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BROADWAY RESTAURANT GROUP BENEFITS 401k Plan overview

Plan NameBROADWAY RESTAURANT GROUP BENEFITS
Plan identification number 501

BROADWAY RESTAURANT GROUP BENEFITS Benefits

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

BROADWAY RESTAURANT GROUP LLC has sponsored the creation of one or more 401k plans.

Company Name:BROADWAY RESTAURANT GROUP LLC
Employer identification number (EIN):611804629
NAIC Classification:722511
NAIC Description:Full-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BROADWAY RESTAURANT GROUP BENEFITS

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-05-01MELISSA HAMAN2024-10-09
5012022-05-01MELISSA HAMAN2023-11-29
5012021-05-01MELISSA HAMAN2022-10-21
5012020-05-01MELISSA HAMAN2022-10-21

Plan Statistics for BROADWAY RESTAURANT GROUP BENEFITS

401k plan membership statisitcs for BROADWAY RESTAURANT GROUP BENEFITS

Measure Date Value
2023: BROADWAY RESTAURANT GROUP BENEFITS 2023 401k membership
Total participants, beginning-of-year2023-05-01154
Total number of active participants reported on line 7a of the Form 55002023-05-0188
Number of retired or separated participants receiving benefits2023-05-010
Number of other retired or separated participants entitled to future benefits2023-05-010
Total of all active and inactive participants2023-05-0188
Number of employers contributing to the scheme2023-05-010
2022: BROADWAY RESTAURANT GROUP BENEFITS 2022 401k membership
Total participants, beginning-of-year2022-05-01202
Total number of active participants reported on line 7a of the Form 55002022-05-01154
Number of retired or separated participants receiving benefits2022-05-010
Number of other retired or separated participants entitled to future benefits2022-05-010
Total of all active and inactive participants2022-05-01154
Number of employers contributing to the scheme2022-05-010
2021: BROADWAY RESTAURANT GROUP BENEFITS 2021 401k membership
Total participants, beginning-of-year2021-05-01217
Total number of active participants reported on line 7a of the Form 55002021-05-01222
Number of retired or separated participants receiving benefits2021-05-010
Number of other retired or separated participants entitled to future benefits2021-05-010
Total of all active and inactive participants2021-05-01222
Number of employers contributing to the scheme2021-05-010
2020: BROADWAY RESTAURANT GROUP BENEFITS 2020 401k membership
Total participants, beginning-of-year2020-05-01220
Total number of active participants reported on line 7a of the Form 55002020-05-01217
Number of retired or separated participants receiving benefits2020-05-010
Number of other retired or separated participants entitled to future benefits2020-05-010
Total of all active and inactive participants2020-05-01217
Number of employers contributing to the scheme2020-05-010

Form 5500 Responses for BROADWAY RESTAURANT GROUP BENEFITS

2023: BROADWAY RESTAURANT GROUP BENEFITS 2023 form 5500 responses
2023-05-01Type of plan entitySingle employer plan
2023-05-01Plan funding arrangement – InsuranceYes
2023-05-01Plan funding arrangement – General assets of the sponsorYes
2023-05-01Plan benefit arrangement – InsuranceYes
2023-05-01Plan benefit arrangement – General assets of the sponsorYes
2022: BROADWAY RESTAURANT GROUP BENEFITS 2022 form 5500 responses
2022-05-01Type of plan entitySingle employer plan
2022-05-01Plan funding arrangement – InsuranceYes
2022-05-01Plan funding arrangement – General assets of the sponsorYes
2022-05-01Plan benefit arrangement – InsuranceYes
2022-05-01Plan benefit arrangement – General assets of the sponsorYes
2021: BROADWAY RESTAURANT GROUP BENEFITS 2021 form 5500 responses
2021-05-01Type of plan entitySingle employer plan
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan funding arrangement – General assets of the sponsorYes
2021-05-01Plan benefit arrangement – InsuranceYes
2021-05-01Plan benefit arrangement – General assets of the sponsorYes
2020: BROADWAY RESTAURANT GROUP BENEFITS 2020 form 5500 responses
2020-05-01Type of plan entitySingle employer plan
2020-05-01Plan funding arrangement – InsuranceYes
2020-05-01Plan funding arrangement – General assets of the sponsorYes
2020-05-01Plan benefit arrangement – InsuranceYes
2020-05-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

HEALTHY ALLIANCE LIFE INSURANCE COMPANY (G0262) (National Association of Insurance Commissioners NAIC id number: 78972 )
Policy contract numberMO2123
Policy instance 1
Insurance contract or identification numberMO2123
Number of Individuals Covered154
Insurance policy start date2023-05-01
Insurance policy end date2024-04-30
Total amount of commissions paid to insurance brokerUSD $6,221
Total amount of fees paid to insurance companyUSD $0
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $50,688
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberMO2123
Policy instance 2
Insurance contract or identification numberMO2123
Number of Individuals Covered71
Insurance policy start date2023-05-01
Insurance policy end date2024-04-30
Total amount of commissions paid to insurance brokerUSD $2,193
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to CarrierUSD $17,869
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
GRAVIE, INC (National Association of Insurance Commissioners NAIC id number: 52429 )
Policy contract numberXBSKQ
Policy instance 3
Insurance contract or identification numberXBSKQ
Number of Individuals Covered56
Insurance policy start date2023-05-01
Insurance policy end date2024-04-30
Total amount of commissions paid to insurance brokerUSD $16,386
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $630,837
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
HEALTHY ALLIANCE LIFE INSURANCE COMPANY (G0262) (National Association of Insurance Commissioners NAIC id number: 78972 )
Policy contract numberMO2123
Policy instance 1
Insurance contract or identification numberMO2123
Number of Individuals Covered243
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $26,984
Total amount of fees paid to insurance companyUSD $941
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $644,238
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $27,112
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerFEES
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberMO2123
Policy instance 2
Insurance contract or identification numberMO2123
Number of Individuals Covered61
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $1,582
Total amount of fees paid to insurance companyUSD $55
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $37,775
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,590
Amount paid for insurance broker fees0
Insurance broker organization code?3
Additional information about fees paid to insurance brokerFEES
HEALTHY ALLIANCE LIFE INSURANCE COMPANY (G0262) (National Association of Insurance Commissioners NAIC id number: 78972 )
Policy contract numberMO2123
Policy instance 1
Insurance contract or identification numberMO2123
Number of Individuals Covered229
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $28,494
Total amount of fees paid to insurance companyUSD $648
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $691,111
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $26,144
Amount paid for insurance broker fees648
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberMO2123
Policy instance 2
Insurance contract or identification numberMO2123
Number of Individuals Covered217
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
Total amount of commissions paid to insurance brokerUSD $1,447
Total amount of fees paid to insurance companyUSD $33
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $35,107
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,328
Amount paid for insurance broker fees33
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
HEALTHY ALLIANCE LIFE INSURANCE COMPANY (G0262) (National Association of Insurance Commissioners NAIC id number: 78972 )
Policy contract numberMO2123
Policy instance 1
Insurance contract or identification numberMO2123
Number of Individuals Covered233
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $34,505
Total amount of fees paid to insurance companyUSD $1,697
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $910,888
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $34,505
Amount paid for insurance broker fees1697
Insurance broker organization code?3
ANTHEM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 61069 )
Policy contract numberMO2123
Policy instance 2
Insurance contract or identification numberMO2123
Number of Individuals Covered220
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $1,772
Total amount of fees paid to insurance companyUSD $87
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $46,783
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,772
Amount paid for insurance broker fees87
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3

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