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EMPLOYEE HEALTH PLAN OF TOMOLIV CORPORATION 401k Plan overview

Plan NameEMPLOYEE HEALTH PLAN OF TOMOLIV CORPORATION
Plan identification number 502

EMPLOYEE HEALTH PLAN OF TOMOLIV CORPORATION Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental

401k Sponsoring company profile

TOMOLIV CORPORATION has sponsored the creation of one or more 401k plans.

Company Name:TOMOLIV CORPORATION
Employer identification number (EIN):113070792
NAIC Classification:722513
NAIC Description:Limited-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE HEALTH PLAN OF TOMOLIV CORPORATION

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022019-05-01
5022018-05-01
5022017-12-01THOMAS CLARKE
5022014-05-01THOMAS CLARKE
5022013-05-01THOMAS CLARKE

Plan Statistics for EMPLOYEE HEALTH PLAN OF TOMOLIV CORPORATION

401k plan membership statisitcs for EMPLOYEE HEALTH PLAN OF TOMOLIV CORPORATION

Measure Date Value
2019: EMPLOYEE HEALTH PLAN OF TOMOLIV CORPORATION 2019 401k membership
Total participants, beginning-of-year2019-05-013
Total number of active participants reported on line 7a of the Form 55002019-05-012
Number of retired or separated participants receiving benefits2019-05-010
Number of other retired or separated participants entitled to future benefits2019-05-010
Total of all active and inactive participants2019-05-012
2018: EMPLOYEE HEALTH PLAN OF TOMOLIV CORPORATION 2018 401k membership
Total participants, beginning-of-year2018-05-012
Total number of active participants reported on line 7a of the Form 55002018-05-012
Number of retired or separated participants receiving benefits2018-05-010
Number of other retired or separated participants entitled to future benefits2018-05-010
Total of all active and inactive participants2018-05-012
2017: EMPLOYEE HEALTH PLAN OF TOMOLIV CORPORATION 2017 401k membership
Total participants, beginning-of-year2017-12-014
Total number of active participants reported on line 7a of the Form 55002017-12-014
Number of retired or separated participants receiving benefits2017-12-010
Number of other retired or separated participants entitled to future benefits2017-12-010
Total of all active and inactive participants2017-12-014
2014: EMPLOYEE HEALTH PLAN OF TOMOLIV CORPORATION 2014 401k membership
Total participants, beginning-of-year2014-05-014
Total number of active participants reported on line 7a of the Form 55002014-05-016
Number of retired or separated participants receiving benefits2014-05-010
Number of other retired or separated participants entitled to future benefits2014-05-010
Total of all active and inactive participants2014-05-016
2013: EMPLOYEE HEALTH PLAN OF TOMOLIV CORPORATION 2013 401k membership
Total participants, beginning-of-year2013-05-017
Total number of active participants reported on line 7a of the Form 55002013-05-017
Number of retired or separated participants receiving benefits2013-05-010
Number of other retired or separated participants entitled to future benefits2013-05-010
Total of all active and inactive participants2013-05-017

Financial Data on EMPLOYEE HEALTH PLAN OF TOMOLIV CORPORATION

Measure Date Value
2020 : EMPLOYEE HEALTH PLAN OF TOMOLIV CORPORATION 2020 401k financial data
Total plan liabilities at end of year2020-04-30$0
Total plan liabilities at beginning of year2020-04-30$0
Total income from all sources2020-04-30$14,947
Expenses. Total of all expenses incurred2020-04-30$9,327
Benefits paid (including direct rollovers)2020-04-30$358
Total plan assets at end of year2020-04-30$47,742
Total plan assets at beginning of year2020-04-30$42,122
Value of fidelity bond covering the plan2020-04-30$45,000
Expenses. Other expenses not covered elsewhere2020-04-30$8,969
Net income (gross income less expenses)2020-04-30$5,620
Net plan assets at end of year (total assets less liabilities)2020-04-30$47,742
Net plan assets at beginning of year (total assets less liabilities)2020-04-30$42,122
Total contributions received or receivable from employer(s)2020-04-30$14,947
2018 : EMPLOYEE HEALTH PLAN OF TOMOLIV CORPORATION 2018 401k financial data
Total income from all sources2018-04-30$8,851
Expenses. Total of all expenses incurred2018-04-30$5,615
Benefits paid (including direct rollovers)2018-04-30$279
Total plan assets at end of year2018-04-30$40,470
Total plan assets at beginning of year2018-04-30$37,234
Value of fidelity bond covering the plan2018-04-30$40,000
Expenses. Other expenses not covered elsewhere2018-04-30$5,336
Net income (gross income less expenses)2018-04-30$3,236
Net plan assets at end of year (total assets less liabilities)2018-04-30$40,470
Net plan assets at beginning of year (total assets less liabilities)2018-04-30$37,234
Total contributions received or receivable from employer(s)2018-04-30$8,851
2015 : EMPLOYEE HEALTH PLAN OF TOMOLIV CORPORATION 2015 401k financial data
Total plan liabilities at end of year2015-04-30$0
Total plan liabilities at beginning of year2015-04-30$772
Total income from all sources2015-04-30$52,119
Expenses. Total of all expenses incurred2015-04-30$32,392
Benefits paid (including direct rollovers)2015-04-30$5,701
Total plan assets at end of year2015-04-30$39,022
Total plan assets at beginning of year2015-04-30$20,067
Value of fidelity bond covering the plan2015-04-30$10,000
Expenses. Other expenses not covered elsewhere2015-04-30$26,691
Net income (gross income less expenses)2015-04-30$19,727
Net plan assets at end of year (total assets less liabilities)2015-04-30$39,022
Net plan assets at beginning of year (total assets less liabilities)2015-04-30$19,295
Total contributions received or receivable from employer(s)2015-04-30$52,119
2014 : EMPLOYEE HEALTH PLAN OF TOMOLIV CORPORATION 2014 401k financial data
Total plan liabilities at end of year2014-04-30$772
Total plan liabilities at beginning of year2014-04-30$0
Total income from all sources2014-04-30$50,321
Expenses. Total of all expenses incurred2014-04-30$31,026
Benefits paid (including direct rollovers)2014-04-30$1,174
Total plan assets at end of year2014-04-30$20,067
Total plan assets at beginning of year2014-04-30$0
Value of fidelity bond covering the plan2014-04-30$10,000
Expenses. Other expenses not covered elsewhere2014-04-30$29,852
Net income (gross income less expenses)2014-04-30$19,295
Net plan assets at end of year (total assets less liabilities)2014-04-30$19,295
Net plan assets at beginning of year (total assets less liabilities)2014-04-30$0
Total contributions received or receivable from employer(s)2014-04-30$50,321

Form 5500 Responses for EMPLOYEE HEALTH PLAN OF TOMOLIV CORPORATION

2019: EMPLOYEE HEALTH PLAN OF TOMOLIV CORPORATION 2019 form 5500 responses
2019-05-01Type of plan entitySingle employer plan
2019-05-01Submission has been amendedNo
2019-05-01This submission is the final filingNo
2019-05-01This return/report is a short plan year return/report (less than 12 months)No
2019-05-01Plan is a collectively bargained planNo
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan funding arrangement – TrustYes
2019-05-01Plan benefit arrangement – InsuranceYes
2019-05-01Plan benefit arrangement - TrustYes
2018: EMPLOYEE HEALTH PLAN OF TOMOLIV CORPORATION 2018 form 5500 responses
2018-05-01Type of plan entitySingle employer plan
2018-05-01Submission has been amendedNo
2018-05-01This submission is the final filingNo
2018-05-01This return/report is a short plan year return/report (less than 12 months)No
2018-05-01Plan is a collectively bargained planNo
2018-05-01Plan funding arrangement – InsuranceYes
2018-05-01Plan funding arrangement – TrustYes
2018-05-01Plan benefit arrangement – InsuranceYes
2018-05-01Plan benefit arrangement - TrustYes
2017: EMPLOYEE HEALTH PLAN OF TOMOLIV CORPORATION 2017 form 5500 responses
2017-12-01Type of plan entitySingle employer plan
2017-12-01First time form 5500 has been submittedYes
2017-12-01Submission has been amendedNo
2017-12-01This submission is the final filingNo
2017-12-01This return/report is a short plan year return/report (less than 12 months)Yes
2017-12-01Plan is a collectively bargained planNo
2017-12-01Plan funding arrangement – InsuranceYes
2017-12-01Plan funding arrangement – TrustYes
2017-12-01Plan benefit arrangement – InsuranceYes
2017-12-01Plan benefit arrangement - TrustYes
2014: EMPLOYEE HEALTH PLAN OF TOMOLIV CORPORATION 2014 form 5500 responses
2014-05-01Type of plan entitySingle employer plan
2014-05-01Submission has been amendedNo
2014-05-01This submission is the final filingNo
2014-05-01This return/report is a short plan year return/report (less than 12 months)No
2014-05-01Plan is a collectively bargained planNo
2014-05-01Plan funding arrangement – InsuranceYes
2014-05-01Plan funding arrangement – TrustYes
2014-05-01Plan benefit arrangement – InsuranceYes
2014-05-01Plan benefit arrangement - TrustYes
2013: EMPLOYEE HEALTH PLAN OF TOMOLIV CORPORATION 2013 form 5500 responses
2013-05-01Type of plan entitySingle employer plan
2013-05-01First time form 5500 has been submittedYes
2013-05-01Submission has been amendedNo
2013-05-01This submission is the final filingNo
2013-05-01This return/report is a short plan year return/report (less than 12 months)No
2013-05-01Plan is a collectively bargained planNo
2013-05-01Plan funding arrangement – InsuranceYes
2013-05-01Plan funding arrangement – TrustYes
2013-05-01Plan benefit arrangement – InsuranceYes
2013-05-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number14210NFA0200
Policy instance 1
Insurance contract or identification number14210NFA0200
Number of Individuals Covered2
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
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 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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $6,125
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number14210NFA0200
Policy instance 1
Insurance contract or identification number14210NFA0200
Number of Individuals Covered2
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
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 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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $4,491
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number14210 NFA 0200
Policy instance 1
Insurance contract or identification number14210 NFA 0200
Number of Individuals Covered4
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
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 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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $3,812
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number14210 NFA 0200
Policy instance 1
Insurance contract or identification number14210 NFA 0200
Number of Individuals Covered11
Insurance policy start date2014-05-01
Insurance policy end date2015-04-30
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $22,150
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number14210 NFA 0200
Policy instance 1
Insurance contract or identification number14210 NFA 0200
Number of Individuals Covered9
Insurance policy start date2013-05-01
Insurance policy end date2014-04-30
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 BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 $21,392
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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