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EMPLOYEE HEALTH PLAN OF FOLEY SPORTS JV LLC DBA GROOVY GOAT 401k Plan overview

Plan NameEMPLOYEE HEALTH PLAN OF FOLEY SPORTS JV LLC DBA GROOVY GOAT
Plan identification number 501

EMPLOYEE HEALTH PLAN OF FOLEY SPORTS JV LLC DBA GROOVY GOAT Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Dental

401k Sponsoring company profile

FOLEY SPORTS JV LLC DBA GROOVY GOAT has sponsored the creation of one or more 401k plans.

Company Name:FOLEY SPORTS JV LLC DBA GROOVY GOAT
Employer identification number (EIN):821762905
NAIC Classification:722513
NAIC Description:Limited-Service Restaurants

Additional information about FOLEY SPORTS JV LLC DBA GROOVY GOAT

Jurisdiction of Incorporation: Florida Department of State Division of Corporations
Incorporation Date: 2017-06-01
Company Identification Number: L17000119872
Legal Registered Office Address: 324 W. MORSE BLVD.

WINTER PARK

32789

More information about FOLEY SPORTS JV LLC DBA GROOVY GOAT

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE HEALTH PLAN OF FOLEY SPORTS JV LLC DBA GROOVY GOAT

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-05-01
5012021-05-01
5012020-05-01
5012019-05-01
5012018-09-01
5012017-09-01ANDREW GROSS

Plan Statistics for EMPLOYEE HEALTH PLAN OF FOLEY SPORTS JV LLC DBA GROOVY GOAT

401k plan membership statisitcs for EMPLOYEE HEALTH PLAN OF FOLEY SPORTS JV LLC DBA GROOVY GOAT

Measure Date Value
2022: EMPLOYEE HEALTH PLAN OF FOLEY SPORTS JV LLC DBA GROOVY GOAT 2022 401k membership
Total participants, beginning-of-year2022-05-015
Total number of active participants reported on line 7a of the Form 55002022-05-015
Number of retired or separated participants receiving benefits2022-05-010
Number of other retired or separated participants entitled to future benefits2022-05-010
Total of all active and inactive participants2022-05-015
2021: EMPLOYEE HEALTH PLAN OF FOLEY SPORTS JV LLC DBA GROOVY GOAT 2021 401k membership
Total participants, beginning-of-year2021-05-015
Total number of active participants reported on line 7a of the Form 55002021-05-016
Number of retired or separated participants receiving benefits2021-05-010
Number of other retired or separated participants entitled to future benefits2021-05-010
Total of all active and inactive participants2021-05-016
2020: EMPLOYEE HEALTH PLAN OF FOLEY SPORTS JV LLC DBA GROOVY GOAT 2020 401k membership
Total participants, beginning-of-year2020-05-019
Total number of active participants reported on line 7a of the Form 55002020-05-016
Number of retired or separated participants receiving benefits2020-05-010
Number of other retired or separated participants entitled to future benefits2020-05-010
Total of all active and inactive participants2020-05-016
2019: EMPLOYEE HEALTH PLAN OF FOLEY SPORTS JV LLC DBA GROOVY GOAT 2019 401k membership
Total participants, beginning-of-year2019-05-0110
Total number of active participants reported on line 7a of the Form 55002019-05-019
Number of retired or separated participants receiving benefits2019-05-010
Number of other retired or separated participants entitled to future benefits2019-05-010
Total of all active and inactive participants2019-05-019
2018: EMPLOYEE HEALTH PLAN OF FOLEY SPORTS JV LLC DBA GROOVY GOAT 2018 401k membership
Total participants, beginning-of-year2018-09-017
Total number of active participants reported on line 7a of the Form 55002018-09-019
Number of retired or separated participants receiving benefits2018-09-010
Number of other retired or separated participants entitled to future benefits2018-09-010
Total of all active and inactive participants2018-09-019
2017: EMPLOYEE HEALTH PLAN OF FOLEY SPORTS JV LLC DBA GROOVY GOAT 2017 401k membership
Total participants, beginning-of-year2017-09-013
Total number of active participants reported on line 7a of the Form 55002017-09-014
Number of retired or separated participants receiving benefits2017-09-010
Number of other retired or separated participants entitled to future benefits2017-09-010
Total of all active and inactive participants2017-09-014

Financial Data on EMPLOYEE HEALTH PLAN OF FOLEY SPORTS JV LLC DBA GROOVY GOAT

Measure Date Value
2023 : EMPLOYEE HEALTH PLAN OF FOLEY SPORTS JV LLC DBA GROOVY GOAT 2023 401k financial data
Total income from all sources2023-04-30$101,714
Expenses. Total of all expenses incurred2023-04-30$101,714
Benefits paid (including direct rollovers)2023-04-30$50,905
Value of fidelity bond covering the plan2023-04-30$9,000
Expenses. Other expenses not covered elsewhere2023-04-30$50,809
Net income (gross income less expenses)2023-04-30$0
Net plan assets at end of year (total assets less liabilities)2023-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2023-04-30$0
Total contributions received or receivable from employer(s)2023-04-30$101,714
2022 : EMPLOYEE HEALTH PLAN OF FOLEY SPORTS JV LLC DBA GROOVY GOAT 2022 401k financial data
Total income from all sources2022-04-30$67,756
Expenses. Total of all expenses incurred2022-04-30$67,756
Benefits paid (including direct rollovers)2022-04-30$33,478
Total plan assets at beginning of year2022-04-30$0
Value of fidelity bond covering the plan2022-04-30$4,000
Expenses. Other expenses not covered elsewhere2022-04-30$34,278
Net income (gross income less expenses)2022-04-30$0
Net plan assets at end of year (total assets less liabilities)2022-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2022-04-30$0
Total contributions received or receivable from employer(s)2022-04-30$67,756
2021 : EMPLOYEE HEALTH PLAN OF FOLEY SPORTS JV LLC DBA GROOVY GOAT 2021 401k financial data
Total plan liabilities at beginning of year2021-04-30$0
Total income from all sources2021-04-30$70,242
Expenses. Total of all expenses incurred2021-04-30$70,242
Benefits paid (including direct rollovers)2021-04-30$34,659
Total plan assets at end of year2021-04-30$0
Total plan assets at beginning of year2021-04-30$0
Value of fidelity bond covering the plan2021-04-30$10,000
Expenses. Other expenses not covered elsewhere2021-04-30$35,583
Net income (gross income less expenses)2021-04-30$0
Net plan assets at end of year (total assets less liabilities)2021-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2021-04-30$0
Total contributions received or receivable from employer(s)2021-04-30$70,242
2020 : EMPLOYEE HEALTH PLAN OF FOLEY SPORTS JV LLC DBA GROOVY GOAT 2020 401k financial data
Total plan liabilities at end of year2020-04-30$0
Total plan liabilities at beginning of year2020-04-30$0
Total income from all sources2020-04-30$76,824
Expenses. Total of all expenses incurred2020-04-30$76,824
Benefits paid (including direct rollovers)2020-04-30$35,129
Total plan assets at end of year2020-04-30$0
Total plan assets at beginning of year2020-04-30$0
Value of fidelity bond covering the plan2020-04-30$10,000
Expenses. Other expenses not covered elsewhere2020-04-30$41,695
Net income (gross income less expenses)2020-04-30$0
Net plan assets at end of year (total assets less liabilities)2020-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2020-04-30$0
Total contributions received or receivable from employer(s)2020-04-30$76,824
2018 : EMPLOYEE HEALTH PLAN OF FOLEY SPORTS JV LLC DBA GROOVY GOAT 2018 401k financial data
Total plan liabilities at end of year2018-04-30$0
Total income from all sources2018-04-30$23,896
Expenses. Total of all expenses incurred2018-04-30$23,896
Benefits paid (including direct rollovers)2018-04-30$11,334
Total plan assets at end of year2018-04-30$0
Value of fidelity bond covering the plan2018-04-30$5,000
Expenses. Other expenses not covered elsewhere2018-04-30$12,562
Net income (gross income less expenses)2018-04-30$0
Net plan assets at end of year (total assets less liabilities)2018-04-30$0
Net plan assets at beginning of year (total assets less liabilities)2018-04-30$0
Total contributions received or receivable from employer(s)2018-04-30$23,896

Form 5500 Responses for EMPLOYEE HEALTH PLAN OF FOLEY SPORTS JV LLC DBA GROOVY GOAT

2022: EMPLOYEE HEALTH PLAN OF FOLEY SPORTS JV LLC DBA GROOVY GOAT 2022 form 5500 responses
2022-05-01Type of plan entitySingle employer plan
2022-05-01Submission has been amendedNo
2022-05-01This submission is the final filingNo
2022-05-01This return/report is a short plan year return/report (less than 12 months)No
2022-05-01Plan is a collectively bargained planNo
2022-05-01Plan funding arrangement – InsuranceYes
2022-05-01Plan funding arrangement – TrustYes
2022-05-01Plan benefit arrangement – InsuranceYes
2022-05-01Plan benefit arrangement - TrustYes
2021: EMPLOYEE HEALTH PLAN OF FOLEY SPORTS JV LLC DBA GROOVY GOAT 2021 form 5500 responses
2021-05-01Type of plan entitySingle employer plan
2021-05-01Submission has been amendedNo
2021-05-01This submission is the final filingNo
2021-05-01This return/report is a short plan year return/report (less than 12 months)No
2021-05-01Plan is a collectively bargained planNo
2021-05-01Plan funding arrangement – InsuranceYes
2021-05-01Plan funding arrangement – TrustYes
2021-05-01Plan benefit arrangement – InsuranceYes
2021-05-01Plan benefit arrangement - TrustYes
2020: EMPLOYEE HEALTH PLAN OF FOLEY SPORTS JV LLC DBA GROOVY GOAT 2020 form 5500 responses
2020-05-01Type of plan entitySingle employer plan
2020-05-01Submission has been amendedNo
2020-05-01This submission is the final filingNo
2020-05-01This return/report is a short plan year return/report (less than 12 months)No
2020-05-01Plan is a collectively bargained planNo
2020-05-01Plan funding arrangement – InsuranceYes
2020-05-01Plan funding arrangement – TrustYes
2020-05-01Plan benefit arrangement – InsuranceYes
2020-05-01Plan benefit arrangement - TrustYes
2019: EMPLOYEE HEALTH PLAN OF FOLEY SPORTS JV LLC DBA GROOVY GOAT 2019 form 5500 responses
2019-05-01Type of plan entitySingle employer plan
2019-05-01Submission has been amendedNo
2019-05-01This submission is the final filingNo
2019-05-01This return/report is a short plan year return/report (less than 12 months)No
2019-05-01Plan is a collectively bargained planNo
2019-05-01Plan funding arrangement – InsuranceYes
2019-05-01Plan funding arrangement – TrustYes
2019-05-01Plan benefit arrangement – InsuranceYes
2019-05-01Plan benefit arrangement - TrustYes
2018: EMPLOYEE HEALTH PLAN OF FOLEY SPORTS JV LLC DBA GROOVY GOAT 2018 form 5500 responses
2018-09-01Type of plan entitySingle employer plan
2018-09-01Submission has been amendedNo
2018-09-01This submission is the final filingNo
2018-09-01This return/report is a short plan year return/report (less than 12 months)Yes
2018-09-01Plan is a collectively bargained planNo
2018-09-01Plan funding arrangement – InsuranceYes
2018-09-01Plan funding arrangement – TrustYes
2018-09-01Plan benefit arrangement – InsuranceYes
2018-09-01Plan benefit arrangement - TrustYes
2017: EMPLOYEE HEALTH PLAN OF FOLEY SPORTS JV LLC DBA GROOVY GOAT 2017 form 5500 responses
2017-09-01Type of plan entitySingle employer plan
2017-09-01First time form 5500 has been submittedYes
2017-09-01Submission has been amendedNo
2017-09-01This submission is the final filingNo
2017-09-01This return/report is a short plan year return/report (less than 12 months)Yes
2017-09-01Plan is a collectively bargained planNo
2017-09-01Plan funding arrangement – InsuranceYes
2017-09-01Plan funding arrangement – TrustYes
2017-09-01Plan benefit arrangement – InsuranceYes
2017-09-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number30017NFA0655
Policy instance 1
Insurance contract or identification number30017NFA0655
Number of Individuals Covered12
Insurance policy start date2022-05-01
Insurance policy end date2023-04-30
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $42,759
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number30017NFA0655
Policy instance 1
Insurance contract or identification number30017NFA0655
Number of Individuals Covered13
Insurance policy start date2021-05-01
Insurance policy end date2022-04-30
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $28,546
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number30017NFA0655
Policy instance 1
Insurance contract or identification number30017NFA0655
Number of Individuals Covered17
Insurance policy start date2020-05-01
Insurance policy end date2021-04-30
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $29,627
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number30017NFA0655
Policy instance 1
Insurance contract or identification number30017NFA0655
Number of Individuals Covered22
Insurance policy start date2019-05-01
Insurance policy end date2020-04-30
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $32,055
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number30017 NFA 0655
Policy instance 1
Insurance contract or identification number30017 NFA 0655
Number of Individuals Covered18
Insurance policy start date2018-05-01
Insurance policy end date2019-04-30
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $21,108
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number30017 NFA 0655
Policy instance 1
Insurance contract or identification number30017 NFA 0655
Number of Individuals Covered10
Insurance policy start date2017-05-01
Insurance policy end date2018-04-30
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 planNo
Contracts With Unallocated Funds Deposit Administration0
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 BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
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 CarrierUSD $10,069
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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