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SSRG HOLDINGS LLC DBA CHICKEN SALAD CHICK WELFARE BENEFITS PLAN 401k Plan overview

Plan NameSSRG HOLDINGS LLC DBA CHICKEN SALAD CHICK WELFARE BENEFITS PLAN
Plan identification number 501

SSRG HOLDINGS LLC DBA CHICKEN SALAD CHICK WELFARE BENEFITS PLAN Benefits

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

401k Sponsoring company profile

SSRG HOLDINGS LLC has sponsored the creation of one or more 401k plans.

Company Name:SSRG HOLDINGS LLC
Employer identification number (EIN):810810129
NAIC Classification:722513
NAIC Description:Limited-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SSRG HOLDINGS LLC DBA CHICKEN SALAD CHICK WELFARE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-01-01MARY LOU ATKINS2024-09-20
5012022-01-01MARY LOU ATKINS2023-08-03
5012021-01-01
5012021-01-01MARY LOU ATKINS
5012020-01-01

Form 5500 Responses for SSRG HOLDINGS LLC DBA CHICKEN SALAD CHICK WELFARE BENEFITS PLAN

2023: SSRG HOLDINGS LLC DBA CHICKEN SALAD CHICK WELFARE BENEFITS PLAN 2023 form 5500 responses
2023-01-01Type of plan entitySingle employer plan
2023-01-01Plan funding arrangement – InsuranceYes
2023-01-01Plan benefit arrangement – InsuranceYes
2022: SSRG HOLDINGS LLC DBA CHICKEN SALAD CHICK WELFARE BENEFITS PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: SSRG HOLDINGS LLC DBA CHICKEN SALAD CHICK WELFARE BENEFITS PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Submission has been amendedNo
2021-01-01This submission is the final filingNo
2021-01-01This return/report is a short plan year return/report (less than 12 months)No
2021-01-01Plan is a collectively bargained planNo
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2020: SSRG HOLDINGS LLC DBA CHICKEN SALAD CHICK WELFARE BENEFITS PLAN 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01First time form 5500 has been submittedYes
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)No
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-046084
Policy instance 1
Insurance contract or identification number010-046084
Number of Individuals Covered404
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $12,404
Total amount of fees paid to insurance companyUSD $1,241
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $89,376
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number926733
Policy instance 2
Insurance contract or identification number926733
Number of Individuals Covered228
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $98,364
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,737,900
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
SUN LIFE ASSURANCE COMPANY OF CANADA (National Association of Insurance Commissioners NAIC id number: 80802 )
Policy contract number949238
Policy instance 3
Insurance contract or identification number949238
Number of Individuals Covered101
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $27,318
Total amount of fees paid to insurance companyUSD $7,010
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT, EMPLOYEE ASSISTANCE PROGRAM, ACCIDENT, CRITICAL ILLNESS
Welfare Benefit Premiums Paid to CarrierUSD $137,775
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberMYIDR1344
Policy instance 4
Insurance contract or identification numberMYIDR1344
Number of Individuals Covered69
Insurance policy start date2023-01-01
Insurance policy end date2023-12-31
Total amount of commissions paid to insurance brokerUSD $651
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedTELEHEALTH
Welfare Benefit Premiums Paid to CarrierUSD $4,340
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-046084
Policy instance 1
Insurance contract or identification number010-046084
Number of Individuals Covered354
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $12,407
Total amount of fees paid to insurance companyUSD $5,318
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $89,119
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-46084
Policy instance 1
AMERITAS LIFE INSURANCE CORP. (National Association of Insurance Commissioners NAIC id number: 61301 )
Policy contract number010-046084
Policy instance 1

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