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FAJITA WILLIE'S CAFE & CANTINA OCCUPATIONAL INJURY BENEFIT PLAN 401k Plan overview

Plan NameFAJITA WILLIE'S CAFE & CANTINA OCCUPATIONAL INJURY BENEFIT PLAN
Plan identification number 501

FAJITA WILLIE'S CAFE & CANTINA OCCUPATIONAL INJURY BENEFIT PLAN Benefits

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

401k Sponsoring company profile

FRIJOLES RESTAURANTS, INC. has sponsored the creation of one or more 401k plans.

Company Name:FRIJOLES RESTAURANTS, INC.
Employer identification number (EIN):061124332
NAIC Classification:722511
NAIC Description:Full-Service Restaurants

Additional information about FRIJOLES RESTAURANTS, INC.

Jurisdiction of Incorporation: Texas Secretary of State
Incorporation Date: 1985-01-29
Company Identification Number: 0073770000
Legal Registered Office Address: 10627 TOWER OAKS BLVD

HOUSTON
United States of America (USA)
77070

More information about FRIJOLES RESTAURANTS, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan FAJITA WILLIE'S CAFE & CANTINA OCCUPATIONAL INJURY BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012015-01-01
5012014-01-01JAY BARNES
5012013-10-02JAY BARNES
5012012-10-02JAY BARNES
5012011-10-02JAY BARNES

Plan Statistics for FAJITA WILLIE'S CAFE & CANTINA OCCUPATIONAL INJURY BENEFIT PLAN

401k plan membership statisitcs for FAJITA WILLIE'S CAFE & CANTINA OCCUPATIONAL INJURY BENEFIT PLAN

Measure Date Value
2015: FAJITA WILLIE'S CAFE & CANTINA OCCUPATIONAL INJURY BENEFIT PLAN 2015 401k membership
Total participants, beginning-of-year2015-01-01204
Total number of active participants reported on line 7a of the Form 55002015-01-010
Number of retired or separated participants receiving benefits2015-01-010
Number of other retired or separated participants entitled to future benefits2015-01-010
Total of all active and inactive participants2015-01-010
2014: FAJITA WILLIE'S CAFE & CANTINA OCCUPATIONAL INJURY BENEFIT PLAN 2014 401k membership
Total participants, beginning-of-year2014-01-01188
Total number of active participants reported on line 7a of the Form 55002014-01-01204
Number of retired or separated participants receiving benefits2014-01-010
Number of other retired or separated participants entitled to future benefits2014-01-010
Total of all active and inactive participants2014-01-01204
2013: FAJITA WILLIE'S CAFE & CANTINA OCCUPATIONAL INJURY BENEFIT PLAN 2013 401k membership
Total participants, beginning-of-year2013-10-02188
Total number of active participants reported on line 7a of the Form 55002013-10-02188
Number of retired or separated participants receiving benefits2013-10-020
Number of other retired or separated participants entitled to future benefits2013-10-020
Total of all active and inactive participants2013-10-02188
2012: FAJITA WILLIE'S CAFE & CANTINA OCCUPATIONAL INJURY BENEFIT PLAN 2012 401k membership
Total participants, beginning-of-year2012-10-02189
Total number of active participants reported on line 7a of the Form 55002012-10-02188
Number of retired or separated participants receiving benefits2012-10-020
Number of other retired or separated participants entitled to future benefits2012-10-020
Total of all active and inactive participants2012-10-02188
2011: FAJITA WILLIE'S CAFE & CANTINA OCCUPATIONAL INJURY BENEFIT PLAN 2011 401k membership
Total participants, beginning-of-year2011-10-02189
Total number of active participants reported on line 7a of the Form 55002011-10-02189
Number of retired or separated participants receiving benefits2011-10-020
Number of other retired or separated participants entitled to future benefits2011-10-020
Total of all active and inactive participants2011-10-02189

Form 5500 Responses for FAJITA WILLIE'S CAFE & CANTINA OCCUPATIONAL INJURY BENEFIT PLAN

2015: FAJITA WILLIE'S CAFE & CANTINA OCCUPATIONAL INJURY BENEFIT PLAN 2015 form 5500 responses
2015-01-01Type of plan entitySingle employer plan
2015-01-01Submission has been amendedNo
2015-01-01This submission is the final filingYes
2015-01-01This return/report is a short plan year return/report (less than 12 months)Yes
2015-01-01Plan is a collectively bargained planNo
2015-01-01Plan funding arrangement – InsuranceYes
2015-01-01Plan benefit arrangement – InsuranceYes
2014: FAJITA WILLIE'S CAFE & CANTINA OCCUPATIONAL INJURY BENEFIT PLAN 2014 form 5500 responses
2014-01-01Type of plan entitySingle employer plan
2014-01-01Submission has been amendedNo
2014-01-01This submission is the final filingNo
2014-01-01This return/report is a short plan year return/report (less than 12 months)No
2014-01-01Plan is a collectively bargained planNo
2014-01-01Plan funding arrangement – InsuranceYes
2014-01-01Plan funding arrangement – General assets of the sponsorYes
2014-01-01Plan benefit arrangement – InsuranceYes
2014-01-01Plan benefit arrangement – General assets of the sponsorYes
2013: FAJITA WILLIE'S CAFE & CANTINA OCCUPATIONAL INJURY BENEFIT PLAN 2013 form 5500 responses
2013-10-02Type of plan entitySingle employer plan
2013-10-02Submission has been amendedNo
2013-10-02This submission is the final filingNo
2013-10-02This return/report is a short plan year return/report (less than 12 months)Yes
2013-10-02Plan is a collectively bargained planNo
2013-10-02Plan funding arrangement – InsuranceYes
2013-10-02Plan funding arrangement – General assets of the sponsorYes
2013-10-02Plan benefit arrangement – InsuranceYes
2013-10-02Plan benefit arrangement – General assets of the sponsorYes
2012: FAJITA WILLIE'S CAFE & CANTINA OCCUPATIONAL INJURY BENEFIT PLAN 2012 form 5500 responses
2012-10-02Type of plan entitySingle employer plan
2012-10-02Submission has been amendedNo
2012-10-02This submission is the final filingNo
2012-10-02This return/report is a short plan year return/report (less than 12 months)No
2012-10-02Plan is a collectively bargained planNo
2012-10-02Plan funding arrangement – InsuranceYes
2012-10-02Plan funding arrangement – General assets of the sponsorYes
2012-10-02Plan benefit arrangement – InsuranceYes
2012-10-02Plan benefit arrangement – General assets of the sponsorYes
2011: FAJITA WILLIE'S CAFE & CANTINA OCCUPATIONAL INJURY BENEFIT PLAN 2011 form 5500 responses
2011-10-02Type of plan entitySingle employer plan
2011-10-02Submission has been amendedNo
2011-10-02This submission is the final filingNo
2011-10-02This return/report is a short plan year return/report (less than 12 months)No
2011-10-02Plan is a collectively bargained planNo
2011-10-02Plan funding arrangement – InsuranceYes
2011-10-02Plan funding arrangement – General assets of the sponsorYes
2011-10-02Plan benefit arrangement – InsuranceYes
2011-10-02Plan benefit arrangement – General assets of the sponsorYes

Insurance Providers Used on plan

GREAT MIDWEST INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 18694 )
Policy contract numberOP00034837
Policy instance 1
Insurance contract or identification numberOP00034837
Number of Individuals Covered100
Insurance policy start date2015-01-01
Insurance policy end date2015-09-30
Total amount of commissions paid to insurance brokerUSD $689
Total amount of fees paid to insurance companyUSD $2
Are there contracts with allocated funds for individual policies?No
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?Yes
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 BenefitNo
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
Other welfare benefits providedOCCUPATIONAL ACCIDENT
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 $2,742
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractOCCUPATIONAL ACCIDENT
Commission paid to Insurance BrokerUSD $689
Amount paid for insurance broker fees2
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
Insurance broker namePERRICONE INSURANCE, INC.
GREAT MIDWEST INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 18694 )
Policy contract numberOP00034837
Policy instance 1
Insurance contract or identification numberOP00034837
Number of Individuals Covered204
Insurance policy start date2014-01-01
Insurance policy end date2014-07-31
Total amount of commissions paid to insurance brokerUSD $477
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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?Yes
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 BenefitNo
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
Other welfare benefits providedOCCUPATIONAL ACCIDENT
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 $3,976
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractOCCUPATIONAL ACCIDENT
Commission paid to Insurance BrokerUSD $477
Insurance broker organization code?3
Insurance broker namePERRICONE INSURANCE, INC.
LEXINGTON INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 19437 )
Policy contract number3719887
Policy instance 2
Insurance contract or identification number3719887
Number of Individuals Covered204
Insurance policy start date2014-07-31
Insurance policy end date2014-12-31
Total amount of commissions paid to insurance brokerUSD $330
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 BenefitNo
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
Other welfare benefits providedOCCUPATIONAL ACCIDENT
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 $1,749
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $330
Insurance broker organization code?3
Insurance broker nameAMWINS BROKERAGE OF TEXAS, INC.
GREAT MIDWEST INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 18694 )
Policy contract numberOP00034837
Policy instance 1
Insurance contract or identification numberOP00034837
Number of Individuals Covered189
Insurance policy start date2013-10-02
Insurance policy end date2013-12-31
Total amount of commissions paid to insurance brokerUSD $711
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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?Yes
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 BenefitNo
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
Other welfare benefits providedOCCUPATIONAL ACCIDENT
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 $5,921
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractOCCUPATIONAL ACCIDENT
Commission paid to Insurance BrokerUSD $711
Insurance broker organization code?3
Insurance broker namePERRICONE INSURANCE, INC.
GREAT MIDWEST INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 18694 )
Policy contract number0P00004166
Policy instance 1
Insurance contract or identification number0P00004166
Number of Individuals Covered188
Insurance policy start date2012-10-02
Insurance policy end date2013-10-01
Total amount of commissions paid to insurance brokerUSD $539
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 BenefitNo
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
Other welfare benefits providedLARGE DEDUCTIBLE OCCUPATIONAL INJURY
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 $9,283
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $539
Insurance broker organization code?3
Insurance broker nameBROWN & BROWN LONE STAR INSURANCE
GREAT MIDWEST INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 18694 )
Policy contract numberOP00034837
Policy instance 2
Insurance contract or identification numberOP00034837
Number of Individuals Covered188
Insurance policy start date2012-10-02
Insurance policy end date2013-10-01
Total amount of commissions paid to insurance brokerUSD $100
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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?Yes
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 BenefitNo
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
Other welfare benefits providedOCCUPATIONAL ACCIDENT
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Other information about contractOCCUPATIONAL ACCIDENT
Commission paid to Insurance BrokerUSD $100
Insurance broker organization code?3
Insurance broker namePERRICONE INSURANCE, INC.
GREAT MIDWEST INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 18694 )
Policy contract number0P00004166
Policy instance 1
Insurance contract or identification number0P00004166
Number of Individuals Covered189
Insurance policy start date2011-10-02
Insurance policy end date2012-10-01
Total amount of commissions paid to insurance brokerUSD $890
Total amount of fees paid to insurance companyUSD $0
Are there contracts with allocated funds for individual policies?No
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 BenefitNo
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
Other welfare benefits providedLARGE DEDUCTIBLE OCCUPATIONAL INJURY
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 $8,776
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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