401k Plan data: ZITO EMPLOYEE HEALTH & WELFARE PLAN plan

ZITO EMPLOYEE HEALTH & WELFARE PLAN 401k Plan overview

Plan Name	ZITO EMPLOYEE HEALTH & WELFARE PLAN
Plan identification number	501

ZITO EMPLOYEE HEALTH & WELFARE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Health (other than dental or vision) Life insurance Supplemental unemployment Dental Vision Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

TREASURE LAKE LP has sponsored the creation of one or more 401k plans.

Company Name: TREASURE LAKE LP

Employer identification number (EIN): 204081440

NAIC Classification: 515100

Form 5500 Filing Information

Submission information for form 5500 for 401k plan ZITO EMPLOYEE HEALTH & WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
501 2023-05-01 JAY STUCKEY 2024-10-17
501 2022-05-01 JAY STUCKEY 2023-09-06
501 2021-05-01 JAY STUCKEY 2022-08-05
501 2020-05-01 JAY STUCKEY 2021-10-05
501 2019-05-01
501 2017-05-01 JAY STUCKEY

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
501	2023-05-01	JAY STUCKEY	2024-10-17
501	2022-05-01	JAY STUCKEY	2023-09-06
501	2021-05-01	JAY STUCKEY	2022-08-05
501	2020-05-01	JAY STUCKEY	2021-10-05
501	2019-05-01
501	2017-05-01	JAY STUCKEY

Plan Statistics for ZITO EMPLOYEE HEALTH & WELFARE PLAN

401k plan membership statisitcs for ZITO EMPLOYEE HEALTH & WELFARE PLAN

Measure Date Value
2023: ZITO EMPLOYEE HEALTH & WELFARE PLAN 2023 401k membership
Total participants, beginning-of-year 2023-05-01 351
Total number of active participants reported on line 7a of the Form 5500 2023-05-01 373
Number of retired or separated participants receiving benefits 2023-05-01 0
Number of other retired or separated participants entitled to future benefits 2023-05-01 0
Total of all active and inactive participants 2023-05-01 373
Number of employers contributing to the scheme 2023-05-01 0
2022: ZITO EMPLOYEE HEALTH & WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year 2022-05-01 345
Total number of active participants reported on line 7a of the Form 5500 2022-05-01 351
Number of retired or separated participants receiving benefits 2022-05-01 0
Number of other retired or separated participants entitled to future benefits 2022-05-01 0
Total of all active and inactive participants 2022-05-01 351
Number of employers contributing to the scheme 2022-05-01 0
2021: ZITO EMPLOYEE HEALTH & WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year 2021-05-01 341
Total number of active participants reported on line 7a of the Form 5500 2021-05-01 345
Number of retired or separated participants receiving benefits 2021-05-01 0
Number of other retired or separated participants entitled to future benefits 2021-05-01 0
Total of all active and inactive participants 2021-05-01 345
Number of employers contributing to the scheme 2021-05-01 0
2020: ZITO EMPLOYEE HEALTH & WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year 2020-05-01 298
Total number of active participants reported on line 7a of the Form 5500 2020-05-01 341
Number of retired or separated participants receiving benefits 2020-05-01 0
Number of other retired or separated participants entitled to future benefits 2020-05-01 0
Total of all active and inactive participants 2020-05-01 341
Number of employers contributing to the scheme 2020-05-01 0
2019: ZITO EMPLOYEE HEALTH & WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year 2019-05-01 230
Total number of active participants reported on line 7a of the Form 5500 2019-05-01 298
Number of retired or separated participants receiving benefits 2019-05-01 0
Number of other retired or separated participants entitled to future benefits 2019-05-01 0
Total of all active and inactive participants 2019-05-01 298
2017: ZITO EMPLOYEE HEALTH & WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year 2017-05-01 193
Total number of active participants reported on line 7a of the Form 5500 2017-05-01 225
Number of retired or separated participants receiving benefits 2017-05-01 0
Number of other retired or separated participants entitled to future benefits 2017-05-01 0
Total of all active and inactive participants 2017-05-01 225

Measure	Date	Value
2023: ZITO EMPLOYEE HEALTH & WELFARE PLAN 2023 401k membership
Total participants, beginning-of-year	2023-05-01	351
Total number of active participants reported on line 7a of the Form 5500	2023-05-01	373
Number of retired or separated participants receiving benefits	2023-05-01	0
Number of other retired or separated participants entitled to future benefits	2023-05-01	0
Total of all active and inactive participants	2023-05-01	373
Number of employers contributing to the scheme	2023-05-01	0
2022: ZITO EMPLOYEE HEALTH & WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year	2022-05-01	345
Total number of active participants reported on line 7a of the Form 5500	2022-05-01	351
Number of retired or separated participants receiving benefits	2022-05-01	0
Number of other retired or separated participants entitled to future benefits	2022-05-01	0
Total of all active and inactive participants	2022-05-01	351
Number of employers contributing to the scheme	2022-05-01	0
2021: ZITO EMPLOYEE HEALTH & WELFARE PLAN 2021 401k membership
Total participants, beginning-of-year	2021-05-01	341
Total number of active participants reported on line 7a of the Form 5500	2021-05-01	345
Number of retired or separated participants receiving benefits	2021-05-01	0
Number of other retired or separated participants entitled to future benefits	2021-05-01	0
Total of all active and inactive participants	2021-05-01	345
Number of employers contributing to the scheme	2021-05-01	0
2020: ZITO EMPLOYEE HEALTH & WELFARE PLAN 2020 401k membership
Total participants, beginning-of-year	2020-05-01	298
Total number of active participants reported on line 7a of the Form 5500	2020-05-01	341
Number of retired or separated participants receiving benefits	2020-05-01	0
Number of other retired or separated participants entitled to future benefits	2020-05-01	0
Total of all active and inactive participants	2020-05-01	341
Number of employers contributing to the scheme	2020-05-01	0
2019: ZITO EMPLOYEE HEALTH & WELFARE PLAN 2019 401k membership
Total participants, beginning-of-year	2019-05-01	230
Total number of active participants reported on line 7a of the Form 5500	2019-05-01	298
Number of retired or separated participants receiving benefits	2019-05-01	0
Number of other retired or separated participants entitled to future benefits	2019-05-01	0
Total of all active and inactive participants	2019-05-01	298
2017: ZITO EMPLOYEE HEALTH & WELFARE PLAN 2017 401k membership
Total participants, beginning-of-year	2017-05-01	193
Total number of active participants reported on line 7a of the Form 5500	2017-05-01	225
Number of retired or separated participants receiving benefits	2017-05-01	0
Number of other retired or separated participants entitled to future benefits	2017-05-01	0
Total of all active and inactive participants	2017-05-01	225

Form 5500 Responses for ZITO EMPLOYEE HEALTH & WELFARE PLAN

2023: ZITO EMPLOYEE HEALTH & WELFARE PLAN 2023 form 5500 responses
2023-05-01	Type of plan entity	Single employer plan
2023-05-01	Plan funding arrangement – Insurance	Yes
2023-05-01	Plan funding arrangement – General assets of the sponsor	Yes
2023-05-01	Plan benefit arrangement – Insurance	Yes
2023-05-01	Plan benefit arrangement – General assets of the sponsor	Yes
2022: ZITO EMPLOYEE HEALTH & WELFARE PLAN 2022 form 5500 responses
2022-05-01	Type of plan entity	Single employer plan
2022-05-01	Plan funding arrangement – Insurance	Yes
2022-05-01	Plan funding arrangement – General assets of the sponsor	Yes
2022-05-01	Plan benefit arrangement – Insurance	Yes
2022-05-01	Plan benefit arrangement – General assets of the sponsor	Yes
2021: ZITO EMPLOYEE HEALTH & WELFARE PLAN 2021 form 5500 responses
2021-05-01	Type of plan entity	Single employer plan
2021-05-01	Plan funding arrangement – Insurance	Yes
2021-05-01	Plan funding arrangement – General assets of the sponsor	Yes
2021-05-01	Plan benefit arrangement – Insurance	Yes
2021-05-01	Plan benefit arrangement – General assets of the sponsor	Yes
2020: ZITO EMPLOYEE HEALTH & WELFARE PLAN 2020 form 5500 responses
2020-05-01	Type of plan entity	Single employer plan
2020-05-01	Plan funding arrangement – Insurance	Yes
2020-05-01	Plan funding arrangement – General assets of the sponsor	Yes
2020-05-01	Plan benefit arrangement – Insurance	Yes
2020-05-01	Plan benefit arrangement – General assets of the sponsor	Yes
2019: ZITO EMPLOYEE HEALTH & WELFARE PLAN 2019 form 5500 responses
2019-05-01	Type of plan entity	Single employer plan
2019-05-01	Submission has been amended	No
2019-05-01	This submission is the final filing	No
2019-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2019-05-01	Plan is a collectively bargained plan	No
2019-05-01	Plan funding arrangement – Insurance	Yes
2019-05-01	Plan funding arrangement – General assets of the sponsor	Yes
2019-05-01	Plan benefit arrangement – Insurance	Yes
2019-05-01	Plan benefit arrangement – General assets of the sponsor	Yes
2017: ZITO EMPLOYEE HEALTH & WELFARE PLAN 2017 form 5500 responses
2017-05-01	Type of plan entity	Single employer plan
2017-05-01	Submission has been amended	No
2017-05-01	This submission is the final filing	No
2017-05-01	This return/report is a short plan year return/report (less than 12 months)	No
2017-05-01	Plan is a collectively bargained plan	No
2017-05-01	Plan funding arrangement – Insurance	Yes
2017-05-01	Plan funding arrangement – General assets of the sponsor	Yes
2017-05-01	Plan benefit arrangement – Insurance	Yes
2017-05-01	Plan benefit arrangement – General assets of the sponsor	Yes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10229318

Policy instance

Insurance contract or identification number	10229318
Number of Individuals Covered	373
Insurance policy start date	2023-05-01
Insurance policy end date	2024-04-30
Total amount of commissions paid to insurance broker	USD $18,153
Total amount of fees paid to insurance company	USD $11,907
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $209,916
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

512366

Policy instance

Insurance contract or identification number	512366
Number of Individuals Covered	298
Insurance policy start date	2023-05-01
Insurance policy end date	2024-04-30
Total amount of commissions paid to insurance broker	USD $3,678
Total amount of fees paid to insurance company	USD $4,518
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $139,130
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10229320

Policy instance

Insurance contract or identification number	10229320
Number of Individuals Covered	351
Insurance policy start date	2022-05-01
Insurance policy end date	2023-04-30
Total amount of commissions paid to insurance broker	USD $20,761
Total amount of fees paid to insurance company	USD $8,858
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $238,956
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

512366

Policy instance

Insurance contract or identification number	512366
Number of Individuals Covered	300
Insurance policy start date	2022-05-01
Insurance policy end date	2023-04-30
Total amount of commissions paid to insurance broker	USD $3,900
Total amount of fees paid to insurance company	USD $3,681
Dental Insurance Welfare Benefit	Yes
Vision Insurance Welfare Benefit	Yes
Welfare Benefit Premiums Paid to Carrier	USD $154,804
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

512366

Policy instance

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10229320

Policy instance

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

10229320

Policy instance

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

512366

Policy instance

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010229318

Policy instance

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00512366

Policy instance

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

40000100022674

Policy instance

ELITE UNDERWRITING (National Association of Insurance Commissioners NAIC id number: 18694 )

Policy contract number

MSL 2019 10424

Policy instance

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010229320

Policy instance

HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )

Policy contract number

098542

Policy instance

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010229319

Policy instance

HM LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 93440 )

Policy contract number

4065080010

Policy instance

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )

Policy contract number

00512366

Policy instance

HIGHMARK BLUE SHIELD (National Association of Insurance Commissioners NAIC id number: 54771 )

Policy contract number

098542

Policy instance

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010229319

Policy instance

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010229318

Policy instance

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )

Policy contract number

000010229320

Policy instance

Potentially related plans

ZITO EMPLOYEE HEALTH & WELFARE PLAN [EIN = 202970880]

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Company Name:	TREASURE LAKE LP
Employer identification number (EIN):	204081440
NAIC Classification:	515100