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BASIC LIFE AD&D 401k Plan overview

Plan NameBASIC LIFE AD&D
Plan identification number 502

BASIC LIFE AD&D Benefits

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

401k Sponsoring company profile

FIREBIRD RESTAURANT OPERATIONS, LLC has sponsored the creation of one or more 401k plans.

Company Name:FIREBIRD RESTAURANT OPERATIONS, LLC
Employer identification number (EIN):364796327
NAIC Classification:722511
NAIC Description:Full-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan BASIC LIFE AD&D

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022020-01-01SANDRA BANKS2021-09-06
5022019-01-01SANDRA BANKS2020-10-14
5022018-01-01ANGIE MARTIN2019-08-01

Plan Statistics for BASIC LIFE AD&D

401k plan membership statisitcs for BASIC LIFE AD&D

Measure Date Value
2020: BASIC LIFE AD&D 2020 401k membership
Total participants, beginning-of-year2020-01-011,270
Total number of active participants reported on line 7a of the Form 55002020-01-01780
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-01780
Number of employers contributing to the scheme2020-01-010
2019: BASIC LIFE AD&D 2019 401k membership
Total participants, beginning-of-year2019-01-011,122
Total number of active participants reported on line 7a of the Form 55002019-01-011,270
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-011,270
Number of employers contributing to the scheme2019-01-010
2018: BASIC LIFE AD&D 2018 401k membership
Total participants, beginning-of-year2018-01-011,135
Total number of active participants reported on line 7a of the Form 55002018-01-011,122
Number of retired or separated participants receiving benefits2018-01-010
Number of other retired or separated participants entitled to future benefits2018-01-010
Total of all active and inactive participants2018-01-011,122
Number of employers contributing to the scheme2018-01-010

Form 5500 Responses for BASIC LIFE AD&D

2020: BASIC LIFE AD&D 2020 form 5500 responses
2020-01-01Type of plan entitySingle employer plan
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan benefit arrangement – InsuranceYes
2019: BASIC LIFE AD&D 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes
2018: BASIC LIFE AD&D 2018 form 5500 responses
2018-01-01Type of plan entitySingle employer plan
2018-01-01First time form 5500 has been submittedYes
2018-01-01Plan funding arrangement – InsuranceYes
2018-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

RENAISSANCE LIFE & HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract number0228/0253
Policy instance 1
Insurance contract or identification number0228/0253
Number of Individuals Covered780
Insurance policy start date2019-11-01
Insurance policy end date2020-10-31
Total amount of commissions paid to insurance brokerUSD $4,821
Total amount of fees paid to insurance companyUSD $0
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 AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $32,138
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,821
Amount paid for insurance broker fees0
Insurance broker organization code?3
RENAISSANCE LIFE & HEALTH INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 52414 )
Policy contract number228, 253
Policy instance 1
Insurance contract or identification number228, 253
Number of Individuals Covered1270
Insurance policy start date2019-01-01
Insurance policy end date2019-10-31
Total amount of commissions paid to insurance brokerUSD $6,964
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 $46,425
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,964
Amount paid for insurance broker fees0
Insurance broker organization code?3
SECURITY MUTUAL LIFE INSURANCE COMPANY OF NY (National Association of Insurance Commissioners NAIC id number: 68772 )
Policy contract numberG00010455500001
Policy instance 1
Insurance contract or identification numberG00010455500001
Number of Individuals Covered1122
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $2,293
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 $15,286
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,293
Amount paid for insurance broker fees0
Insurance broker organization code?3

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