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EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 401k Plan overview

Plan NameEMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120
Plan identification number 503

EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Temporary disability (accident and sickness)
  • Long-term disability cover

401k Sponsoring company profile

CAVE ENTERPRISES has sponsored the creation of one or more 401k plans.

Company Name:CAVE ENTERPRISES
Employer identification number (EIN):204023518
NAIC Classification:722513
NAIC Description:Limited-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032022-05-01
5032021-05-01PATRICK KOLINA2023-01-20
5032020-05-01PATRICK KALINA2022-02-04
5032019-05-01
5032018-05-01
5032017-05-01PATRICK KALINA
5032016-05-01
5032015-05-01ADAM VELARDE
5032014-05-01ADAM VELARDE
5032013-05-01ADAM VELARDE
5032012-05-01ADAM VELARDE
5032011-05-01ADAM VELARDE
5032010-05-01ADAM VELARDE

Plan Statistics for EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120

401k plan membership statisitcs for EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120

Measure Date Value
2022: EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2022 401k membership
Total participants, beginning-of-year2022-05-01335
Total number of active participants reported on line 7a of the Form 55002022-05-01252
Number of retired or separated participants receiving benefits2022-05-010
Number of other retired or separated participants entitled to future benefits2022-05-010
Total of all active and inactive participants2022-05-01252
2021: EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2021 401k membership
Total participants, beginning-of-year2021-05-01418
Total number of active participants reported on line 7a of the Form 55002021-05-01335
Number of retired or separated participants receiving benefits2021-05-010
Number of other retired or separated participants entitled to future benefits2021-05-010
Total of all active and inactive participants2021-05-01335
2020: EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2020 401k membership
Total participants, beginning-of-year2020-05-01281
Total number of active participants reported on line 7a of the Form 55002020-05-01418
Number of retired or separated participants receiving benefits2020-05-010
Number of other retired or separated participants entitled to future benefits2020-05-010
Total of all active and inactive participants2020-05-01418
2019: EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2019 401k membership
Total participants, beginning-of-year2019-05-01242
Total number of active participants reported on line 7a of the Form 55002019-05-01220
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 participants2019-05-01220
2018: EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2018 401k membership
Total participants, beginning-of-year2018-05-01187
Total number of active participants reported on line 7a of the Form 55002018-05-01211
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 participants2018-05-01211
2017: EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2017 401k membership
Total participants, beginning-of-year2017-05-01183
Total number of active participants reported on line 7a of the Form 55002017-05-01178
Number of retired or separated participants receiving benefits2017-05-010
Number of other retired or separated participants entitled to future benefits2017-05-010
Total of all active and inactive participants2017-05-01178
2016: EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2016 401k membership
Total participants, beginning-of-year2016-05-0191
Total number of active participants reported on line 7a of the Form 55002016-05-01167
Number of retired or separated participants receiving benefits2016-05-010
Number of other retired or separated participants entitled to future benefits2016-05-010
Total of all active and inactive participants2016-05-01167
2015: EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2015 401k membership
Total participants, beginning-of-year2015-05-0169
Total number of active participants reported on line 7a of the Form 55002015-05-0168
Number of retired or separated participants receiving benefits2015-05-010
Number of other retired or separated participants entitled to future benefits2015-05-010
Total of all active and inactive participants2015-05-0168
2014: EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2014 401k membership
Total participants, beginning-of-year2014-05-0115
Total number of active participants reported on line 7a of the Form 55002014-05-0147
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 participants2014-05-0147
2013: EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2013 401k membership
Total participants, beginning-of-year2013-05-0120
Total number of active participants reported on line 7a of the Form 55002013-05-0113
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 participants2013-05-0113
2012: EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2012 401k membership
Total participants, beginning-of-year2012-05-0119
Total number of active participants reported on line 7a of the Form 55002012-05-0120
Number of retired or separated participants receiving benefits2012-05-010
Number of other retired or separated participants entitled to future benefits2012-05-010
Total of all active and inactive participants2012-05-0120
2011: EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2011 401k membership
Total participants, beginning-of-year2011-05-016
Total number of active participants reported on line 7a of the Form 55002011-05-0119
Number of retired or separated participants receiving benefits2011-05-010
Number of other retired or separated participants entitled to future benefits2011-05-010
Total of all active and inactive participants2011-05-0119
2010: EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2010 401k membership
Total participants, beginning-of-year2010-05-016
Total number of active participants reported on line 7a of the Form 55002010-05-016
Number of retired or separated participants receiving benefits2010-05-010
Number of other retired or separated participants entitled to future benefits2010-05-010
Total of all active and inactive participants2010-05-016

Financial Data on EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120

Measure Date Value
2021 : EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2021 401k financial data
Total unrealized appreciation/depreciation of assets2021-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-04-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2021-04-30$0
Total income from all sources (including contributions)2021-04-30$1,839,995
Total loss/gain on sale of assets2021-04-30$0
Total of all expenses incurred2021-04-30$1,839,995
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2021-04-30$859,042
Total contributions o plan (from employers,participants, others, non cash contrinutions)2021-04-30$1,839,995
Value of total assets at end of year2021-04-30$0
Value of total assets at beginning of year2021-04-30$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2021-04-30$980,953
Total interest from all sources2021-04-30$0
Total dividends received (eg from common stock, registered investment company shares)2021-04-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2021-04-30No
Was this plan covered by a fidelity bond2021-04-30Yes
Value of fidelity bond cover2021-04-30$140,000
If this is an individual account plan, was there a blackout period2021-04-30No
Were there any nonexempt tranactions with any party-in-interest2021-04-30No
Value of other receiveables (less allowance for doubtful accounts) at end of year2021-04-30$31,460
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2021-04-30$31,237
Administrative expenses (other) incurred2021-04-30$980,953
Total non interest bearing cash at end of year2021-04-30$-31,460
Total non interest bearing cash at beginning of year2021-04-30$-31,237
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2021-04-30No
Value of net income/loss2021-04-30$0
Value of net assets at end of year (total assets less liabilities)2021-04-30$0
Value of net assets at beginning of year (total assets less liabilities)2021-04-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2021-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2021-04-30No
Were any leases to which the plan was party in default or uncollectible2021-04-30No
Expenses. Payments to insurance carriers foe the provision of benefits2021-04-30$859,042
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2021-04-30No
Was there a failure to transmit to the plan any participant contributions2021-04-30No
Has the plan failed to provide any benefit when due under the plan2021-04-30No
Contributions received in cash from employer2021-04-30$1,839,995
Did the plan have assets held for investment2021-04-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2021-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2021-04-30Yes
Opinion of an independent qualified public accountant for this plan2021-04-30Unqualified
Accountancy firm name2021-04-30BENNETT THRASHER
Accountancy firm EIN2021-04-30581673613
2020 : EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2020 401k financial data
Total unrealized appreciation/depreciation of assets2020-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-04-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2020-04-30$0
Total income from all sources (including contributions)2020-04-30$1,773,845
Total loss/gain on sale of assets2020-04-30$0
Total of all expenses incurred2020-04-30$1,773,845
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2020-04-30$803,245
Total contributions o plan (from employers,participants, others, non cash contrinutions)2020-04-30$1,773,845
Value of total assets at end of year2020-04-30$0
Value of total assets at beginning of year2020-04-30$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2020-04-30$970,600
Total interest from all sources2020-04-30$0
Total dividends received (eg from common stock, registered investment company shares)2020-04-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2020-04-30No
Was this plan covered by a fidelity bond2020-04-30Yes
Value of fidelity bond cover2020-04-30$140,000
If this is an individual account plan, was there a blackout period2020-04-30No
Were there any nonexempt tranactions with any party-in-interest2020-04-30No
Contributions received from participants2020-04-30$569,489
Value of other receiveables (less allowance for doubtful accounts) at end of year2020-04-30$31,237
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2020-04-30$63,042
Administrative expenses (other) incurred2020-04-30$970,600
Total non interest bearing cash at end of year2020-04-30$-31,237
Total non interest bearing cash at beginning of year2020-04-30$-63,042
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2020-04-30No
Value of net income/loss2020-04-30$0
Value of net assets at end of year (total assets less liabilities)2020-04-30$0
Value of net assets at beginning of year (total assets less liabilities)2020-04-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2020-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2020-04-30No
Were any leases to which the plan was party in default or uncollectible2020-04-30No
Expenses. Payments to insurance carriers foe the provision of benefits2020-04-30$803,245
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2020-04-30No
Was there a failure to transmit to the plan any participant contributions2020-04-30No
Has the plan failed to provide any benefit when due under the plan2020-04-30No
Contributions received in cash from employer2020-04-30$1,204,356
Did the plan have assets held for investment2020-04-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2020-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2020-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2020-04-30No
Opinion of an independent qualified public accountant for this plan2020-04-30Unqualified
Accountancy firm name2020-04-30BENNETT THRASHER
Accountancy firm EIN2020-04-30581673613
2019 : EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2019 401k financial data
Total unrealized appreciation/depreciation of assets2019-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-04-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2019-04-30$0
Total income from all sources (including contributions)2019-04-30$1,360,474
Total loss/gain on sale of assets2019-04-30$0
Total of all expenses incurred2019-04-30$1,360,474
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2019-04-30$578,104
Total contributions o plan (from employers,participants, others, non cash contrinutions)2019-04-30$1,360,474
Value of total assets at end of year2019-04-30$0
Value of total assets at beginning of year2019-04-30$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2019-04-30$782,370
Total interest from all sources2019-04-30$0
Total dividends received (eg from common stock, registered investment company shares)2019-04-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2019-04-30No
Was this plan covered by a fidelity bond2019-04-30Yes
Value of fidelity bond cover2019-04-30$140,000
If this is an individual account plan, was there a blackout period2019-04-30No
Were there any nonexempt tranactions with any party-in-interest2019-04-30No
Contributions received from participants2019-04-30$507,130
Value of other receiveables (less allowance for doubtful accounts) at end of year2019-04-30$63,042
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2019-04-30$12,679
Administrative expenses (other) incurred2019-04-30$782,370
Total non interest bearing cash at end of year2019-04-30$-63,042
Total non interest bearing cash at beginning of year2019-04-30$-12,679
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2019-04-30No
Value of net income/loss2019-04-30$0
Value of net assets at end of year (total assets less liabilities)2019-04-30$0
Value of net assets at beginning of year (total assets less liabilities)2019-04-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2019-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2019-04-30No
Were any leases to which the plan was party in default or uncollectible2019-04-30No
Expenses. Payments to insurance carriers foe the provision of benefits2019-04-30$578,104
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2019-04-30No
Was there a failure to transmit to the plan any participant contributions2019-04-30No
Has the plan failed to provide any benefit when due under the plan2019-04-30No
Contributions received in cash from employer2019-04-30$853,344
Did the plan have assets held for investment2019-04-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2019-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2019-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2019-04-30No
Opinion of an independent qualified public accountant for this plan2019-04-30Unqualified
Accountancy firm name2019-04-30BENNETT THRASHER
Accountancy firm EIN2019-04-30581673613
2018 : EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2018 401k financial data
Total unrealized appreciation/depreciation of assets2018-04-30$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-04-30$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)2018-04-30$0
Total income from all sources (including contributions)2018-04-30$1,116,007
Total loss/gain on sale of assets2018-04-30$0
Total of all expenses incurred2018-04-30$1,116,007
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others2018-04-30$482,693
Total contributions o plan (from employers,participants, others, non cash contrinutions)2018-04-30$1,116,007
Value of total assets at end of year2018-04-30$0
Value of total assets at beginning of year2018-04-30$0
Total of administrative expenses incurred including professional, contract, advisory and management fees2018-04-30$633,314
Total interest from all sources2018-04-30$0
Total dividends received (eg from common stock, registered investment company shares)2018-04-30$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year2018-04-30No
Was this plan covered by a fidelity bond2018-04-30Yes
Value of fidelity bond cover2018-04-30$90,000
If this is an individual account plan, was there a blackout period2018-04-30No
Were there any nonexempt tranactions with any party-in-interest2018-04-30No
Contributions received from participants2018-04-30$454,095
Value of other receiveables (less allowance for doubtful accounts) at end of year2018-04-30$12,679
Value of other receiveables (less allowance for doubtful accounts) at beginning of year2018-04-30$0
Administrative expenses (other) incurred2018-04-30$633,314
Total non interest bearing cash at end of year2018-04-30$-12,679
Total non interest bearing cash at beginning of year2018-04-30$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser2018-04-30No
Value of net income/loss2018-04-30$0
Value of net assets at end of year (total assets less liabilities)2018-04-30$0
Value of net assets at beginning of year (total assets less liabilities)2018-04-30$0
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)2018-04-30No
Were any loans by the plan or fixed income obligations due to the plan in default2018-04-30No
Were any leases to which the plan was party in default or uncollectible2018-04-30No
Expenses. Payments to insurance carriers foe the provision of benefits2018-04-30$482,693
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets2018-04-30No
Was there a failure to transmit to the plan any participant contributions2018-04-30No
Has the plan failed to provide any benefit when due under the plan2018-04-30No
Contributions received in cash from employer2018-04-30$661,912
Did the plan have assets held for investment2018-04-30No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser2018-04-30No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC2018-04-30No
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)2018-04-30No
Opinion of an independent qualified public accountant for this plan2018-04-30Unqualified
Accountancy firm name2018-04-30ROSS LANE & COMPANY, LLC
Accountancy firm EIN2018-04-30581686745
2017 : EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2017 401k financial data
Total plan liabilities at end of year2017-04-30$0
Total plan liabilities at beginning of year2017-04-30$0
Total income from all sources2017-04-30$879,116
Expenses. Total of all expenses incurred2017-04-30$879,116
Benefits paid (including direct rollovers)2017-04-30$390,620
Total plan assets at end of year2017-04-30$0
Total plan assets at beginning of year2017-04-30$0
Value of fidelity bond covering the plan2017-04-30$90,000
Expenses. Other expenses not covered elsewhere2017-04-30$488,496
Net income (gross income less expenses)2017-04-30$0
Net plan assets at end of year (total assets less liabilities)2017-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2017-04-30$0
Total contributions received or receivable from employer(s)2017-04-30$879,116
2016 : EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2016 401k financial data
Total plan liabilities at end of year2016-04-30$0
Total plan liabilities at beginning of year2016-04-30$493
Total income from all sources2016-04-30$655,841
Expenses. Total of all expenses incurred2016-04-30$655,841
Benefits paid (including direct rollovers)2016-04-30$307,634
Total plan assets at end of year2016-04-30$0
Total plan assets at beginning of year2016-04-30$493
Value of fidelity bond covering the plan2016-04-30$70,000
Expenses. Other expenses not covered elsewhere2016-04-30$348,207
Net income (gross income less expenses)2016-04-30$0
Net plan assets at end of year (total assets less liabilities)2016-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2016-04-30$0
Total contributions received or receivable from employer(s)2016-04-30$655,841
2015 : EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2015 401k financial data
Total plan liabilities at end of year2015-04-30$493
Total plan liabilities at beginning of year2015-04-30$3,288
Total income from all sources2015-04-30$487,849
Expenses. Total of all expenses incurred2015-04-30$487,849
Benefits paid (including direct rollovers)2015-04-30$234,393
Total plan assets at end of year2015-04-30$493
Total plan assets at beginning of year2015-04-30$3,288
Value of fidelity bond covering the plan2015-04-30$50,000
Expenses. Other expenses not covered elsewhere2015-04-30$253,456
Net income (gross income less expenses)2015-04-30$0
Net plan assets at end of year (total assets less liabilities)2015-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2015-04-30$0
Total contributions received or receivable from employer(s)2015-04-30$487,849
2014 : EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2014 401k financial data
Total plan liabilities at end of year2014-04-30$3,288
Total plan liabilities at beginning of year2014-04-30$1,134
Total income from all sources2014-04-30$192,900
Expenses. Total of all expenses incurred2014-04-30$192,900
Benefits paid (including direct rollovers)2014-04-30$90,733
Total plan assets at end of year2014-04-30$3,288
Total plan assets at beginning of year2014-04-30$1,134
Value of fidelity bond covering the plan2014-04-30$25,000
Expenses. Other expenses not covered elsewhere2014-04-30$102,167
Net income (gross income less expenses)2014-04-30$0
Net plan assets at end of year (total assets less liabilities)2014-04-30$0
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$192,900
2013 : EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2013 401k financial data
Total plan liabilities at end of year2013-04-30$1,134
Total plan liabilities at beginning of year2013-04-30$1,422
Total income from all sources2013-04-30$142,675
Expenses. Total of all expenses incurred2013-04-30$142,675
Benefits paid (including direct rollovers)2013-04-30$70,258
Total plan assets at end of year2013-04-30$1,134
Total plan assets at beginning of year2013-04-30$1,422
Expenses. Other expenses not covered elsewhere2013-04-30$72,417
Net income (gross income less expenses)2013-04-30$0
Net plan assets at end of year (total assets less liabilities)2013-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2013-04-30$0
Total contributions received or receivable from employer(s)2013-04-30$142,675
2012 : EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2012 401k financial data
Total plan liabilities at end of year2012-04-30$1,422
Total plan liabilities at beginning of year2012-04-30$857
Total income from all sources2012-04-30$82,845
Expenses. Total of all expenses incurred2012-04-30$89,704
Benefits paid (including direct rollovers)2012-04-30$47,678
Total plan assets at end of year2012-04-30$1,422
Total plan assets at beginning of year2012-04-30$7,716
Expenses. Other expenses not covered elsewhere2012-04-30$42,026
Net income (gross income less expenses)2012-04-30$-6,859
Net plan assets at end of year (total assets less liabilities)2012-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2012-04-30$6,859
Total contributions received or receivable from employer(s)2012-04-30$82,845
2011 : EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2011 401k financial data
Total plan liabilities at end of year2011-04-30$857
Total plan liabilities at beginning of year2011-04-30$0
Total income from all sources2011-04-30$37,234
Expenses. Total of all expenses incurred2011-04-30$30,375
Benefits paid (including direct rollovers)2011-04-30$12,844
Total plan assets at end of year2011-04-30$7,716
Total plan assets at beginning of year2011-04-30$0
Expenses. Other expenses not covered elsewhere2011-04-30$17,531
Net income (gross income less expenses)2011-04-30$6,859
Net plan assets at end of year (total assets less liabilities)2011-04-30$6,859
Net plan assets at beginning of year (total assets less liabilities)2011-04-30$0
Total contributions received or receivable from employer(s)2011-04-30$37,234

Form 5500 Responses for EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120

2022: EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2022 form 5500 responses
2022-05-01Type of plan entitySingle employer plan
2022-05-01Submission has been amendedNo
2022-05-01This submission is the final filingNo
2022-05-01This return/report is a short plan year return/report (less than 12 months)No
2022-05-01Plan is a collectively bargained planNo
2022-05-01Plan funding arrangement – InsuranceYes
2022-05-01Plan funding arrangement – General assets of the sponsorYes
2022-05-01Plan benefit arrangement – InsuranceYes
2022-05-01Plan benefit arrangement – General assets of the sponsorYes
2021: EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2021 form 5500 responses
2021-05-01Type of plan entitySingle employer plan
2021-05-01Submission has been amendedNo
2021-05-01This submission is the final filingNo
2021-05-01This return/report is a short plan year return/report (less than 12 months)No
2021-05-01Plan is a collectively bargained planNo
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan funding arrangement – General assets of the sponsorYes
2021-05-01Plan benefit arrangement – InsuranceYes
2021-05-01Plan benefit arrangement – General assets of the sponsorYes
2020: EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2020 form 5500 responses
2020-05-01Type of plan entitySingle employer plan
2020-05-01Submission has been amendedNo
2020-05-01This submission is the final filingNo
2020-05-01This return/report is a short plan year return/report (less than 12 months)No
2020-05-01Plan is a collectively bargained planNo
2020-05-01Plan funding arrangement – InsuranceYes
2020-05-01Plan funding arrangement – TrustYes
2020-05-01Plan benefit arrangement – InsuranceYes
2020-05-01Plan benefit arrangement - TrustYes
2019: EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 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 CAVE ENTERPRISES BK 120 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 CAVE ENTERPRISES BK 120 2017 form 5500 responses
2017-05-01Type of plan entitySingle employer plan
2017-05-01Submission has been amendedNo
2017-05-01This submission is the final filingNo
2017-05-01This return/report is a short plan year return/report (less than 12 months)No
2017-05-01Plan is a collectively bargained planNo
2017-05-01Plan funding arrangement – InsuranceYes
2017-05-01Plan funding arrangement – TrustYes
2017-05-01Plan benefit arrangement – InsuranceYes
2017-05-01Plan benefit arrangement - TrustYes
2016: EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2016 form 5500 responses
2016-05-01Type of plan entitySingle employer plan
2016-05-01Submission has been amendedNo
2016-05-01This submission is the final filingNo
2016-05-01This return/report is a short plan year return/report (less than 12 months)No
2016-05-01Plan is a collectively bargained planNo
2016-05-01Plan funding arrangement – InsuranceYes
2016-05-01Plan funding arrangement – TrustYes
2016-05-01Plan benefit arrangement – InsuranceYes
2016-05-01Plan benefit arrangement - TrustYes
2015: EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2015 form 5500 responses
2015-05-01Type of plan entitySingle employer plan
2015-05-01Submission has been amendedNo
2015-05-01This submission is the final filingNo
2015-05-01This return/report is a short plan year return/report (less than 12 months)No
2015-05-01Plan is a collectively bargained planNo
2015-05-01Plan funding arrangement – InsuranceYes
2015-05-01Plan funding arrangement – TrustYes
2015-05-01Plan benefit arrangement – InsuranceYes
2015-05-01Plan benefit arrangement - TrustYes
2014: EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 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 CAVE ENTERPRISES BK 120 2013 form 5500 responses
2013-05-01Type of plan entitySingle employer plan
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
2012: EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2012 form 5500 responses
2012-05-01Type of plan entitySingle employer plan
2012-05-01Submission has been amendedNo
2012-05-01This submission is the final filingNo
2012-05-01This return/report is a short plan year return/report (less than 12 months)No
2012-05-01Plan is a collectively bargained planNo
2012-05-01Plan funding arrangement – InsuranceYes
2012-05-01Plan funding arrangement – TrustYes
2012-05-01Plan benefit arrangement – InsuranceYes
2012-05-01Plan benefit arrangement - TrustYes
2011: EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2011 form 5500 responses
2011-05-01Type of plan entitySingle employer plan
2011-05-01Submission has been amendedNo
2011-05-01This submission is the final filingNo
2011-05-01This return/report is a short plan year return/report (less than 12 months)No
2011-05-01Plan is a collectively bargained planNo
2011-05-01Plan funding arrangement – InsuranceYes
2011-05-01Plan funding arrangement – TrustYes
2011-05-01Plan benefit arrangement – InsuranceYes
2011-05-01Plan benefit arrangement - TrustYes
2010: EMPLOYEE HEALTH PLAN OF CAVE ENTERPRISES BK 120 2010 form 5500 responses
2010-05-01Type of plan entitySingle employer plan
2010-05-01First time form 5500 has been submittedYes
2010-05-01Submission has been amendedNo
2010-05-01This submission is the final filingNo
2010-05-01This return/report is a short plan year return/report (less than 12 months)No
2010-05-01Plan is a collectively bargained planNo
2010-05-01Plan funding arrangement – InsuranceYes
2010-05-01Plan funding arrangement – TrustYes
2010-05-01Plan benefit arrangement – InsuranceYes
2010-05-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

PAN-AMERICAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 67539 )
Policy contract numberSE770
Policy instance 3
Insurance contract or identification numberSE770
Number of Individuals Covered28
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $4,344
Total amount of fees paid to insurance companyUSD $0
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 BenefitYes
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 $44,750
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,344
Insurance broker organization code?3
BLUECROSS BLUESHIELD OF TEXAS (National Association of Insurance Commissioners NAIC id number: 70670 )
Policy contract number77494
Policy instance 2
Insurance contract or identification number77494
Number of Individuals Covered252
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $55,700
Total amount of fees paid to insurance companyUSD $0
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 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 $348,126
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $55,700
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5977588
Policy instance 1
Insurance contract or identification number5977588
Number of Individuals Covered230
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
Total amount of commissions paid to insurance brokerUSD $14,854
Total amount of fees paid to insurance companyUSD $2,554
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 BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
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 $108,377
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $14,854
Amount paid for insurance broker fees2554
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
METROPOLITAN LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65978 )
Policy contract number5977588
Policy instance 1
Insurance contract or identification number5977588
Number of Individuals Covered335
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
Total amount of commissions paid to insurance brokerUSD $12,023
Total amount of fees paid to insurance companyUSD $1,436
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 BenefitYes
Temporary Disability Insurance Welfare BenefitYes
Long Term Disability Insurance Welfare BenefitYes
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 $81,152
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $12,023
Amount paid for insurance broker fees1436
Additional information about fees paid to insurance brokerSUPPLEMENTAL COMPENSATION
Insurance broker organization code?3
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number12051 NFA 0041
Policy instance 1
Insurance contract or identification number12051 NFA 0041
Number of Individuals Covered418
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 $766,985
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 number12051 NFA 0041
Policy instance 1
Insurance contract or identification number12051 NFA 0041
Number of Individuals Covered367
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
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 number12051 NFA 0041
Policy instance 1
Insurance contract or identification number12051 NFA 0041
Number of Individuals Covered351
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 $580,758
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 number12051 NFA 0041
Policy instance 1
Insurance contract or identification number12051 NFA 0041
Number of Individuals Covered302
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 $479,730
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 number12051 NFA 0041
Policy instance 1
Insurance contract or identification number12051 NFA 0041
Number of Individuals Covered127
Insurance policy start date2015-05-01
Insurance policy end date2016-04-30
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 $275,826
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 number12051 NFA 0041
Policy instance 1
Insurance contract or identification number12051 NFA 0041
Number of Individuals Covered90
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 $204,562
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 number12051 NFA 0041
Policy instance 1
Insurance contract or identification number12051 NFA 0041
Number of Individuals Covered37
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 $82,132
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 number12051 NFA 0041
Policy instance 1
Insurance contract or identification number12051 NFA 0041
Number of Individuals Covered38
Insurance policy start date2012-05-01
Insurance policy end date2013-04-30
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 $53,904
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 number12051 NFA 0041
Policy instance 1
Insurance contract or identification number12051 NFA 0041
Number of Individuals Covered33
Insurance policy start date2011-05-01
Insurance policy end date2012-04-30
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 $29,177
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 number12051 NFA 0041
Policy instance 1
Insurance contract or identification number12051 NFA 0041
Number of Individuals Covered13
Insurance policy start date2010-05-01
Insurance policy end date2011-04-30
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 $14,275
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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