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GRAVISS MCDONALDS HEALTH BENEFIT PLAN 401k Plan overview

Plan NameGRAVISS MCDONALDS HEALTH BENEFIT PLAN
Plan identification number 501

GRAVISS MCDONALDS HEALTH 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)

401k Sponsoring company profile

GRAVISS MAIN OFFICE INC. has sponsored the creation of one or more 401k plans.

Company Name:GRAVISS MAIN OFFICE INC.
Employer identification number (EIN):900750792
NAIC Classification:722513
NAIC Description:Limited-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GRAVISS MCDONALDS HEALTH BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012017-01-01JOE GRAVISS JOE GRAVISS2018-09-05
5012016-01-01BILL HARDY BILL HARDY2017-07-24
5012015-01-01BILL HARDY BILL HARDY2016-08-31
5012014-01-01BILL HARDY BILL HARDY2015-06-10

Plan Statistics for GRAVISS MCDONALDS HEALTH BENEFIT PLAN

401k plan membership statisitcs for GRAVISS MCDONALDS HEALTH BENEFIT PLAN

Measure Date Value
2017: GRAVISS MCDONALDS HEALTH BENEFIT PLAN 2017 401k membership
Total participants, beginning-of-year2017-01-010
Total number of active participants reported on line 7a of the Form 55002017-01-010
Number of retired or separated participants receiving benefits2017-01-010
Number of other retired or separated participants entitled to future benefits2017-01-010
Total of all active and inactive participants2017-01-010
2016: GRAVISS MCDONALDS HEALTH BENEFIT PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-0188
Total number of active participants reported on line 7a of the Form 55002016-01-0177
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Total of all active and inactive participants2016-01-0177
2015: GRAVISS MCDONALDS HEALTH BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01144
Total number of active participants reported on line 7a of the Form 55002015-01-0188
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-0188
2014: GRAVISS MCDONALDS HEALTH BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-010
Total number of active participants reported on line 7a of the Form 55002014-01-01144
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01144

Form 5500 Responses for GRAVISS MCDONALDS HEALTH BENEFIT PLAN

2017: GRAVISS MCDONALDS HEALTH BENEFIT PLAN 2017 form 5500 responses
2017-01-01Type of plan entityMulti-employer plan
2017-01-01This submission is the final filingYes
2017-01-01Plan funding arrangement – InsuranceYes
2017-01-01Plan funding arrangement – General assets of the sponsorYes
2017-01-01Plan benefit arrangement – InsuranceYes
2017-01-01Plan benefit arrangement – General assets of the sponsorYes
2016: GRAVISS MCDONALDS HEALTH BENEFIT PLAN 2016 form 5500 responses
2016-01-01Type of plan entityMulti-employer plan
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan funding arrangement – General assets of the sponsorYes
2016-01-01Plan benefit arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – General assets of the sponsorYes
2015: GRAVISS MCDONALDS HEALTH BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entityMulti-employer plan
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan funding arrangement – General assets of the sponsorYes
2015-01-01Plan benefit arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – General assets of the sponsorYes
2014: GRAVISS MCDONALDS HEALTH BENEFIT PLAN 2014 form 5500 responses
2014-01-01Type of plan entityMulti-employer plan
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

BLUEGRASS FAMILY HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95071 )
Policy contract number030830
Policy instance 1
Insurance contract or identification number030830
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Are there contracts with allocated funds for individual policies?1
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Insurance broker nameENERGY INSURANCE AGENCY
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00487482
Policy instance 2
Insurance contract or identification number00487482
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Long Term Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?Yes
Insurance broker nameLIFETIME FIN GROWTH CO OF OHIO LLC
BLUEGRASS FAMILY HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95071 )
Policy contract number030830
Policy instance 1
Insurance contract or identification number030830
Number of Individuals Covered74
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $19,960
Are there contracts with allocated funds for individual policies?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $19,960
Insurance broker nameENERGY INSURANCE AGENCY
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00487482
Policy instance 2
Insurance contract or identification number00487482
Number of Individuals Covered88
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $8,343
Long Term Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,328
Insurance broker nameLIFETIME FIN GROWTH CO OF OHIO LLC
BLUEGRASS FAMILY HEALTH, INC. (National Association of Insurance Commissioners NAIC id number: 95071 )
Policy contract number030830
Policy instance 1
Insurance contract or identification number030830
Number of Individuals Covered144
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $25,560
Are there contracts with allocated funds for individual policies?Yes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $25,560
Insurance broker nameENERGY INSURANCE AGENCY
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number00487482
Policy instance 2
Insurance contract or identification number00487482
Number of Individuals Covered114
Insurance policy start date2014-01-01
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $10,453
Long Term Disability Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,863
Insurance broker nameLIFETIME FIN GROWTH CO OF OHIO LLC

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