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METROVEST HOSPITALITY EMPLOYEE LIFE INSURANCE PLAN 401k Plan overview

Plan NameMETROVEST HOSPITALITY EMPLOYEE LIFE INSURANCE PLAN
Plan identification number 501

METROVEST HOSPITALITY EMPLOYEE LIFE INSURANCE 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

401k Sponsoring company profile

METROVEST HOSPITALITY (DBA GURNEY'S NEWPORT RESORT & MARINA) has sponsored the creation of one or more 401k plans.

Company Name:METROVEST HOSPITALITY (DBA GURNEY'S NEWPORT RESORT & MARINA)
Employer identification number (EIN):814434599
NAIC Classification:721191
NAIC Description:Bed-and-Breakfast Inns

Form 5500 Filing Information

Submission information for form 5500 for 401k plan METROVEST HOSPITALITY EMPLOYEE LIFE INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012019-05-01WILLIAM BECKERT2020-09-10
5012018-05-01WILLIAM BECKERT2019-11-20
5012017-05-01

Plan Statistics for METROVEST HOSPITALITY EMPLOYEE LIFE INSURANCE PLAN

401k plan membership statisitcs for METROVEST HOSPITALITY EMPLOYEE LIFE INSURANCE PLAN

Measure Date Value
2019: METROVEST HOSPITALITY EMPLOYEE LIFE INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year2019-05-01167
Total number of active participants reported on line 7a of the Form 55002019-05-010
Number of retired or separated participants receiving benefits2019-05-010
Number of other retired or separated participants entitled to future benefits2019-05-010
Total of all active and inactive participants2019-05-010
Number of employers contributing to the scheme2019-05-010
2018: METROVEST HOSPITALITY EMPLOYEE LIFE INSURANCE PLAN 2018 401k membership
Total participants, beginning-of-year2018-05-01190
Total number of active participants reported on line 7a of the Form 55002018-05-01264
Number of retired or separated participants receiving benefits2018-05-013
Number of other retired or separated participants entitled to future benefits2018-05-010
Total of all active and inactive participants2018-05-01267
Number of employers contributing to the scheme2018-05-010
2017: METROVEST HOSPITALITY EMPLOYEE LIFE INSURANCE PLAN 2017 401k membership
Total participants, beginning-of-year2017-05-01194
Total number of active participants reported on line 7a of the Form 55002017-05-01174
Number of retired or separated participants receiving benefits2017-05-010
Number of other retired or separated participants entitled to future benefits2017-05-010
Total of all active and inactive participants2017-05-01174

Form 5500 Responses for METROVEST HOSPITALITY EMPLOYEE LIFE INSURANCE PLAN

2019: METROVEST HOSPITALITY EMPLOYEE LIFE INSURANCE PLAN 2019 form 5500 responses
2019-05-01Type of plan entitySingle employer plan
2019-05-01This submission is the final filingYes
2019-05-01This return/report is a short plan year return/report (less than 12 months)Yes
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan benefit arrangement – InsuranceYes
2018: METROVEST HOSPITALITY EMPLOYEE LIFE INSURANCE PLAN 2018 form 5500 responses
2018-05-01Type of plan entitySingle employer plan
2018-05-01Plan funding arrangement – InsuranceYes
2018-05-01Plan benefit arrangement – InsuranceYes
2017: METROVEST HOSPITALITY EMPLOYEE LIFE INSURANCE PLAN 2017 form 5500 responses
2017-05-01Type of plan entitySingle employer plan
2017-05-01First time form 5500 has been submittedYes
2017-05-01Submission has been amendedNo
2017-05-01This submission is the final filingNo
2017-05-01This return/report is a short plan year return/report (less than 12 months)No
2017-05-01Plan is a collectively bargained planNo
2017-05-01Plan funding arrangement – InsuranceYes
2017-05-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number914309
Policy instance 1
Insurance contract or identification number914309
Number of Individuals Covered280
Insurance policy start date2019-04-01
Insurance policy end date2020-03-31
Total amount of commissions paid to insurance brokerUSD $121,239
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,459,928
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $80,552
Amount paid for insurance broker fees0
Insurance broker organization code?3
ANTHEM LIFE & DISABILITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 13573 )
Policy contract number131356
Policy instance 2
Insurance contract or identification number131356
Number of Individuals Covered165
Insurance policy start date2019-03-01
Insurance policy end date2020-02-29
Total amount of commissions paid to insurance brokerUSD $8,635
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $86,682
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,635
Amount paid for insurance broker fees0
Insurance broker organization code?3
UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 )
Policy contract number914309
Policy instance 1
Insurance contract or identification number914309
Number of Individuals Covered264
Insurance policy start date2018-04-01
Insurance policy end date2019-03-31
Total amount of commissions paid to insurance brokerUSD $66,710
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $1,715,117
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $58,456
Amount paid for insurance broker fees0
Insurance broker organization code?3
ANTHEM LIFE & DISABILITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 13573 )
Policy contract number131356
Policy instance 2
Insurance contract or identification number131356
Number of Individuals Covered158
Insurance policy start date2018-03-01
Insurance policy end date2019-02-28
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $85,660
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
ANTHEM LIFE & DISABILITY INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 13573 )
Policy contract number131356
Policy instance 1
Insurance contract or identification number131356
Number of Individuals Covered174
Insurance policy start date2017-03-01
Insurance policy end date2018-02-28
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 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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
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 $35,111
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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