401k Plan data: ROYALE BLUE HOSPITALITY plan

ROYALE BLUE HOSPITALITY 401k Plan overview

Plan Name	ROYALE BLUE HOSPITALITY
Plan identification number	501

ROYALE BLUE HOSPITALITY Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision)

401k Sponsoring company profile

ROYALE BLUE HOSPITALITY, LLC. has sponsored the creation of one or more 401k plans.

Company Name: ROYALE BLUE HOSPITALITY, LLC.

Employer identification number (EIN): 660926746

NAIC Classification: 721110
NAIC Description: Hotels (except Casino Hotels) and Motels

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ROYALE BLUE HOSPITALITY

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2022-06-01
501 2021-06-01

Plan Statistics for ROYALE BLUE HOSPITALITY

401k plan membership statisitcs for ROYALE BLUE HOSPITALITY

Measure Date Value
2022: ROYALE BLUE HOSPITALITY 2022 401k membership
Total participants, beginning-of-year 2022-06-01 267
Total number of active participants reported on line 7a of the Form 5500 2022-06-01 297
Total of all active and inactive participants 2022-06-01 297
Total participants 2022-06-01 297
2021: ROYALE BLUE HOSPITALITY 2021 401k membership
Total participants, beginning-of-year 2021-06-01 110
Total number of active participants reported on line 7a of the Form 5500 2021-06-01 257
Total of all active and inactive participants 2021-06-01 257
Total participants 2021-06-01 257

Measure	Date	Value
2022: ROYALE BLUE HOSPITALITY 2022 401k membership
Total participants, beginning-of-year	2022-06-01	267
Total number of active participants reported on line 7a of the Form 5500	2022-06-01	297
Total of all active and inactive participants	2022-06-01	297
Total participants	2022-06-01	297
2021: ROYALE BLUE HOSPITALITY 2021 401k membership
Total participants, beginning-of-year	2021-06-01	110
Total number of active participants reported on line 7a of the Form 5500	2021-06-01	257
Total of all active and inactive participants	2021-06-01	257
Total participants	2021-06-01	257

Form 5500 Responses for ROYALE BLUE HOSPITALITY

2022: ROYALE BLUE HOSPITALITY 2022 form 5500 responses
2022-06-01	Type of plan entity	Single employer plan
2022-06-01	Submission has been amended	No
2022-06-01	This submission is the final filing	No
2022-06-01	This return/report is a short plan year return/report (less than 12 months)	No
2022-06-01	Plan is a collectively bargained plan	No
2022-06-01	Plan funding arrangement – Insurance	Yes
2022-06-01	Plan benefit arrangement – Insurance	Yes
2021: ROYALE BLUE HOSPITALITY 2021 form 5500 responses
2021-06-01	Type of plan entity	Single employer plan
2021-06-01	Submission has been amended	No
2021-06-01	This submission is the final filing	No
2021-06-01	This return/report is a short plan year return/report (less than 12 months)	No
2021-06-01	Plan is a collectively bargained plan	No
2021-06-01	Plan funding arrangement – Insurance	Yes
2021-06-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

HUMANA INSURANCE OF PUERTO RICO (National Association of Insurance Commissioners NAIC id number: 84603 )

Policy contract number

306680

Policy instance

Insurance contract or identification number	306680
Number of Individuals Covered	297
Insurance policy start date	2022-06-01
Insurance policy end date	2022-05-31
Total amount of commissions paid to insurance broker	USD $51,605
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	51605
Additional information about fees paid to insurance broker	BROKER

HUMANA INSURANCE OF PUERTO RICO (National Association of Insurance Commissioners NAIC id number: 84603 )

Policy contract number

306680

Policy instance

Insurance contract or identification number	306680
Number of Individuals Covered	257
Insurance policy start date	2021-06-01
Insurance policy end date	2022-05-31
Total amount of commissions paid to insurance broker	USD $38,094
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	Yes
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	38094
Additional information about fees paid to insurance broker	BROKER

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Company Name:	ROYALE BLUE HOSPITALITY, LLC.
Employer identification number (EIN):	660926746
NAIC Classification:	721110
NAIC Description:	Hotels (except Casino Hotels) and Motels