PLAN

Measure Date Value
2019 : JERSEY PIZZA LLC EMPLOYER HEALTH & WELFARE PLAN 2019 401k financial data
Total plan liabilities at end of year2019-06-30$0
Total plan liabilities at beginning of year2019-06-30$0
Total income from all sources2019-06-30$60,304
Expenses. Total of all expenses incurred2019-06-30$60,304
Benefits paid (including direct rollovers)2019-06-30$23,530
Total plan assets at end of year2019-06-30$0
Total plan assets at beginning of year2019-06-30$0
Total contributions received or receivable from participants2019-06-30$1,598
Net income (gross income less expenses)2019-06-30$0
Net plan assets at end of year (total assets less liabilities)2019-06-30$0
Net plan assets at beginning of year (total assets less liabilities)2019-06-30$0
Total contributions received or receivable from employer(s)2019-06-30$58,706
Value of certain deemed distributions of participant loans2019-06-30$0
Value of corrective distributions2019-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2019-06-30$36,774
2017 : JERSEY PIZZA LLC EMPLOYER HEALTH & WELFARE PLAN 2017 401k financial data
Total plan liabilities at beginning of year2017-06-30$0
Total income from all sources2017-06-30$50,805
Expenses. Total of all expenses incurred2017-06-30$50,805
Benefits paid (including direct rollovers)2017-06-30$24,998
Total plan assets at beginning of year2017-06-30$0
Total contributions received or receivable from participants2017-06-30$1,351
Net income (gross income less expenses)2017-06-30$0
Net plan assets at end of year (total assets less liabilities)2017-06-30$0
Net plan assets at beginning of year (total assets less liabilities)2017-06-30$0
Total contributions received or receivable from employer(s)2017-06-30$49,454
Expenses. Administrative service providers (salaries,fees and commissions)2017-06-30$25,807
2016 : JERSEY PIZZA LLC EMPLOYER HEALTH & WELFARE PLAN 2016 401k financial data
Total plan liabilities at end of year2016-06-30$0
Total plan liabilities at beginning of year2016-06-30$0
Total income from all sources2016-06-30$11,029
Expenses. Total of all expenses incurred2016-06-30$11,029
Benefits paid (including direct rollovers)2016-06-30$213
Total plan assets at end of year2016-06-30$0
Total plan assets at beginning of year2016-06-30$0
Total contributions received or receivable from participants2016-06-30$0
Expenses. Other expenses not covered elsewhere2016-06-30$5,141
Contributions received from other sources (not participants or employers)2016-06-30$0
Other income received2016-06-30$0
Noncash contributions received2016-06-30$0
Net income (gross income less expenses)2016-06-30$0
Net plan assets at end of year (total assets less liabilities)2016-06-30$0
Net plan assets at beginning of year (total assets less liabilities)2016-06-30$0
Total contributions received or receivable from employer(s)2016-06-30$11,029
Value of certain deemed distributions of participant loans2016-06-30$0
Value of corrective distributions2016-06-30$0
Expenses. Administrative service providers (salaries,fees and commissions)2016-06-30$5,675

Form 5500 Responses for JERSEY PIZZA LLC EMPLOYER HEALTH & WELFARE PLAN

2016: JERSEY PIZZA LLC EMPLOYER HEALTH & WELFARE PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01Submission has been amendedNo
2016-07-01This submission is the final filingNo
2016-07-01This return/report is a short plan year return/report (less than 12 months)No
2016-07-01Plan is a collectively bargained planNo
2016-07-01Plan funding arrangement – InsuranceYes
2016-07-01Plan funding arrangement – TrustYes
2016-07-01Plan funding arrangement – General assets of the sponsorYes
2016-07-01Plan benefit arrangement – InsuranceYes
2016-07-01Plan benefit arrangement - TrustYes
2016-07-01Plan benefit arrangement – General assets of the sponsorYes
2015: JERSEY PIZZA LLC EMPLOYER HEALTH & WELFARE PLAN 2015 form 5500 responses
2015-07-01Type of plan entitySingle employer plan
2015-07-01First time form 5500 has been submittedYes
2015-07-01Submission has been amendedNo
2015-07-01This submission is the final filingNo
2015-07-01This return/report is a short plan year return/report (less than 12 months)No
2015-07-01Plan is a collectively bargained planNo
2015-07-01Plan funding arrangement – InsuranceYes
2015-07-01Plan funding arrangement – TrustYes
2015-07-01Plan funding arrangement – General assets of the sponsorYes
2015-07-01Plan benefit arrangement – InsuranceYes
2015-07-01Plan benefit arrangement - TrustYes
2015-07-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION (National Association of Insurance Commissioners NAIC id number: 96030 )
Policy contract numberKM05929292
Policy instance 1
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract number00
Policy instance 2

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