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EMPLOYEE HEALTH PLAN OF JETHWA MANAGEMENT LLC 401k Plan overview

Plan NameEMPLOYEE HEALTH PLAN OF JETHWA MANAGEMENT LLC
Plan identification number 502

EMPLOYEE HEALTH PLAN OF JETHWA MANAGEMENT LLC Benefits

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

401k Sponsoring company profile

JETHWA MANAGEMENT, LLC has sponsored the creation of one or more 401k plans.

Company Name:JETHWA MANAGEMENT, LLC
Employer identification number (EIN):223666724
NAIC Classification:722513
NAIC Description:Limited-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE HEALTH PLAN OF JETHWA MANAGEMENT LLC

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-05-01
5022020-05-01
5022019-05-01
5022018-07-01

Plan Statistics for EMPLOYEE HEALTH PLAN OF JETHWA MANAGEMENT LLC

401k plan membership statisitcs for EMPLOYEE HEALTH PLAN OF JETHWA MANAGEMENT LLC

Measure Date Value
2022: EMPLOYEE HEALTH PLAN OF JETHWA MANAGEMENT LLC 2022 401k membership
Total participants, beginning-of-year2022-05-017
Total number of active participants reported on line 7a of the Form 55002022-05-017
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 participants2022-05-017
2020: EMPLOYEE HEALTH PLAN OF JETHWA MANAGEMENT LLC 2020 401k membership
Total participants, beginning-of-year2020-05-0112
Total number of active participants reported on line 7a of the Form 55002020-05-0110
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 participants2020-05-0110
2019: EMPLOYEE HEALTH PLAN OF JETHWA MANAGEMENT LLC 2019 401k membership
Total participants, beginning-of-year2019-05-0112
Total number of active participants reported on line 7a of the Form 55002019-05-0112
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 participants2019-05-0112
2018: EMPLOYEE HEALTH PLAN OF JETHWA MANAGEMENT LLC 2018 401k membership
Total participants, beginning-of-year2018-07-0112
Total number of active participants reported on line 7a of the Form 55002018-07-0112
Number of retired or separated participants receiving benefits2018-07-010
Number of other retired or separated participants entitled to future benefits2018-07-010
Total of all active and inactive participants2018-07-0112

Financial Data on EMPLOYEE HEALTH PLAN OF JETHWA MANAGEMENT LLC

Measure Date Value
2023 : EMPLOYEE HEALTH PLAN OF JETHWA MANAGEMENT LLC 2023 401k financial data
Total income from all sources2023-04-30$54,862
Expenses. Total of all expenses incurred2023-04-30$33,111
Benefits paid (including direct rollovers)2023-04-30$3,392
Total plan assets at end of year2023-04-30$58,824
Total plan assets at beginning of year2023-04-30$37,073
Value of fidelity bond covering the plan2023-04-30$4,000
Expenses. Other expenses not covered elsewhere2023-04-30$29,719
Net income (gross income less expenses)2023-04-30$21,751
Net plan assets at end of year (total assets less liabilities)2023-04-30$58,824
Net plan assets at beginning of year (total assets less liabilities)2023-04-30$37,073
Total contributions received or receivable from employer(s)2023-04-30$54,862
2021 : EMPLOYEE HEALTH PLAN OF JETHWA MANAGEMENT LLC 2021 401k financial data
Total plan liabilities at beginning of year2021-04-30$0
Total income from all sources2021-04-30$64,372
Expenses. Total of all expenses incurred2021-04-30$91,320
Benefits paid (including direct rollovers)2021-04-30$55,476
Total plan assets at end of year2021-04-30$20,291
Total plan assets at beginning of year2021-04-30$47,239
Value of fidelity bond covering the plan2021-04-30$20,000
Expenses. Other expenses not covered elsewhere2021-04-30$35,844
Net income (gross income less expenses)2021-04-30$-26,948
Net plan assets at end of year (total assets less liabilities)2021-04-30$20,291
Net plan assets at beginning of year (total assets less liabilities)2021-04-30$47,239
Total contributions received or receivable from employer(s)2021-04-30$64,372
2020 : EMPLOYEE HEALTH PLAN OF JETHWA MANAGEMENT LLC 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$75,228
Expenses. Total of all expenses incurred2020-04-30$51,042
Benefits paid (including direct rollovers)2020-04-30$9,320
Total plan assets at end of year2020-04-30$47,239
Total plan assets at beginning of year2020-04-30$23,053
Value of fidelity bond covering the plan2020-04-30$20,000
Expenses. Other expenses not covered elsewhere2020-04-30$41,722
Net income (gross income less expenses)2020-04-30$24,186
Net plan assets at end of year (total assets less liabilities)2020-04-30$47,239
Net plan assets at beginning of year (total assets less liabilities)2020-04-30$23,053
Total contributions received or receivable from employer(s)2020-04-30$75,228
2019 : EMPLOYEE HEALTH PLAN OF JETHWA MANAGEMENT LLC 2019 401k financial data
Total plan liabilities at end of year2019-04-30$0
Total plan liabilities at beginning of year2019-04-30$0
Total income from all sources2019-04-30$67,631
Expenses. Total of all expenses incurred2019-04-30$44,578
Benefits paid (including direct rollovers)2019-04-30$5,320
Total plan assets at end of year2019-04-30$23,053
Total plan assets at beginning of year2019-04-30$0
Value of fidelity bond covering the plan2019-04-30$20,000
Expenses. Other expenses not covered elsewhere2019-04-30$39,258
Net income (gross income less expenses)2019-04-30$23,053
Net plan assets at end of year (total assets less liabilities)2019-04-30$23,053
Net plan assets at beginning of year (total assets less liabilities)2019-04-30$0
Total contributions received or receivable from employer(s)2019-04-30$67,631

Form 5500 Responses for EMPLOYEE HEALTH PLAN OF JETHWA MANAGEMENT LLC

2022: EMPLOYEE HEALTH PLAN OF JETHWA MANAGEMENT LLC 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 – TrustYes
2022-05-01Plan benefit arrangement – InsuranceYes
2022-05-01Plan benefit arrangement - TrustYes
2020: EMPLOYEE HEALTH PLAN OF JETHWA MANAGEMENT LLC 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 JETHWA MANAGEMENT LLC 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 JETHWA MANAGEMENT LLC 2018 form 5500 responses
2018-07-01Type of plan entitySingle employer plan
2018-07-01First time form 5500 has been submittedYes
2018-07-01Submission has been amendedNo
2018-07-01This submission is the final filingNo
2018-07-01This return/report is a short plan year return/report (less than 12 months)Yes
2018-07-01Plan is a collectively bargained planNo
2018-07-01Plan funding arrangement – InsuranceYes
2018-07-01Plan funding arrangement – TrustYes
2018-07-01Plan benefit arrangement – InsuranceYes
2018-07-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number14470NFA0704
Policy instance 1
Insurance contract or identification number14470NFA0704
Number of Individuals Covered7
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
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 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 $23,472
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 number14470NFA0704
Policy instance 1
Insurance contract or identification number14470NFA0704
Number of Individuals Covered10
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
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 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 $26,720
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 number14470NFA0704
Policy instance 1
Insurance contract or identification number14470NFA0704
Number of Individuals Covered13
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 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 $31,409
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 number14470NFA0704
Policy instance 1
Insurance contract or identification number14470NFA0704
Number of Individuals Covered13
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 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 $29,191
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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