| Plan Name | EMPLOYEE BENEFITS PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | ROCK SOLID RESTAURANTS LLC |
| Employer identification number (EIN): | 462371003 |
| NAIC Classification: | 722511 |
| NAIC Description: | Full-Service Restaurants |
Additional information about ROCK SOLID RESTAURANTS LLC
| Jurisdiction of Incorporation: | Oregon Secretary of State Corporations Division |
| Incorporation Date: | 2016-01-15 |
| Company Identification Number: | 117841692 |
| Legal Registered Office Address: |
17155 SE SUNNYSIDE RD HAPPY VALLEY United States of America (USA) 97086 |
More information about ROCK SOLID RESTAURANTS LLC
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2022-10-01 | TOMMY TRIBBETT | 2024-07-10 | ||
| 501 | 2021-10-01 | TOMMY TRIBBETT | 2023-01-10 | ||
| 501 | 2020-12-01 | TOMMY TRIBBETT | 2022-01-18 | ||
| 501 | 2019-12-01 | THOMAS H. TRIBBETT | 2021-06-01 | ||
| 501 | 2019-12-01 | THOMAS H. TRIBBETT | 2021-05-28 | ||
| 501 | 2018-12-01 | THOMAS H. TRIBBETT | 2020-09-08 | ||
| 501 | 2018-12-01 | THOMAS H. TRIBBETT | 2021-05-28 |
| 2022: EMPLOYEE BENEFITS PLAN 2022 form 5500 responses | ||
|---|---|---|
| 2022-10-01 | Type of plan entity | Single employer plan |
| 2022-10-01 | Plan funding arrangement – Insurance | Yes |
| 2022-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2021: EMPLOYEE BENEFITS PLAN 2021 form 5500 responses | ||
| 2021-10-01 | Type of plan entity | Single employer plan |
| 2021-10-01 | Plan funding arrangement – Insurance | Yes |
| 2021-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2020: EMPLOYEE BENEFITS PLAN 2020 form 5500 responses | ||
| 2020-12-01 | Type of plan entity | Single employer plan |
| 2020-12-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2020-12-01 | Plan funding arrangement – Insurance | Yes |
| 2020-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2019: EMPLOYEE BENEFITS PLAN 2019 form 5500 responses | ||
| 2019-12-01 | Type of plan entity | Single employer plan |
| 2019-12-01 | Submission has been amended | Yes |
| 2019-12-01 | Plan funding arrangement – Insurance | Yes |
| 2019-12-01 | Plan benefit arrangement – Insurance | Yes |
| 2018: EMPLOYEE BENEFITS PLAN 2018 form 5500 responses | ||
| 2018-12-01 | Type of plan entity | Single employer plan |
| 2018-12-01 | First time form 5500 has been submitted | Yes |
| 2018-12-01 | Submission has been amended | Yes |
| 2018-12-01 | Plan funding arrangement – Insurance | Yes |
| 2018-12-01 | Plan benefit arrangement – Insurance | Yes |
| LIFEMAP ASSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 97985 ) | |
| Policy contract number | GRPO0005384 |
| Policy instance | 3 |
| REGENCE BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 53902 ) | |
| Policy contract number | 10044035 |
| Policy instance | 2 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 554419 |
| Policy instance | 1 |
| REGENCE BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 53902 ) | |
| Policy contract number | 10044035 |
| Policy instance | 2 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 554419 |
| Policy instance | 1 |
| REGENCE BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 53902 ) | |
| Policy contract number | 10044035 |
| Policy instance | 2 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 554419 |
| Policy instance | 1 |
| REGENCE BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 53902 ) | |
| Policy contract number | 10044035 |
| Policy instance | 2 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 554419 |
| Policy instance | 1 |
| REGENCE BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 53902 ) | |
| Policy contract number | 10044035 |
| Policy instance | 3 |
| GROUP HEALTH OPTIONS, INC. (National Association of Insurance Commissioners NAIC id number: 47055 ) | |
| Policy contract number | 6549000 |
| Policy instance | 1 |
| THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 ) | |
| Policy contract number | 554419 |
| Policy instance | 2 |