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| Plan Name | BLACKSTONE NATIONAL GOLF CLUB EMPLOYEE HEALTH PLAN |
| Plan identification number | 501 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | BLACKSTONE NATIONAL GOLF CLUB |
| Employer identification number (EIN): | 043337958 |
| NAIC Classification: | 713900 |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 501 | 2010-05-01 | CAROLYN KAUFMAN | |||
| 501 | 2009-05-01 | CAROLYN KAUFMAN | |||
| 501 | 2009-05-01 | CAROLYN KAUFMAN |
| Measure | Date | Value |
|---|---|---|
| 2010: BLACKSTONE NATIONAL GOLF CLUB EMPLOYEE HEALTH PLAN 2010 401k membership | ||
| Total participants, beginning-of-year | 2010-05-01 | 6 |
| Total number of active participants reported on line 7a of the Form 5500 | 2010-05-01 | 5 |
| Number of retired or separated participants receiving benefits | 2010-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2010-05-01 | 0 |
| Total of all active and inactive participants | 2010-05-01 | 5 |
| 2009: BLACKSTONE NATIONAL GOLF CLUB EMPLOYEE HEALTH PLAN 2009 401k membership | ||
| Total participants, beginning-of-year | 2009-05-01 | 5 |
| Total number of active participants reported on line 7a of the Form 5500 | 2009-05-01 | 5 |
| Number of retired or separated participants receiving benefits | 2009-05-01 | 0 |
| Number of other retired or separated participants entitled to future benefits | 2009-05-01 | 0 |
| Total of all active and inactive participants | 2009-05-01 | 5 |
| Measure | Date | Value |
|---|---|---|
| 2011 : BLACKSTONE NATIONAL GOLF CLUB EMPLOYEE HEALTH PLAN 2011 401k financial data | ||
| Total plan liabilities at beginning of year | 2011-04-30 | $698 |
| Total income from all sources | 2011-04-30 | $33,232 |
| Expenses. Total of all expenses incurred | 2011-04-30 | $28,634 |
| Benefits paid (including direct rollovers) | 2011-04-30 | $22,097 |
| Total plan assets at end of year | 2011-04-30 | $3,900 |
| Total contributions received or receivable from participants | 2011-04-30 | $8,203 |
| Net income (gross income less expenses) | 2011-04-30 | $4,598 |
| Net plan assets at end of year (total assets less liabilities) | 2011-04-30 | $3,900 |
| Net plan assets at beginning of year (total assets less liabilities) | 2011-04-30 | $-698 |
| Total contributions received or receivable from employer(s) | 2011-04-30 | $25,029 |
| Expenses. Administrative service providers (salaries,fees and commissions) | 2011-04-30 | $6,537 |
| 2010: BLACKSTONE NATIONAL GOLF CLUB EMPLOYEE HEALTH PLAN 2010 form 5500 responses | ||
|---|---|---|
| 2010-05-01 | Type of plan entity | Single employer plan |
| 2010-05-01 | Plan funding arrangement – Trust | Yes |
| 2010-05-01 | Plan benefit arrangement - Trust | Yes |
| 2009: BLACKSTONE NATIONAL GOLF CLUB EMPLOYEE HEALTH PLAN 2009 form 5500 responses | ||
| 2009-05-01 | Type of plan entity | Single employer plan |
| 2009-05-01 | Submission has been amended | Yes |
| 2009-05-01 | Plan funding arrangement – Trust | Yes |
| 2009-05-01 | Plan benefit arrangement - Trust | Yes |
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