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| Plan Name | UNITEDHEALTHCARE GROUP |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | HOTELCRAFTERS LAGUNA, LLC |
| Employer identification number (EIN): | 824638468 |
| 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 |
|---|---|---|---|---|---|
| 501 | 2018-04-01 |
| Measure | Date | Value |
|---|---|---|
| 2018: UNITEDHEALTHCARE GROUP 2018 401k membership | ||
| Total participants, beginning-of-year | 2018-04-01 | 100 |
| Total number of active participants reported on line 7a of the Form 5500 | 2018-04-01 | 89 |
| Number of retired or separated participants receiving benefits | 2018-04-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2018-04-01 | 0 |
| Total of all active and inactive participants | 2018-04-01 | 89 |
| Number of employers contributing to the scheme | 2018-04-01 | 0 |
| 2018: UNITEDHEALTHCARE GROUP 2018 form 5500 responses | ||
|---|---|---|
| 2018-04-01 | Type of plan entity | Single employer plan |
| 2018-04-01 | First time form 5500 has been submitted | Yes |
| 2018-04-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2018-04-01 | Plan funding arrangement – Insurance | Yes |
| 2018-04-01 | Plan funding arrangement – General assets of the sponsor | Yes |
| 2018-04-01 | Plan benefit arrangement – Insurance | Yes |
| 2018-04-01 | Plan benefit arrangement – General assets of the sponsor | Yes |
| UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) | |
| Policy contract number | 911972 |
| Policy instance | 1 |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 231630 |
| Policy instance | 2 |
| EYEMED VISION CARE (National Association of Insurance Commissioners NAIC id number: 71870 ) | |
| Policy contract number | 10136971004 |
| Policy instance | 3 |
| UNITED HEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 01H4836 |
| Policy instance | 4 |
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