401k Plan data: EVERBRIGHT PACIFIC LLC DBA WISP RESORT EMPLOYEE LIFE AND AD&D PLAN plan

EVERBRIGHT PACIFIC LLC DBA WISP RESORT EMPLOYEE LIFE AND AD&D PLAN 401k Plan overview

Plan Name	EVERBRIGHT PACIFIC LLC DBA WISP RESORT EMPLOYEE LIFE AND AD&D PLAN
Plan identification number	502

EVERBRIGHT PACIFIC LLC DBA WISP RESORT EMPLOYEE LIFE AND AD&D PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance) Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

EVERBRIGHT PACIFIC LLC has sponsored the creation of one or more 401k plans.

Company Name: EVERBRIGHT PACIFIC LLC

Employer identification number (EIN): 900851307

NAIC Classification: 713900

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EVERBRIGHT PACIFIC LLC DBA WISP RESORT EMPLOYEE LIFE AND AD&D PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2020-05-01
502 2018-05-01 WANDA MAYLE 2019-10-22
502 2017-05-01
502 2016-05-01

Plan Statistics for EVERBRIGHT PACIFIC LLC DBA WISP RESORT EMPLOYEE LIFE AND AD&D PLAN

401k plan membership statisitcs for EVERBRIGHT PACIFIC LLC DBA WISP RESORT EMPLOYEE LIFE AND AD&D PLAN

Measure Date Value
2020: EVERBRIGHT PACIFIC LLC DBA WISP RESORT EMPLOYEE LIFE AND AD&D PLAN 2020 401k membership
Total participants, beginning-of-year 2020-05-01 66
Total number of active participants reported on line 7a of the Form 5500 2020-05-01 57
Number of retired or separated participants receiving benefits 2020-05-01 1
Number of other retired or separated participants entitled to future benefits 2020-05-01 0
Total of all active and inactive participants 2020-05-01 58
Total participants 2020-05-01 58
2018: EVERBRIGHT PACIFIC LLC DBA WISP RESORT EMPLOYEE LIFE AND AD&D PLAN 2018 401k membership
Total participants, beginning-of-year 2018-05-01 105
Total number of active participants reported on line 7a of the Form 5500 2018-05-01 96
Number of retired or separated participants receiving benefits 2018-05-01 0
Number of other retired or separated participants entitled to future benefits 2018-05-01 0
Total of all active and inactive participants 2018-05-01 96
Number of employers contributing to the scheme 2018-05-01 0
2017: EVERBRIGHT PACIFIC LLC DBA WISP RESORT EMPLOYEE LIFE AND AD&D PLAN 2017 401k membership
Total participants, beginning-of-year 2017-05-01 111
Total number of active participants reported on line 7a of the Form 5500 2017-05-01 105
Number of retired or separated participants receiving benefits 2017-05-01 0
Number of other retired or separated participants entitled to future benefits 2017-05-01 0
Total of all active and inactive participants 2017-05-01 105
2016: EVERBRIGHT PACIFIC LLC DBA WISP RESORT EMPLOYEE LIFE AND AD&D PLAN 2016 401k membership
Total participants, beginning-of-year 2016-05-01 111
Total number of active participants reported on line 7a of the Form 5500 2016-05-01 124
Number of retired or separated participants receiving benefits 2016-05-01 0
Number of other retired or separated participants entitled to future benefits 2016-05-01 0
Total of all active and inactive participants 2016-05-01 124

Measure	Date	Value
2020: EVERBRIGHT PACIFIC LLC DBA WISP RESORT EMPLOYEE LIFE AND AD&D PLAN 2020 401k membership
Total participants, beginning-of-year	2020-05-01	66
Total number of active participants reported on line 7a of the Form 5500	2020-05-01	57
Number of retired or separated participants receiving benefits	2020-05-01	1
Number of other retired or separated participants entitled to future benefits	2020-05-01	0
Total of all active and inactive participants	2020-05-01	58
Total participants	2020-05-01	58
2018: EVERBRIGHT PACIFIC LLC DBA WISP RESORT EMPLOYEE LIFE AND AD&D PLAN 2018 401k membership
Total participants, beginning-of-year	2018-05-01	105
Total number of active participants reported on line 7a of the Form 5500	2018-05-01	96
Number of retired or separated participants receiving benefits	2018-05-01	0
Number of other retired or separated participants entitled to future benefits	2018-05-01	0
Total of all active and inactive participants	2018-05-01	96
Number of employers contributing to the scheme	2018-05-01	0
2017: EVERBRIGHT PACIFIC LLC DBA WISP RESORT EMPLOYEE LIFE AND AD&D PLAN 2017 401k membership
Total participants, beginning-of-year	2017-05-01	111
Total number of active participants reported on line 7a of the Form 5500	2017-05-01	105
Number of retired or separated participants receiving benefits	2017-05-01	0
Number of other retired or separated participants entitled to future benefits	2017-05-01	0
Total of all active and inactive participants	2017-05-01	105
2016: EVERBRIGHT PACIFIC LLC DBA WISP RESORT EMPLOYEE LIFE AND AD&D PLAN 2016 401k membership
Total participants, beginning-of-year	2016-05-01	111
Total number of active participants reported on line 7a of the Form 5500	2016-05-01	124
Number of retired or separated participants receiving benefits	2016-05-01	0
Number of other retired or separated participants entitled to future benefits	2016-05-01	0
Total of all active and inactive participants	2016-05-01	124

Form 5500 Responses for EVERBRIGHT PACIFIC LLC DBA WISP RESORT EMPLOYEE LIFE AND AD&D PLAN

2020: EVERBRIGHT PACIFIC LLC DBA WISP RESORT EMPLOYEE LIFE AND AD&D PLAN 2020 form 5500 responses
2020-05-01	Type of plan entity	Single employer plan
2020-05-01	Submission has been amended	No
2020-05-01	This submission is the final filing	No
2020-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-05-01	Plan is a collectively bargained plan	No
2020-05-01	Plan funding arrangement – Insurance	Yes
2020-05-01	Plan benefit arrangement – Insurance	Yes
2018: EVERBRIGHT PACIFIC LLC DBA WISP RESORT EMPLOYEE LIFE AND AD&D PLAN 2018 form 5500 responses
2018-05-01	Type of plan entity	Single employer plan
2018-05-01	Plan funding arrangement – Insurance	Yes
2018-05-01	Plan benefit arrangement – Insurance	Yes
2017: EVERBRIGHT PACIFIC LLC DBA WISP RESORT EMPLOYEE LIFE AND AD&D PLAN 2017 form 5500 responses
2017-05-01	Type of plan entity	Single employer plan
2017-05-01	Plan funding arrangement – Insurance	Yes
2017-05-01	Plan benefit arrangement – Insurance	Yes
2016: EVERBRIGHT PACIFIC LLC DBA WISP RESORT EMPLOYEE LIFE AND AD&D PLAN 2016 form 5500 responses
2016-05-01	Type of plan entity	Single employer plan
2016-05-01	First time form 5500 has been submitted	Yes
2016-05-01	Submission has been amended	No
2016-05-01	This submission is the final filing	No
2016-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-05-01	Plan is a collectively bargained plan	No
2016-05-01	Plan funding arrangement – Insurance	Yes
2016-05-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

000010228613

Policy instance

Insurance contract or identification number	000010228613
Number of Individuals Covered	116
Insurance policy start date	2020-05-01
Insurance policy end date	2021-04-30
Total amount of commissions paid to insurance broker	USD $831
Total amount of fees paid to insurance company	USD $339
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
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 Carrier	USD $5,537
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	277
Additional information about fees paid to insurance broker	TPA FEES
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

000010228614

Policy instance

Insurance contract or identification number	000010228614
Number of Individuals Covered	12
Insurance policy start date	2020-05-01
Insurance policy end date	2021-04-30
Total amount of commissions paid to insurance broker	USD $1,598
Total amount of fees paid to insurance company	USD $655
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $10,650
Amount paid for insurance broker fees	533
Additional information about fees paid to insurance broker	TPA FEE
Insurance broker organization code?	3
Commission paid to Insurance Broker	USD $1,598

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

000010228615

Policy instance

Insurance contract or identification number	000010228615
Number of Individuals Covered	10
Insurance policy start date	2020-05-01
Insurance policy end date	2021-04-30
Total amount of commissions paid to insurance broker	USD $842
Total amount of fees paid to insurance company	USD $366
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $5,613
Amount paid for insurance broker fees	281
Additional information about fees paid to insurance broker	TPA FEE
Insurance broker organization code?	3
Commission paid to Insurance Broker	USD $842

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

00040GG01000

Policy instance

Insurance contract or identification number	00040GG01000
Number of Individuals Covered	48
Insurance policy start date	2020-05-01
Insurance policy end date	2021-04-30
Total amount of commissions paid to insurance broker	USD $1,530
Total amount of fees paid to insurance company	USD $646
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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
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 Carrier	USD $10,201
Amount paid for insurance broker fees	510
Additional information about fees paid to insurance broker	TPA FEE
Insurance broker organization code?	3
Commission paid to Insurance Broker	USD $1,530

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

10228613

Policy instance

Insurance contract or identification number	10228613
Number of Individuals Covered	95
Insurance policy start date	2018-05-01
Insurance policy end date	2019-04-30
Total amount of commissions paid to insurance broker	USD $4,820
Total amount of fees paid to insurance company	USD $2,112
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $32,132
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $4,820
Amount paid for insurance broker fees	2112
Additional information about fees paid to insurance broker	BROKER BONUS
Insurance broker organization code?	3

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65675 )

Policy contract number

10228613

Policy instance

Insurance contract or identification number	10228613
Number of Individuals Covered	105
Insurance policy start date	2017-05-01
Insurance policy end date	2018-04-30
Total amount of commissions paid to insurance broker	USD $3,758
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $25,057
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $3,758
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Insurance broker name	CORPORATE SYNERGIES GROUP, LLC

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Company Name:	EVERBRIGHT PACIFIC LLC
Employer identification number (EIN):	900851307
NAIC Classification:	713900

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
502	2020-05-01
502	2018-05-01	WANDA MAYLE	2019-10-22
502	2017-05-01
502	2016-05-01