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| Plan Name | BERTUCCI'S RESTAURANT HEALTH AND WELFARE PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | BERTUCCI'S RESTAURANT LLC |
| Employer identification number (EIN): | 830799571 |
| NAIC Classification: | 722511 |
| NAIC Description: | Full-Service Restaurants |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2018-06-21 | CHRISTINE MOSCARITOLO | 2019-10-11 | ||
| 501 | 2018-06-21 | CHRISTINE MOSCARITOLO | 2020-09-24 |
| 2018: BERTUCCI'S RESTAURANT HEALTH AND WELFARE PLAN 2018 form 5500 responses | ||
|---|---|---|
| 2018-06-21 | Type of plan entity | Single employer plan |
| 2018-06-21 | First time form 5500 has been submitted | Yes |
| 2018-06-21 | Submission has been amended | Yes |
| 2018-06-21 | This submission is the final filing | Yes |
| 2018-06-21 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2018-06-21 | Plan is a collectively bargained plan | No |
| 2018-06-21 | Plan funding arrangement – Insurance | Yes |
| 2018-06-21 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-06-21 | Plan benefit arrangement – Insurance | Yes |
| 2018-06-21 | Plan benefit arrangement – General assets of the sponsor | Yes |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47317 ) | |
| Policy contract number | 30085120 |
| Policy instance | 2 |
| NATIONWIDE LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 66869 ) | |
| Policy contract number | FV1167 |
| Policy instance | 1 |
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) | |
| Policy contract number | 01-016077-00 |
| Policy instance | 3 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | E0490235 |
| Policy instance | 4 |
| SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 ) | |
| Policy contract number | 0101607700 |
| Policy instance | 2 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |
| Policy contract number | E0490235 |
| Policy instance | 3 |
| VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 47317 ) | |
| Policy contract number | 30085120 |
| Policy instance | 4 |
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