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| Plan Name | SHILO INNS EMPLOYEE HEALTH AND WELFARE PLAN |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | SHILO MANAGEMENT CORPORATION |
| Employer identification number (EIN): | 931049552 |
| NAIC Classification: | 721110 |
| NAIC Description: | Hotels (except Casino Hotels) and Motels |
Additional information about SHILO MANAGEMENT CORPORATION
| Jurisdiction of Incorporation: | Oregon Secretary of State Corporations Division |
| Incorporation Date: | 1991-01-14 |
| Company Identification Number: | 23155187 |
| Legal Registered Office Address: |
11707 NE AIRPORT WAY PORTLAND United States of America (USA) 97220 |
More information about SHILO MANAGEMENT CORPORATION
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2016-03-01 | DENISE LARUE | DENISE LARUE | 2017-09-25 | |
| 502 | 2015-03-01 | DENISE LARUE | DENISE LARUE | 2016-10-25 |
| Measure | Date | Value |
|---|---|---|
| 2016: SHILO INNS EMPLOYEE HEALTH AND WELFARE PLAN 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-03-01 | 79 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-03-01 | 79 |
| Number of retired or separated participants receiving benefits | 2016-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2016-03-01 | 0 |
| Total of all active and inactive participants | 2016-03-01 | 79 |
| 2015: SHILO INNS EMPLOYEE HEALTH AND WELFARE PLAN 2015 401k membership | ||
| Total participants, beginning-of-year | 2015-03-01 | 111 |
| Total number of active participants reported on line 7a of the Form 5500 | 2015-03-01 | 105 |
| Number of retired or separated participants receiving benefits | 2015-03-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2015-03-01 | 0 |
| Total of all active and inactive participants | 2015-03-01 | 105 |
| 2016: SHILO INNS EMPLOYEE HEALTH AND WELFARE PLAN 2016 form 5500 responses | ||
|---|---|---|
| 2016-03-01 | Type of plan entity | Single employer plan |
| 2016-03-01 | Plan funding arrangement – Insurance | Yes |
| 2016-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2016-03-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2015: SHILO INNS EMPLOYEE HEALTH AND WELFARE PLAN 2015 form 5500 responses | ||
| 2015-03-01 | Type of plan entity | Single employer plan |
| 2015-03-01 | First time form 5500 has been submitted | Yes |
| 2015-03-01 | Plan funding arrangement – Insurance | Yes |
| 2015-03-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2015-03-01 | Plan benefit arrangement – Insurance | Yes |
| 2015-03-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68195 ) | |||||||||||||||||||||||||||||||
| Policy contract number | 0010499715 | ||||||||||||||||||||||||||||||
| Policy instance | 1 | ||||||||||||||||||||||||||||||
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| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |||||||||||||||||||||||||||||||
| Policy contract number | 631969 | ||||||||||||||||||||||||||||||
| Policy instance | 2 | ||||||||||||||||||||||||||||||
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| UNUM LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 62235 ) | |||||||||||||||||||||||||||||||
| Policy contract number | R0576074 | ||||||||||||||||||||||||||||||
| Policy instance | 3 | ||||||||||||||||||||||||||||||
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