401k Plan data: THE YARROW GROUP EMPLOYEE BENEFITS PLAN plan

THE YARROW GROUP EMPLOYEE BENEFITS PLAN 401k Plan overview

Plan Name	THE YARROW GROUP EMPLOYEE BENEFITS PLAN
Plan identification number	501

THE YARROW GROUP EMPLOYEE BENEFITS PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Dental Vision

401k Sponsoring company profile

THE YARROW GROUP, LLC has sponsored the creation of one or more 401k plans.

Company Name: THE YARROW GROUP, LLC

Employer identification number (EIN): 461243007

NAIC Classification: 722513
NAIC Description: Limited-Service Restaurants

Additional information about THE YARROW GROUP, LLC

Jurisdiction of Incorporation: Washington Secretary of State Corporations Division

Incorporation Date: 2012-09-19

Company Identification Number: 603239452

Legal Registered Office Address: 1780 BARNES BLVD SW

TUMWATER
United States of America (USA)
98512

More information about THE YARROW GROUP, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE YARROW GROUP EMPLOYEE BENEFITS PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2020-03-01

Plan Statistics for THE YARROW GROUP EMPLOYEE BENEFITS PLAN

401k plan membership statisitcs for THE YARROW GROUP EMPLOYEE BENEFITS PLAN

Measure Date Value
2020: THE YARROW GROUP EMPLOYEE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year 2020-03-01 110
Total number of active participants reported on line 7a of the Form 5500 2020-03-01 53
Number of retired or separated participants receiving benefits 2020-03-01 1
Total of all active and inactive participants 2020-03-01 54

Measure	Date	Value
2020: THE YARROW GROUP EMPLOYEE BENEFITS PLAN 2020 401k membership
Total participants, beginning-of-year	2020-03-01	110
Total number of active participants reported on line 7a of the Form 5500	2020-03-01	53
Number of retired or separated participants receiving benefits	2020-03-01	1
Total of all active and inactive participants	2020-03-01	54

Form 5500 Responses for THE YARROW GROUP EMPLOYEE BENEFITS PLAN

2020: THE YARROW GROUP EMPLOYEE BENEFITS PLAN 2020 form 5500 responses
2020-03-01	Type of plan entity	Single employer plan
2020-03-01	First time form 5500 has been submitted	Yes
2020-03-01	Submission has been amended	No
2020-03-01	This submission is the final filing	No
2020-03-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-03-01	Plan is a collectively bargained plan	No
2020-03-01	Plan funding arrangement – Insurance	Yes
2020-03-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-03-01	Plan benefit arrangement – Insurance	Yes
2020-03-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

VISION SERVICE PLAN (National Association of Insurance Commissioners NAIC id number: 53031 )

Policy contract number

30082142

Policy instance

Insurance contract or identification number	30082142
Number of Individuals Covered	53
Insurance policy start date	2020-03-01
Insurance policy end date	2021-02-28
Total amount of commissions paid to insurance broker	USD $518
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	Yes
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $5,357
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $518
Insurance broker organization code?	3

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )

Policy contract number

0143184

Policy instance

Insurance contract or identification number	0143184
Number of Individuals Covered	51
Insurance policy start date	2020-03-01
Insurance policy end date	2021-02-28
Total amount of commissions paid to insurance broker	USD $20,803
Total amount of fees paid to insurance company	USD $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 plan	No
Contracts With Unallocated Funds Deposit Administration	0
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 Benefit	Yes
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
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 Carrier	USD $455,145
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $20,803
Insurance broker organization code?	3

Potentially related plans

THE YARROW PROJECT 401(K) PLAN [EIN = 873586869]

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Company Name:	THE YARROW GROUP, LLC
Employer identification number (EIN):	461243007
NAIC Classification:	722513
NAIC Description:	Limited-Service Restaurants

Jurisdiction of Incorporation:	Washington Secretary of State Corporations Division
Incorporation Date:	2012-09-19
Company Identification Number:	603239452
Legal Registered Office Address:	1780 BARNES BLVD SW TUMWATER United States of America (USA) 98512