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TIJUANA FLATS RESTAURANTS, LLC VOLUNTARY LIFE AND ACCIDENTAL DEATH PLAN 401k Plan overview

Plan NameTIJUANA FLATS RESTAURANTS, LLC VOLUNTARY LIFE AND ACCIDENTAL DEATH PLAN
Plan identification number 506

TIJUANA FLATS RESTAURANTS, LLC VOLUNTARY LIFE AND ACCIDENTAL DEATH PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Death benefits (include travel accident but not life insurance)
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

TIJUANA FLATS RESTAURANTS, LLC has sponsored the creation of one or more 401k plans.

Company Name:TIJUANA FLATS RESTAURANTS, LLC
Employer identification number (EIN):474472442
NAIC Classification:722300
NAIC Description: Special Food Services

Additional information about TIJUANA FLATS RESTAURANTS, LLC

Jurisdiction of Incorporation: Florida Department of State Division of Corporations
Incorporation Date: 2015-07-01
Company Identification Number: L15000114299
Legal Registered Office Address: 2300 MAITLAND CENTER PKWY

MAITLAND

32751

More information about TIJUANA FLATS RESTAURANTS, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan TIJUANA FLATS RESTAURANTS, LLC VOLUNTARY LIFE AND ACCIDENTAL DEATH PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5062021-07-01CHRISTINE FIELDS2023-01-25
5062020-07-01CHRISTINE FIELDS2021-11-23
5062019-07-01CHRISTINE FIELDS2021-01-20
5062018-07-01CHRISTINE FIELDS2020-01-10
5062017-07-01
5062016-07-01

Plan Statistics for TIJUANA FLATS RESTAURANTS, LLC VOLUNTARY LIFE AND ACCIDENTAL DEATH PLAN

401k plan membership statisitcs for TIJUANA FLATS RESTAURANTS, LLC VOLUNTARY LIFE AND ACCIDENTAL DEATH PLAN

Measure Date Value
2021: TIJUANA FLATS RESTAURANTS, LLC VOLUNTARY LIFE AND ACCIDENTAL DEATH PLAN 2021 401k membership
Total participants, beginning-of-year2021-07-01113
Total number of active participants reported on line 7a of the Form 55002021-07-0178
Number of retired or separated participants receiving benefits2021-07-010
Number of other retired or separated participants entitled to future benefits2021-07-010
Total of all active and inactive participants2021-07-0178
Number of employers contributing to the scheme2021-07-010
2020: TIJUANA FLATS RESTAURANTS, LLC VOLUNTARY LIFE AND ACCIDENTAL DEATH PLAN 2020 401k membership
Total participants, beginning-of-year2020-07-01126
Total number of active participants reported on line 7a of the Form 55002020-07-01113
Number of retired or separated participants receiving benefits2020-07-010
Number of other retired or separated participants entitled to future benefits2020-07-010
Total of all active and inactive participants2020-07-01113
Number of employers contributing to the scheme2020-07-010
2019: TIJUANA FLATS RESTAURANTS, LLC VOLUNTARY LIFE AND ACCIDENTAL DEATH PLAN 2019 401k membership
Total participants, beginning-of-year2019-07-01434
Total number of active participants reported on line 7a of the Form 55002019-07-01331
Number of retired or separated participants receiving benefits2019-07-011
Number of other retired or separated participants entitled to future benefits2019-07-010
Total of all active and inactive participants2019-07-01332
Number of employers contributing to the scheme2019-07-010
2018: TIJUANA FLATS RESTAURANTS, LLC VOLUNTARY LIFE AND ACCIDENTAL DEATH PLAN 2018 401k membership
Total participants, beginning-of-year2018-07-01423
Total number of active participants reported on line 7a of the Form 55002018-07-01432
Number of retired or separated participants receiving benefits2018-07-013
Number of other retired or separated participants entitled to future benefits2018-07-010
Total of all active and inactive participants2018-07-01435
Number of employers contributing to the scheme2018-07-010
2017: TIJUANA FLATS RESTAURANTS, LLC VOLUNTARY LIFE AND ACCIDENTAL DEATH PLAN 2017 401k membership
Total participants, beginning-of-year2017-07-01141
Total number of active participants reported on line 7a of the Form 55002017-07-01116
Number of retired or separated participants receiving benefits2017-07-010
Number of other retired or separated participants entitled to future benefits2017-07-010
Total of all active and inactive participants2017-07-01116
2016: TIJUANA FLATS RESTAURANTS, LLC VOLUNTARY LIFE AND ACCIDENTAL DEATH PLAN 2016 401k membership
Total participants, beginning-of-year2016-07-01114
Total number of active participants reported on line 7a of the Form 55002016-07-01121
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 participants2016-07-01121

Form 5500 Responses for TIJUANA FLATS RESTAURANTS, LLC VOLUNTARY LIFE AND ACCIDENTAL DEATH PLAN

2021: TIJUANA FLATS RESTAURANTS, LLC VOLUNTARY LIFE AND ACCIDENTAL DEATH PLAN 2021 form 5500 responses
2021-07-01Type of plan entitySingle employer plan
2021-07-01Plan funding arrangement – InsuranceYes
2021-07-01Plan benefit arrangement – InsuranceYes
2020: TIJUANA FLATS RESTAURANTS, LLC VOLUNTARY LIFE AND ACCIDENTAL DEATH PLAN 2020 form 5500 responses
2020-07-01Type of plan entitySingle employer plan
2020-07-01Plan funding arrangement – InsuranceYes
2020-07-01Plan benefit arrangement – InsuranceYes
2019: TIJUANA FLATS RESTAURANTS, LLC VOLUNTARY LIFE AND ACCIDENTAL DEATH PLAN 2019 form 5500 responses
2019-07-01Type of plan entitySingle employer plan
2019-07-01Plan funding arrangement – InsuranceYes
2019-07-01Plan benefit arrangement – InsuranceYes
2018: TIJUANA FLATS RESTAURANTS, LLC VOLUNTARY LIFE AND ACCIDENTAL DEATH PLAN 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan benefit arrangement – InsuranceYes
2017: TIJUANA FLATS RESTAURANTS, LLC VOLUNTARY LIFE AND ACCIDENTAL DEATH PLAN 2017 form 5500 responses
2017-07-01Type of plan entitySingle employer plan
2017-07-01Plan funding arrangement – InsuranceYes
2017-07-01Plan benefit arrangement – InsuranceYes
2016: TIJUANA FLATS RESTAURANTS, LLC VOLUNTARY LIFE AND ACCIDENTAL DEATH PLAN 2016 form 5500 responses
2016-07-01Type of plan entitySingle employer plan
2016-07-01First time form 5500 has been submittedYes
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 benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0ASV2
Policy instance 1
Insurance contract or identification numberGVTL0ASV2
Number of Individuals Covered79
Insurance policy start date2021-07-01
Insurance policy end date2022-06-30
Total amount of commissions paid to insurance brokerUSD $3,710
Total amount of fees paid to insurance companyUSD $1,498
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $24,759
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,710
Amount paid for insurance broker fees1498
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0ASV2
Policy instance 1
Insurance contract or identification numberGVTL0ASV2
Number of Individuals Covered80
Insurance policy start date2020-07-01
Insurance policy end date2021-06-30
Total amount of commissions paid to insurance brokerUSD $2,501
Total amount of fees paid to insurance companyUSD $1,128
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $16,671
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,501
Amount paid for insurance broker fees1128
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0ASV2
Policy instance 1
Insurance contract or identification numberGVTL0ASV2
Number of Individuals Covered73
Insurance policy start date2019-07-01
Insurance policy end date2020-06-30
Total amount of commissions paid to insurance brokerUSD $2,239
Total amount of fees paid to insurance companyUSD $1,005
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $14,926
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,239
Amount paid for insurance broker fees1005
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0ASV2
Policy instance 1
Insurance contract or identification numberGVTL0ASV2
Number of Individuals Covered97
Insurance policy start date2018-07-01
Insurance policy end date2019-06-30
Total amount of commissions paid to insurance brokerUSD $2,342
Total amount of fees paid to insurance companyUSD $1,346
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $15,613
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,342
Amount paid for insurance broker fees1346
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )
Policy contract numberGVTL0ASV2
Policy instance 1
Insurance contract or identification numberGVTL0ASV2
Number of Individuals Covered104
Insurance policy start date2017-07-01
Insurance policy end date2018-06-30
Total amount of commissions paid to insurance brokerUSD $3,005
Total amount of fees paid to insurance companyUSD $1,182
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $20,032
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,005
Amount paid for insurance broker fees1182
Additional information about fees paid to insurance brokerOTHER COMPENSATION
Insurance broker organization code?3
Insurance broker nameDIGITAL INSURANCE, INC.

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