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BLAKE'S LOTABURGER, LLC/ TEEWINOT INVESTMENTS WELFARE BENEFIT PLAN 401k Plan overview

Plan NameBLAKE'S LOTABURGER, LLC/ TEEWINOT INVESTMENTS WELFARE BENEFIT PLAN
Plan identification number 501

BLAKE'S LOTABURGER, LLC/ TEEWINOT INVESTMENTS WELFARE BENEFIT PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Other welfare benefit cover

401k Sponsoring company profile

BLAKE'S LOTABURGER, LLC has sponsored the creation of one or more 401k plans.

Company Name:BLAKE'S LOTABURGER, LLC
Employer identification number (EIN):841619686
NAIC Classification:722513
NAIC Description:Limited-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BLAKE'S LOTABURGER, LLC/ TEEWINOT INVESTMENTS WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012019-02-01
5012017-02-01SCOTT ESPLIN
5012016-04-01SCOTT ESPLIN
5012015-04-01SCOTT ESPLIN
5012014-04-01SCOTT ESPLIN
5012013-04-01SCOTT ESPLIN
5012012-04-01SCOTT ESPLIN
5012011-04-01SCOTT ESPLIN

Plan Statistics for BLAKE'S LOTABURGER, LLC/ TEEWINOT INVESTMENTS WELFARE BENEFIT PLAN

401k plan membership statisitcs for BLAKE'S LOTABURGER, LLC/ TEEWINOT INVESTMENTS WELFARE BENEFIT PLAN

Measure Date Value
2019: BLAKE'S LOTABURGER, LLC/ TEEWINOT INVESTMENTS WELFARE BENEFIT PLAN 2019 401k membership
Total participants, beginning-of-year2019-02-01148
Total number of active participants reported on line 7a of the Form 55002019-02-01122
Number of retired or separated participants receiving benefits2019-02-012
Number of other retired or separated participants entitled to future benefits2019-02-010
Total of all active and inactive participants2019-02-01124
2017: BLAKE'S LOTABURGER, LLC/ TEEWINOT INVESTMENTS WELFARE BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-02-01181
Total number of active participants reported on line 7a of the Form 55002017-02-01155
Number of retired or separated participants receiving benefits2017-02-010
Number of other retired or separated participants entitled to future benefits2017-02-010
Total of all active and inactive participants2017-02-01155
2016: BLAKE'S LOTABURGER, LLC/ TEEWINOT INVESTMENTS WELFARE BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-04-01181
Total number of active participants reported on line 7a of the Form 55002016-04-01181
Number of retired or separated participants receiving benefits2016-04-010
Number of other retired or separated participants entitled to future benefits2016-04-010
Total of all active and inactive participants2016-04-01181
2015: BLAKE'S LOTABURGER, LLC/ TEEWINOT INVESTMENTS WELFARE BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-04-01161
Total number of active participants reported on line 7a of the Form 55002015-04-01181
Number of retired or separated participants receiving benefits2015-04-010
Number of other retired or separated participants entitled to future benefits2015-04-010
Total of all active and inactive participants2015-04-01181
2014: BLAKE'S LOTABURGER, LLC/ TEEWINOT INVESTMENTS WELFARE BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-04-01122
Total number of active participants reported on line 7a of the Form 55002014-04-01161
Number of retired or separated participants receiving benefits2014-04-010
Number of other retired or separated participants entitled to future benefits2014-04-010
Total of all active and inactive participants2014-04-01161
2013: BLAKE'S LOTABURGER, LLC/ TEEWINOT INVESTMENTS WELFARE BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-04-01101
Total number of active participants reported on line 7a of the Form 55002013-04-01122
Number of retired or separated participants receiving benefits2013-04-010
Number of other retired or separated participants entitled to future benefits2013-04-010
Total of all active and inactive participants2013-04-01122
2012: BLAKE'S LOTABURGER, LLC/ TEEWINOT INVESTMENTS WELFARE BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-04-01107
Total number of active participants reported on line 7a of the Form 55002012-04-01101
Number of retired or separated participants receiving benefits2012-04-010
Number of other retired or separated participants entitled to future benefits2012-04-010
Total of all active and inactive participants2012-04-01101
2011: BLAKE'S LOTABURGER, LLC/ TEEWINOT INVESTMENTS WELFARE BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-04-0186
Total number of active participants reported on line 7a of the Form 55002011-04-01107
Number of retired or separated participants receiving benefits2011-04-010
Number of other retired or separated participants entitled to future benefits2011-04-010
Total of all active and inactive participants2011-04-01107

Form 5500 Responses for BLAKE'S LOTABURGER, LLC/ TEEWINOT INVESTMENTS WELFARE BENEFIT PLAN

2019: BLAKE'S LOTABURGER, LLC/ TEEWINOT INVESTMENTS WELFARE BENEFIT PLAN 2019 form 5500 responses
2019-02-01Type of plan entitySingle employer plan
2019-02-01Submission has been amendedNo
2019-02-01This submission is the final filingNo
2019-02-01This return/report is a short plan year return/report (less than 12 months)No
2019-02-01Plan is a collectively bargained planNo
2019-02-01Plan funding arrangement – InsuranceYes
2019-02-01Plan benefit arrangement – InsuranceYes
2017: BLAKE'S LOTABURGER, LLC/ TEEWINOT INVESTMENTS WELFARE BENEFIT PLAN 2017 form 5500 responses
2017-02-01Type of plan entitySingle employer plan
2017-02-01Submission has been amendedNo
2017-02-01This submission is the final filingNo
2017-02-01This return/report is a short plan year return/report (less than 12 months)No
2017-02-01Plan is a collectively bargained planNo
2017-02-01Plan funding arrangement – InsuranceYes
2017-02-01Plan benefit arrangement – InsuranceYes
2016: BLAKE'S LOTABURGER, LLC/ TEEWINOT INVESTMENTS WELFARE BENEFIT PLAN 2016 form 5500 responses
2016-04-01Type of plan entitySingle employer plan
2016-04-01Submission has been amendedNo
2016-04-01This submission is the final filingNo
2016-04-01This return/report is a short plan year return/report (less than 12 months)No
2016-04-01Plan is a collectively bargained planNo
2016-04-01Plan funding arrangement – InsuranceYes
2016-04-01Plan benefit arrangement – InsuranceYes
2015: BLAKE'S LOTABURGER, LLC/ TEEWINOT INVESTMENTS WELFARE BENEFIT PLAN 2015 form 5500 responses
2015-04-01Type of plan entitySingle employer plan
2015-04-01Submission has been amendedNo
2015-04-01This submission is the final filingNo
2015-04-01This return/report is a short plan year return/report (less than 12 months)No
2015-04-01Plan is a collectively bargained planNo
2015-04-01Plan funding arrangement – InsuranceYes
2015-04-01Plan benefit arrangement – InsuranceYes
2014: BLAKE'S LOTABURGER, LLC/ TEEWINOT INVESTMENTS WELFARE BENEFIT PLAN 2014 form 5500 responses
2014-04-01Type of plan entitySingle employer plan
2014-04-01Submission has been amendedNo
2014-04-01This submission is the final filingNo
2014-04-01This return/report is a short plan year return/report (less than 12 months)No
2014-04-01Plan is a collectively bargained planNo
2014-04-01Plan funding arrangement – InsuranceYes
2014-04-01Plan benefit arrangement – InsuranceYes
2013: BLAKE'S LOTABURGER, LLC/ TEEWINOT INVESTMENTS WELFARE BENEFIT PLAN 2013 form 5500 responses
2013-04-01Type of plan entitySingle employer plan
2013-04-01Submission has been amendedNo
2013-04-01This submission is the final filingNo
2013-04-01This return/report is a short plan year return/report (less than 12 months)No
2013-04-01Plan is a collectively bargained planNo
2013-04-01Plan funding arrangement – InsuranceYes
2013-04-01Plan benefit arrangement – InsuranceYes
2012: BLAKE'S LOTABURGER, LLC/ TEEWINOT INVESTMENTS WELFARE BENEFIT PLAN 2012 form 5500 responses
2012-04-01Type of plan entitySingle employer plan
2012-04-01Submission has been amendedNo
2012-04-01This submission is the final filingNo
2012-04-01This return/report is a short plan year return/report (less than 12 months)No
2012-04-01Plan is a collectively bargained planNo
2012-04-01Plan funding arrangement – InsuranceYes
2012-04-01Plan benefit arrangement – InsuranceYes
2011: BLAKE'S LOTABURGER, LLC/ TEEWINOT INVESTMENTS WELFARE BENEFIT PLAN 2011 form 5500 responses
2011-04-01Type of plan entitySingle employer plan
2011-04-01Submission has been amendedNo
2011-04-01This submission is the final filingNo
2011-04-01This return/report is a short plan year return/report (less than 12 months)No
2011-04-01Plan is a collectively bargained planNo
2011-04-01Plan funding arrangement – InsuranceYes
2011-04-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

TRUE HEALTH NEW MEXICO (National Association of Insurance Commissioners NAIC id number: 16281 )
Policy contract numberGT00281001
Policy instance 1
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5944997
Policy instance 2
NEW MEXICO HEALTH CONNECTIONS (National Association of Insurance Commissioners NAIC id number: 0000 )
Policy contract numberG903830001
Policy instance 1
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05736838
Policy instance 2
TRUE HEALTH NEW MEXICO (National Association of Insurance Commissioners NAIC id number: 16281 )
Policy contract numberGT00281001
Policy instance 3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract numberKM05944997
Policy instance 4

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