| Plan Name | EMPLOYEE HEALTH PLAN OF FACTORIAL RESTAURANT HOLDINGS LLC |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
|
| Company Name: | FACTORIAL RESTAURANT HOLDINGS LLC |
| Employer identification number (EIN): | 852920023 |
| 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 |
|---|---|---|---|---|---|
| 501 | 2020-11-01 |
| Measure | Date | Value |
|---|---|---|
| 2021 : EMPLOYEE HEALTH PLAN OF FACTORIAL RESTAURANT HOLDINGS LLC 2021 401k financial data | ||
| Total income from all sources | 2021-04-30 | $279,477 |
| Expenses. Total of all expenses incurred | 2021-04-30 | $273,096 |
| Benefits paid (including direct rollovers) | 2021-04-30 | $127,899 |
| Total plan assets at end of year | 2021-04-30 | $6,381 |
| Value of fidelity bond covering the plan | 2021-04-30 | $60,000 |
| Expenses. Other expenses not covered elsewhere | 2021-04-30 | $145,197 |
| Net income (gross income less expenses) | 2021-04-30 | $6,381 |
| Net plan assets at end of year (total assets less liabilities) | 2021-04-30 | $6,381 |
| 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 | $279,477 |
| 2020: EMPLOYEE HEALTH PLAN OF FACTORIAL RESTAURANT HOLDINGS LLC 2020 form 5500 responses | ||
|---|---|---|
| 2020-11-01 | Type of plan entity | Single employer plan |
| 2020-11-01 | First time form 5500 has been submitted | Yes |
| 2020-11-01 | Submission has been amended | No |
| 2020-11-01 | This submission is the final filing | No |
| 2020-11-01 | This return/report is a short plan year return/report (less than 12 months) | Yes |
| 2020-11-01 | Plan is a collectively bargained plan | No |
| 2020-11-01 | Plan funding arrangement – Insurance | Yes |
| 2020-11-01 | Plan funding arrangement – Trust | Yes |
| 2020-11-01 | Plan benefit arrangement – Insurance | Yes |
| 2020-11-01 | Plan benefit arrangement - Trust | Yes |
| NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 ) | |
| Policy contract number | 14493 NFA 0805 |
| Policy instance | 1 |