| Plan Name | EMPLOYEE HEALTH PLAN OF TBAYOU LLC |
| Plan identification number | 502 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | TBAYOU LLC |
| Employer identification number (EIN): | 822263506 |
| NAIC Classification: | 722513 |
| NAIC Description: | Limited-Service Restaurants |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 502 | 2017-10-01 | DANIEL A. TAPIA |
| Measure | Date | Value |
|---|---|---|
| 2018 : EMPLOYEE HEALTH PLAN OF TBAYOU LLC 2018 401k financial data | ||
| Total income from all sources | 2018-04-30 | $10,589 |
| Expenses. Total of all expenses incurred | 2018-04-30 | $7,891 |
| Benefits paid (including direct rollovers) | 2018-04-30 | $2,351 |
| Total plan assets at end of year | 2018-04-30 | $2,698 |
| Value of fidelity bond covering the plan | 2018-04-30 | $5,000 |
| Expenses. Other expenses not covered elsewhere | 2018-04-30 | $5,540 |
| Net income (gross income less expenses) | 2018-04-30 | $2,698 |
| Net plan assets at end of year (total assets less liabilities) | 2018-04-30 | $2,698 |
| 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 | $10,589 |
| 2017: EMPLOYEE HEALTH PLAN OF TBAYOU LLC 2017 form 5500 responses | ||
|---|---|---|
| 2017-10-01 | Type of plan entity | Single employer plan |
| 2017-10-01 | First time form 5500 has been submitted | Yes |
| 2017-10-01 | Submission has been amended | No |
| 2017-10-01 | This submission is the final filing | No |
| 2017-10-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2017-10-01 | Plan is a collectively bargained plan | No |
| 2017-10-01 | Plan funding arrangement – Insurance | Yes |
| 2017-10-01 | Plan funding arrangement – Trust | Yes |
| 2017-10-01 | Plan benefit arrangement – Insurance | Yes |
| 2017-10-01 | Plan benefit arrangement - Trust | Yes |
| NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 ) | |
| Policy contract number | 14459 NFA 0663 |
| Policy instance | 1 |