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EMPLOYEE HEALTH PLAN OF DEEP VALLEY ENTERPRISES 401k Plan overview

Plan NameEMPLOYEE HEALTH PLAN OF DEEP VALLEY ENTERPRISES
Plan identification number 501

EMPLOYEE HEALTH PLAN OF DEEP VALLEY ENTERPRISES Benefits

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

401k Sponsoring company profile

DEEP VALLEY ENTERPRISES has sponsored the creation of one or more 401k plans.

Company Name:DEEP VALLEY ENTERPRISES
Employer identification number (EIN):942580612
NAIC Classification:722511
NAIC Description:Full-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan EMPLOYEE HEALTH PLAN OF DEEP VALLEY ENTERPRISES

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
5012020-01-01

Plan Statistics for EMPLOYEE HEALTH PLAN OF DEEP VALLEY ENTERPRISES

401k plan membership statisitcs for EMPLOYEE HEALTH PLAN OF DEEP VALLEY ENTERPRISES

Measure Date Value
2022: EMPLOYEE HEALTH PLAN OF DEEP VALLEY ENTERPRISES 2022 401k membership
Total participants, beginning-of-year2022-05-014
Total number of active participants reported on line 7a of the Form 55002022-05-014
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 participants2022-05-014
2021: EMPLOYEE HEALTH PLAN OF DEEP VALLEY ENTERPRISES 2021 401k membership
Total participants, beginning-of-year2021-05-014
Total number of active participants reported on line 7a of the Form 55002021-05-014
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 participants2021-05-014
2020: EMPLOYEE HEALTH PLAN OF DEEP VALLEY ENTERPRISES 2020 401k membership
Total participants, beginning-of-year2020-05-016
Total number of active participants reported on line 7a of the Form 55002020-05-014
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 participants2020-05-014
Total participants, beginning-of-year2020-01-015
Total number of active participants reported on line 7a of the Form 55002020-01-015
Number of retired or separated participants receiving benefits2020-01-010
Number of other retired or separated participants entitled to future benefits2020-01-010
Total of all active and inactive participants2020-01-015

Financial Data on EMPLOYEE HEALTH PLAN OF DEEP VALLEY ENTERPRISES

Measure Date Value
2023 : EMPLOYEE HEALTH PLAN OF DEEP VALLEY ENTERPRISES 2023 401k financial data
Total income from all sources2023-04-30$8,501
Expenses. Total of all expenses incurred2023-04-30$5,915
Benefits paid (including direct rollovers)2023-04-30$880
Total plan assets at end of year2023-04-30$9,905
Total plan assets at beginning of year2023-04-30$7,319
Value of fidelity bond covering the plan2023-04-30$2,000
Expenses. Other expenses not covered elsewhere2023-04-30$5,035
Net income (gross income less expenses)2023-04-30$2,586
Net plan assets at end of year (total assets less liabilities)2023-04-30$9,905
Net plan assets at beginning of year (total assets less liabilities)2023-04-30$7,319
Total contributions received or receivable from employer(s)2023-04-30$8,501
2022 : EMPLOYEE HEALTH PLAN OF DEEP VALLEY ENTERPRISES 2022 401k financial data
Total income from all sources2022-04-30$8,442
Expenses. Total of all expenses incurred2022-04-30$5,226
Benefits paid (including direct rollovers)2022-04-30$260
Total plan assets at end of year2022-04-30$7,319
Total plan assets at beginning of year2022-04-30$4,103
Value of fidelity bond covering the plan2022-04-30$1,000
Expenses. Other expenses not covered elsewhere2022-04-30$4,966
Net income (gross income less expenses)2022-04-30$3,216
Net plan assets at end of year (total assets less liabilities)2022-04-30$7,319
Net plan assets at beginning of year (total assets less liabilities)2022-04-30$4,103
Total contributions received or receivable from employer(s)2022-04-30$8,442
2021 : EMPLOYEE HEALTH PLAN OF DEEP VALLEY ENTERPRISES 2021 401k financial data
Total plan liabilities at beginning of year2021-04-30$0
Total income from all sources2021-04-30$9,954
Expenses. Total of all expenses incurred2021-04-30$6,856
Benefits paid (including direct rollovers)2021-04-30$919
Total plan assets at end of year2021-04-30$4,103
Total plan assets at beginning of year2021-04-30$1,005
Value of fidelity bond covering the plan2021-04-30$5,000
Expenses. Other expenses not covered elsewhere2021-04-30$5,937
Net income (gross income less expenses)2021-04-30$3,098
Net plan assets at end of year (total assets less liabilities)2021-04-30$4,103
Net plan assets at beginning of year (total assets less liabilities)2021-04-30$1,005
Total contributions received or receivable from employer(s)2021-04-30$9,954
2020 : EMPLOYEE HEALTH PLAN OF DEEP VALLEY ENTERPRISES 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$2,638
Expenses. Total of all expenses incurred2020-04-30$1,633
Benefits paid (including direct rollovers)2020-04-30$72
Total plan assets at end of year2020-04-30$1,005
Total plan assets at beginning of year2020-04-30$0
Value of fidelity bond covering the plan2020-04-30$5,000
Expenses. Other expenses not covered elsewhere2020-04-30$1,561
Net income (gross income less expenses)2020-04-30$1,005
Net plan assets at end of year (total assets less liabilities)2020-04-30$1,005
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$2,638

Form 5500 Responses for EMPLOYEE HEALTH PLAN OF DEEP VALLEY ENTERPRISES

2022: EMPLOYEE HEALTH PLAN OF DEEP VALLEY ENTERPRISES 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 DEEP VALLEY ENTERPRISES 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 DEEP VALLEY ENTERPRISES 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
2020-01-01Type of plan entitySingle employer plan
2020-01-01First time form 5500 has been submittedYes
2020-01-01Submission has been amendedNo
2020-01-01This submission is the final filingNo
2020-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2020-01-01Plan is a collectively bargained planNo
2020-01-01Plan funding arrangement – InsuranceYes
2020-01-01Plan funding arrangement – TrustYes
2020-01-01Plan benefit arrangement – InsuranceYes
2020-01-01Plan benefit arrangement - TrustYes

Insurance Providers Used on plan

NFA HEALTH PLUS INCORPORATED CELL (National Association of Insurance Commissioners NAIC id number: 0 )
Policy contract number14479 NFA 0756
Policy instance 1
Insurance contract or identification number14479 NFA 0756
Number of Individuals Covered4
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 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 $3,687
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 number14479 NFA 0756
Policy instance 1
Insurance contract or identification number14479 NFA 0756
Number of Individuals Covered4
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 $3,727
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 number14479 NFA 0756
Policy instance 1
Insurance contract or identification number14479 NFA 0756
Number of Individuals Covered4
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 $4,387
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 number14479 NFA 0756
Policy instance 1
Insurance contract or identification number14479 NFA 0756
Number of Individuals Covered5
Insurance policy start date2020-01-01
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 $1,162
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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