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| Plan Name | THE FORT WORTH CLUB HEALTH REIMBURSEMENT ARRANGEMENT |
| Plan identification number | 535 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | THE FORT WORTH CLUB |
| Employer identification number (EIN): | 750275110 |
| NAIC Classification: | 721110 |
| NAIC Description: | Hotels (except Casino Hotels) and Motels |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 535 | 2018-01-01 | ||||
| 535 | 2016-01-01 | GINGER SHEPPARD |
| Measure | Date | Value |
|---|---|---|
| 2018: THE FORT WORTH CLUB HEALTH REIMBURSEMENT ARRANGEMENT 2018 401k membership | ||
| Total participants, beginning-of-year | 2018-01-01 | 98 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-01-01 | 0 |
| Total of all active and inactive participants | 2018-01-01 | 0 |
| Total participants | 2018-01-01 | 0 |
| 2016: THE FORT WORTH CLUB HEALTH REIMBURSEMENT ARRANGEMENT 2016 401k membership | ||
| Total participants, beginning-of-year | 2016-01-01 | 102 |
| Total number of active participants reported on line 7a of the Form 5500 | 2016-01-01 | 95 |
| Number of retired or separated participants receiving benefits | 2016-01-01 | 0 |
| Total of all active and inactive participants | 2016-01-01 | 95 |
| Total participants | 2016-01-01 | 95 |
| 2018: THE FORT WORTH CLUB HEALTH REIMBURSEMENT ARRANGEMENT 2018 form 5500 responses | ||
|---|---|---|
| 2018-01-01 | Type of plan entity | Single employer plan |
| 2018-01-01 | Submission has been amended | No |
| 2018-01-01 | This submission is the final filing | Yes |
| 2018-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2018-01-01 | Plan is a collectively bargained plan | No |
| 2018-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| 2016: THE FORT WORTH CLUB HEALTH REIMBURSEMENT ARRANGEMENT 2016 form 5500 responses | ||
| 2016-01-01 | Type of plan entity | Single employer plan |
| 2016-01-01 | First time form 5500 has been submitted | Yes |
| 2016-01-01 | Submission has been amended | No |
| 2016-01-01 | This submission is the final filing | No |
| 2016-01-01 | This return/report is a short plan year return/report (less than 12 months) | No |
| 2016-01-01 | Plan is a collectively bargained plan | No |
| 2016-01-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2016-01-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
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