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DAVIDSON & JONES HOTEL CORPORATION GROUP INSURANCE 401k Plan overview

Plan NameDAVIDSON & JONES HOTEL CORPORATION GROUP INSURANCE
Plan identification number 501

DAVIDSON & JONES HOTEL CORPORATION GROUP INSURANCE Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Temporary disability (accident and sickness)
  • Long-term disability cover
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

DAVIDSON & JONES HOTEL CORPORATION has sponsored the creation of one or more 401k plans.

Company Name:DAVIDSON & JONES HOTEL CORPORATION
Employer identification number (EIN):561349573
NAIC Classification:721110
NAIC Description:Hotels (except Casino Hotels) and Motels

Form 5500 Filing Information

Submission information for form 5500 for 401k plan DAVIDSON & JONES HOTEL CORPORATION GROUP INSURANCE

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012016-01-01
5012015-01-01
5012014-01-01
5012013-01-01
5012012-01-01JAY A MAHAN
5012011-01-01JAY A MAHAN
5012009-01-01JAY A. MAHAN

Plan Statistics for DAVIDSON & JONES HOTEL CORPORATION GROUP INSURANCE

401k plan membership statisitcs for DAVIDSON & JONES HOTEL CORPORATION GROUP INSURANCE

Measure Date Value
2016: DAVIDSON & JONES HOTEL CORPORATION GROUP INSURANCE 2016 401k membership
Total participants, beginning-of-year2016-01-0152
Total number of active participants reported on line 7a of the Form 55002016-01-0153
Total of all active and inactive participants2016-01-0153
2015: DAVIDSON & JONES HOTEL CORPORATION GROUP INSURANCE 2015 401k membership
Total participants, beginning-of-year2015-01-01167
Total number of active participants reported on line 7a of the Form 55002015-01-0152
Total of all active and inactive participants2015-01-0152
2014: DAVIDSON & JONES HOTEL CORPORATION GROUP INSURANCE 2014 401k membership
Total participants, beginning-of-year2014-01-01131
Total number of active participants reported on line 7a of the Form 55002014-01-01167
Total of all active and inactive participants2014-01-01167
2013: DAVIDSON & JONES HOTEL CORPORATION GROUP INSURANCE 2013 401k membership
Total participants, beginning-of-year2013-01-01128
Total number of active participants reported on line 7a of the Form 55002013-01-01131
Total of all active and inactive participants2013-01-01131
2012: DAVIDSON & JONES HOTEL CORPORATION GROUP INSURANCE 2012 401k membership
Total participants, beginning-of-year2012-01-01145
Total number of active participants reported on line 7a of the Form 55002012-01-01128
Total of all active and inactive participants2012-01-01128
2011: DAVIDSON & JONES HOTEL CORPORATION GROUP INSURANCE 2011 401k membership
Total participants, beginning-of-year2011-01-01145
Total number of active participants reported on line 7a of the Form 55002011-01-01145
Total of all active and inactive participants2011-01-01145
2009: DAVIDSON & JONES HOTEL CORPORATION GROUP INSURANCE 2009 401k membership
Total participants, beginning-of-year2009-01-01144
Total number of active participants reported on line 7a of the Form 55002009-01-01140
Total of all active and inactive participants2009-01-01140
Number of employers contributing to the scheme2009-01-017

Form 5500 Responses for DAVIDSON & JONES HOTEL CORPORATION GROUP INSURANCE

2016: DAVIDSON & JONES HOTEL CORPORATION GROUP INSURANCE 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: DAVIDSON & JONES HOTEL CORPORATION GROUP INSURANCE 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: DAVIDSON & JONES HOTEL CORPORATION GROUP INSURANCE 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: DAVIDSON & JONES HOTEL CORPORATION GROUP INSURANCE 2013 form 5500 responses
2013-01-01Type of plan entitySingle employer plan
2013-01-01Plan funding arrangement – InsuranceYes
2013-01-01Plan funding arrangement – General assets of the sponsorYes
2013-01-01Plan benefit arrangement – InsuranceYes
2013-01-01Plan benefit arrangement – General assets of the sponsorYes
2012: DAVIDSON & JONES HOTEL CORPORATION GROUP INSURANCE 2012 form 5500 responses
2012-01-01Type of plan entitySingle employer plan
2012-01-01Plan funding arrangement – InsuranceYes
2012-01-01Plan funding arrangement – General assets of the sponsorYes
2012-01-01Plan benefit arrangement – InsuranceYes
2012-01-01Plan benefit arrangement – General assets of the sponsorYes
2011: DAVIDSON & JONES HOTEL CORPORATION GROUP INSURANCE 2011 form 5500 responses
2011-01-01Type of plan entitySingle employer plan
2011-01-01Plan funding arrangement – InsuranceYes
2011-01-01Plan funding arrangement – General assets of the sponsorYes
2011-01-01Plan benefit arrangement – InsuranceYes
2011-01-01Plan benefit arrangement – General assets of the sponsorYes
2009: DAVIDSON & JONES HOTEL CORPORATION GROUP INSURANCE 2009 form 5500 responses
2009-01-01Type of plan entityMulti-employer plan
2009-01-01This submission is the final filingNo
2009-01-01Plan is a collectively bargained planYes
2009-01-01Plan funding arrangement – InsuranceYes
2009-01-01Plan funding arrangement – General assets of the sponsorYes
2009-01-01Plan benefit arrangement – InsuranceYes
2009-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number695669G
Policy instance 1
Insurance contract or identification number695669G
Number of Individuals Covered50
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $4,175
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $27,834
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,175
Insurance broker organization code?3
Insurance broker nameHCW EMPLOYEE BENEFIT SVS
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95343 )
Policy contract number0492425HNO
Policy instance 3
Insurance contract or identification number0492425HNO
Number of Individuals Covered44
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Welfare Benefit Premiums Paid to CarrierUSD $271,783
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )
Policy contract number21896
Policy instance 2
Insurance contract or identification number21896
Number of Individuals Covered52
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
Total amount of commissions paid to insurance brokerUSD $3,048
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $30,475
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,048
Insurance broker organization code?3
Insurance broker nameHCW EMPLOYEE BENEFIT SERVICES
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number695669G
Policy instance 1
Insurance contract or identification number695669G
Number of Individuals Covered167
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $6,125
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $40,833
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,127
Insurance broker organization code?3
Insurance broker nameJAMES A SCOTT & SON INC
BLUECROSS BLUESHIELD OF NORTH CAROLINA (National Association of Insurance Commissioners NAIC id number: 54631 )
Policy contract number21896
Policy instance 2
Insurance contract or identification number21896
Number of Individuals Covered56
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $2,911
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $29,114
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,911
Insurance broker organization code?3
Insurance broker name
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95343 )
Policy contract number492425
Policy instance 3
Insurance contract or identification number492425
Number of Individuals Covered45
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
Total amount of commissions paid to insurance brokerUSD $262
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $226,082
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $262
Insurance broker organization code?3
Insurance broker nameHCW EMPLOYEE BENEFIT SERVICES
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number695669G
Policy instance 1
Insurance contract or identification number695669G
Number of Individuals Covered131
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $6,203
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $41,345
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,768
Insurance broker organization code?3
Insurance broker nameHCW EMPLOYEE BENEFIT SVS
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number492425
Policy instance 2
Insurance contract or identification number492425
Number of Individuals Covered87
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $2,217
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $34,933
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,566
Insurance broker organization code?3
Insurance broker nameHCW EMPLOYEE BENEFIT SERVICES
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95343 )
Policy contract numberUS438107
Policy instance 3
Insurance contract or identification numberUS438107
Number of Individuals Covered86
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $243,721
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number695669G
Policy instance 1
Insurance contract or identification number695669G
Number of Individuals Covered128
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $6,649
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $48,191
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,649
Insurance broker organization code?3
Insurance broker nameJAMES A SCOTT & SON INC
AETNA HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95343 )
Policy contract numberUS438107
Policy instance 3
Insurance contract or identification numberUS438107
Number of Individuals Covered114
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Welfare Benefit Premiums Paid to CarrierUSD $253,301
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number492425
Policy instance 2
Insurance contract or identification number492425
Number of Individuals Covered108
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
Total amount of commissions paid to insurance brokerUSD $2,404
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $37,605
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,404
Insurance broker organization code?3
Insurance broker nameJAMES A SCOTT & SON INC
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number695669G
Policy instance 1
Insurance contract or identification number695669G
Number of Individuals Covered145
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $6,921
Total amount of fees paid to insurance companyUSD $228
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $42,263
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number492425
Policy instance 2
Insurance contract or identification number492425
Number of Individuals Covered111
Insurance policy start date2010-03-01
Insurance policy end date2011-02-28
Total amount of commissions paid to insurance brokerUSD $18,471
Total amount of fees paid to insurance companyUSD $256
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $362,372
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number492425-SHORT
Policy instance 3
Insurance contract or identification number492425-SHORT
Number of Individuals Covered109
Insurance policy start date2011-03-01
Insurance policy end date2011-04-30
Total amount of commissions paid to insurance brokerUSD $2,942
Total amount of fees paid to insurance companyUSD $22
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $56,855
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70815 )
Policy contract number695669G
Policy instance 1
Insurance contract or identification number695669G
Number of Individuals Covered145
Insurance policy start date2009-05-01
Insurance policy end date2010-04-30
Total amount of commissions paid to insurance brokerUSD $6,673
Total amount of fees paid to insurance companyUSD $266
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $44,483
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,673
Insurance broker organization code?3
Amount paid for insurance broker fees266
Additional information about fees paid to insurance brokerINCENTIVE COMPENSATION
Insurance broker nameWILLIS OF VIRGINIA INC
UNION SECURITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 70408 )
Policy contract number004I01600
Policy instance 2
Insurance contract or identification number004I01600
Number of Individuals Covered61
Insurance policy start date2009-03-01
Insurance policy end date2010-02-28
Total amount of commissions paid to insurance brokerUSD $3,827
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Dental Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $38,273
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,308
Insurance broker organization code?3
Insurance broker nameJAMES A SCOTT & SON INC
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number492425-ERG
Policy instance 3
Insurance contract or identification number492425-ERG
Number of Individuals Covered77
Insurance policy start date2009-03-01
Insurance policy end date2010-02-28
Total amount of commissions paid to insurance brokerUSD $18,188
Total amount of fees paid to insurance companyUSD $0
Contract purchased, in whole or in part, to distribute benefits from a terminating planNo
Contracts With Unallocated Funds Deposit Administration0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $349,745
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $18,188
Insurance broker organization code?3
Insurance broker nameJAMES A SCOTT & SON INC

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