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ESCAPE LODGING, LLC LIFE AND AD&D PLAN 401k Plan overview

Plan NameESCAPE LODGING, LLC LIFE AND AD&D PLAN
Plan identification number 504

ESCAPE LODGING, LLC LIFE AND AD&D PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Death benefits (include travel accident but not life insurance)
  • Other welfare benefit cover

401k Sponsoring company profile

ESCAPE LODGING, LLC has sponsored the creation of one or more 401k plans.

Company Name:ESCAPE LODGING, LLC
Employer identification number (EIN):931328932
NAIC Classification:721110
NAIC Description:Hotels (except Casino Hotels) and Motels

Additional information about ESCAPE LODGING, LLC

Jurisdiction of Incorporation: Oregon Secretary of State Corporations Division
Incorporation Date: 2001-09-13
Company Identification Number: 3526993
Legal Registered Office Address: 1315 S HEMLOCK ST

CANNON BEACH
United States of America (USA)
97110

More information about ESCAPE LODGING, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ESCAPE LODGING, LLC LIFE AND AD&D PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5042016-01-01DEBBIE CALHOUN
5042016-01-01DEBBIE CALHOUN2021-10-22
5042015-01-01DEBBIE CALHOUN

Plan Statistics for ESCAPE LODGING, LLC LIFE AND AD&D PLAN

401k plan membership statisitcs for ESCAPE LODGING, LLC LIFE AND AD&D PLAN

Measure Date Value
2016: ESCAPE LODGING, LLC LIFE AND AD&D PLAN 2016 401k membership
Total participants, beginning-of-year2016-01-01145
Total number of active participants reported on line 7a of the Form 55002016-01-01147
Total of all active and inactive participants2016-01-01147
Total participants2016-01-01147
Number of retired or separated participants receiving benefits2016-01-010
Number of other retired or separated participants entitled to future benefits2016-01-010
Number of employers contributing to the scheme2016-01-010
2015: ESCAPE LODGING, LLC LIFE AND AD&D PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01120
Total number of active participants reported on line 7a of the Form 55002015-01-01133
Total of all active and inactive participants2015-01-01133
Total participants2015-01-01133

Form 5500 Responses for ESCAPE LODGING, LLC LIFE AND AD&D PLAN

2016: ESCAPE LODGING, LLC LIFE AND AD&D PLAN 2016 form 5500 responses
2016-01-01Type of plan entitySingle employer plan
2016-01-01Submission has been amendedNo
2016-01-01This submission is the final filingNo
2016-01-01This return/report is a short plan year return/report (less than 12 months)No
2016-01-01Plan is a collectively bargained planNo
2016-01-01Plan funding arrangement – InsuranceYes
2016-01-01Plan benefit arrangement – InsuranceYes
2015: ESCAPE LODGING, LLC LIFE AND AD&D PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01First time form 5500 has been submittedYes
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingNo
2015-01-01This return/report is a short plan year return/report (less than 12 months)No
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010075888
Policy instance 1
Insurance contract or identification number000010075888
Number of Individuals Covered147
Insurance policy start date2016-01-01
Insurance policy end date2016-12-31
Total amount of commissions paid to insurance brokerUSD $939
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & 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 CarrierUSD $7,535
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $279
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameTOMPKINS BENEFIT GROUP INC.
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number10075888
Policy instance 1
Insurance contract or identification number10075888
Number of Individuals Covered147
Insurance policy start date2016-01-01
Insurance policy end date2016-12-31
Total amount of commissions paid to insurance brokerUSD $939
Total amount of fees paid to insurance companyUSD $0
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $7,535
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $660
Amount paid for insurance broker fees0
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010075888
Policy instance 1
Insurance contract or identification number000010075888
Number of Individuals Covered133
Insurance policy start date2015-01-01
Insurance policy end date2015-12-31
Total amount of commissions paid to insurance brokerUSD $763
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Other welfare benefits providedACCIDENTAL DEATH & 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 CarrierUSD $5,933
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $763
Amount paid for insurance broker fees0
Insurance broker organization code?3
Insurance broker nameTOMPKINS BENEFIT GROUP INC.

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