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FIRED UP, INC. WORK RELATED INJURY BENEFIT PLAN 401k Plan overview

Plan NameFIRED UP, INC. WORK RELATED INJURY BENEFIT PLAN
Plan identification number 502

FIRED UP, INC. WORK RELATED INJURY BENEFIT PLAN Benefits

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

401k Sponsoring company profile

FIRED UP, INC. has sponsored the creation of one or more 401k plans.

Company Name:FIRED UP, INC.
Employer identification number (EIN):742837719
NAIC Classification:722511
NAIC Description:Full-Service Restaurants

Additional information about FIRED UP, INC.

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 3146474

More information about FIRED UP, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FIRED UP, INC. WORK RELATED INJURY BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022015-06-01VICI LACY
5022014-06-01VICI LACY
5022013-06-01VICI LACY
5022012-06-01RACHAEL SMITH
5022011-06-01RACHAEL SMITH
5022009-06-01RACHAEL SMITH

Plan Statistics for FIRED UP, INC. WORK RELATED INJURY BENEFIT PLAN

401k plan membership statisitcs for FIRED UP, INC. WORK RELATED INJURY BENEFIT PLAN

Measure Date Value
2015: FIRED UP, INC. WORK RELATED INJURY BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-06-011,834
Total number of active participants reported on line 7a of the Form 55002015-06-011,379
Number of retired or separated participants receiving benefits2015-06-010
Number of other retired or separated participants entitled to future benefits2015-06-010
Total of all active and inactive participants2015-06-011,379
2014: FIRED UP, INC. WORK RELATED INJURY BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-06-011,924
Total number of active participants reported on line 7a of the Form 55002014-06-011,830
Number of retired or separated participants receiving benefits2014-06-010
Number of other retired or separated participants entitled to future benefits2014-06-010
Total of all active and inactive participants2014-06-011,830
2013: FIRED UP, INC. WORK RELATED INJURY BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-06-012,645
Total number of active participants reported on line 7a of the Form 55002013-06-011,924
Number of retired or separated participants receiving benefits2013-06-010
Number of other retired or separated participants entitled to future benefits2013-06-010
Total of all active and inactive participants2013-06-011,924
2012: FIRED UP, INC. WORK RELATED INJURY BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-06-012,719
Total number of active participants reported on line 7a of the Form 55002012-06-013,100
Number of retired or separated participants receiving benefits2012-06-010
Number of other retired or separated participants entitled to future benefits2012-06-010
Total of all active and inactive participants2012-06-013,100
2011: FIRED UP, INC. WORK RELATED INJURY BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-06-012,585
Total number of active participants reported on line 7a of the Form 55002011-06-012,719
Number of retired or separated participants receiving benefits2011-06-010
Number of other retired or separated participants entitled to future benefits2011-06-010
Total of all active and inactive participants2011-06-012,719
2009: FIRED UP, INC. WORK RELATED INJURY BENEFIT PLAN 2009 401k membership
Total participants, beginning-of-year2009-06-013,400
Total number of active participants reported on line 7a of the Form 55002009-06-012,617
Number of retired or separated participants receiving benefits2009-06-010
Number of other retired or separated participants entitled to future benefits2009-06-010
Total of all active and inactive participants2009-06-012,617

Form 5500 Responses for FIRED UP, INC. WORK RELATED INJURY BENEFIT PLAN

2015: FIRED UP, INC. WORK RELATED INJURY BENEFIT PLAN 2015 form 5500 responses
2015-06-01Type of plan entitySingle employer plan
2015-06-01Submission has been amendedNo
2015-06-01This submission is the final filingNo
2015-06-01This return/report is a short plan year return/report (less than 12 months)No
2015-06-01Plan is a collectively bargained planNo
2015-06-01Plan funding arrangement – InsuranceYes
2015-06-01Plan funding arrangement – General assets of the sponsorYes
2015-06-01Plan benefit arrangement – InsuranceYes
2015-06-01Plan benefit arrangement – General assets of the sponsorYes
2014: FIRED UP, INC. WORK RELATED INJURY BENEFIT PLAN 2014 form 5500 responses
2014-06-01Type of plan entitySingle employer plan
2014-06-01Submission has been amendedNo
2014-06-01This submission is the final filingNo
2014-06-01This return/report is a short plan year return/report (less than 12 months)No
2014-06-01Plan is a collectively bargained planNo
2014-06-01Plan funding arrangement – InsuranceYes
2014-06-01Plan funding arrangement – General assets of the sponsorYes
2014-06-01Plan benefit arrangement – InsuranceYes
2014-06-01Plan benefit arrangement – General assets of the sponsorYes
2013: FIRED UP, INC. WORK RELATED INJURY BENEFIT PLAN 2013 form 5500 responses
2013-06-01Type of plan entitySingle employer plan
2013-06-01Submission has been amendedNo
2013-06-01This submission is the final filingNo
2013-06-01This return/report is a short plan year return/report (less than 12 months)No
2013-06-01Plan is a collectively bargained planNo
2013-06-01Plan funding arrangement – InsuranceYes
2013-06-01Plan funding arrangement – General assets of the sponsorYes
2013-06-01Plan benefit arrangement – InsuranceYes
2013-06-01Plan benefit arrangement – General assets of the sponsorYes
2012: FIRED UP, INC. WORK RELATED INJURY BENEFIT PLAN 2012 form 5500 responses
2012-06-01Type of plan entitySingle employer plan
2012-06-01Submission has been amendedNo
2012-06-01This submission is the final filingNo
2012-06-01This return/report is a short plan year return/report (less than 12 months)No
2012-06-01Plan is a collectively bargained planNo
2012-06-01Plan funding arrangement – General assets of the sponsorYes
2012-06-01Plan benefit arrangement – General assets of the sponsorYes
2011: FIRED UP, INC. WORK RELATED INJURY BENEFIT PLAN 2011 form 5500 responses
2011-06-01Type of plan entitySingle employer plan
2011-06-01Submission has been amendedNo
2011-06-01This submission is the final filingNo
2011-06-01This return/report is a short plan year return/report (less than 12 months)No
2011-06-01Plan is a collectively bargained planNo
2011-06-01Plan funding arrangement – General assets of the sponsorYes
2011-06-01Plan benefit arrangement – General assets of the sponsorYes
2009: FIRED UP, INC. WORK RELATED INJURY BENEFIT PLAN 2009 form 5500 responses
2009-06-01Type of plan entitySingle employer plan
2009-06-01Submission has been amendedNo
2009-06-01This submission is the final filingNo
2009-06-01This return/report is a short plan year return/report (less than 12 months)No
2009-06-01Plan is a collectively bargained planNo
2009-06-01Plan funding arrangement – General assets of the sponsorYes
2009-06-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

NORTH AMERICAN SPECIALTY INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 29874 )
Policy contract numberEPG050039
Policy instance 1
Insurance contract or identification numberEPG050039
Number of Individuals Covered1379
Insurance policy start date2015-06-01
Insurance policy end date2016-05-31
Total amount of commissions paid to insurance brokerUSD $13,134
Total amount of fees paid to insurance companyUSD $3,380
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $64,070
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,134
Amount paid for insurance broker fees1380
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker organization code?3
Insurance broker nameANCHOR RISK MANAGEMENT
NORTH AMERICAN SPECIALTY INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 29874 )
Policy contract numberEPG040039,30039
Policy instance 1
Insurance contract or identification numberEPG040039,30039
Number of Individuals Covered1830
Insurance policy start date2014-06-01
Insurance policy end date2015-05-31
Total amount of commissions paid to insurance brokerUSD $13,894
Total amount of fees paid to insurance companyUSD $3,278
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $67,777
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $13,894
Amount paid for insurance broker fees1278
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker organization code?3
Insurance broker nameANCHOR RISK MANAGEMENT
NORTH AMERICAN SPECIALTY INSURANCE CO (National Association of Insurance Commissioners NAIC id number: 29874 )
Policy contract numberEPG030039
Policy instance 1
Insurance contract or identification numberEPG030039
Number of Individuals Covered1924
Insurance policy start date2013-06-01
Insurance policy end date2014-05-31
Total amount of commissions paid to insurance brokerUSD $16,344
Total amount of fees paid to insurance companyUSD $3,577
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $79,726
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $16,344
Amount paid for insurance broker fees1577
Additional information about fees paid to insurance brokerFEES PAID
Insurance broker organization code?3
Insurance broker nameANCHOR RISK MANAGEMENT

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