401k Plan data: THE REVEL GROUP LIFE, AD&D, LTD, & STD PLAN plan

THE REVEL GROUP LIFE, AD&D, LTD, & STD PLAN 401k Plan overview

Plan Name	THE REVEL GROUP LIFE, AD&D, LTD, & STD PLAN
Plan identification number	502

THE REVEL GROUP LIFE, AD&D, LTD, & STD PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Temporary disability (accident and sickness) Long-term disability cover Other welfare benefit cover Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

THE REVEL GROUP, INC. has sponsored the creation of one or more 401k plans.

Company Name: THE REVEL GROUP, INC.

Employer identification number (EIN): 474053030

NAIC Classification: 551112
NAIC Description: Offices of Other Holding Companies

Additional information about THE REVEL GROUP, INC.

Jurisdiction of Incorporation: Texas Secretary of State

Incorporation Date: 1994-11-17

Company Identification Number: 0133426200

More information about THE REVEL GROUP, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan THE REVEL GROUP LIFE, AD&D, LTD, & STD PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
502 2020-01-01 CLINT PATON 2021-09-07 CLINT PATON 2021-09-07

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
502	2020-01-01	CLINT PATON	2021-09-07	CLINT PATON	2021-09-07

Plan Statistics for THE REVEL GROUP LIFE, AD&D, LTD, & STD PLAN

401k plan membership statisitcs for THE REVEL GROUP LIFE, AD&D, LTD, & STD PLAN

Measure Date Value
2020: THE REVEL GROUP LIFE, AD&D, LTD, & STD PLAN 2020 401k membership
Total participants, beginning-of-year 2020-01-01 123
Total number of active participants reported on line 7a of the Form 5500 2020-01-01 22
Number of retired or separated participants receiving benefits 2020-01-01 0
Number of other retired or separated participants entitled to future benefits 2020-01-01 0
Total of all active and inactive participants 2020-01-01 22

Measure	Date	Value
2020: THE REVEL GROUP LIFE, AD&D, LTD, & STD PLAN 2020 401k membership
Total participants, beginning-of-year	2020-01-01	123
Total number of active participants reported on line 7a of the Form 5500	2020-01-01	22
Number of retired or separated participants receiving benefits	2020-01-01	0
Number of other retired or separated participants entitled to future benefits	2020-01-01	0
Total of all active and inactive participants	2020-01-01	22

Form 5500 Responses for THE REVEL GROUP LIFE, AD&D, LTD, & STD PLAN

2020: THE REVEL GROUP LIFE, AD&D, LTD, & STD PLAN 2020 form 5500 responses
2020-01-01	Type of plan entity	Single employer plan
2020-01-01	First time form 5500 has been submitted	Yes
2020-01-01	Submission has been amended	No
2020-01-01	This submission is the final filing	No
2020-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2020-01-01	Plan is a collectively bargained plan	No
2020-01-01	Plan funding arrangement – Insurance	Yes
2020-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

DEARBORN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 71129 )

Policy contract number

F019882

Policy instance

Insurance contract or identification number	F019882
Number of Individuals Covered	49
Insurance policy start date	2020-01-01
Insurance policy end date	2020-12-31
Total amount of commissions paid to insurance broker	USD $2,371
Total amount of fees paid to insurance company	USD $1,256
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	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
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 $19,381
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $2,371
Amount paid for insurance broker fees	649
Additional information about fees paid to insurance broker	ADDITIONAL COMPENSATION
Insurance broker organization code?	3

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Company Name:	THE REVEL GROUP, INC.
Employer identification number (EIN):	474053030
NAIC Classification:	551112
NAIC Description:	Offices of Other Holding Companies

Jurisdiction of Incorporation:	Texas Secretary of State
Incorporation Date:	1994-11-17
Company Identification Number:	0133426200