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MOD SUPER FAST PIZZA, LLC CRITICAL ILLNESS AND HOSPITAL INDEMNITY PLAN 401k Plan overview

Plan NameMOD SUPER FAST PIZZA, LLC CRITICAL ILLNESS AND HOSPITAL INDEMNITY PLAN
Plan identification number 502

MOD SUPER FAST PIZZA, LLC CRITICAL ILLNESS AND HOSPITAL INDEMNITY PLAN Benefits

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

401k Sponsoring company profile

MOD SUPER FAST PIZZA, LLC has sponsored the creation of one or more 401k plans.

Company Name:MOD SUPER FAST PIZZA, LLC
Employer identification number (EIN):262450462
NAIC Classification:722511
NAIC Description:Full-Service Restaurants

Additional information about MOD SUPER FAST PIZZA, LLC

Jurisdiction of Incorporation: State of Delaware Division of Corporations
Incorporation Date:
Company Identification Number: 4507708

More information about MOD SUPER FAST PIZZA, LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan MOD SUPER FAST PIZZA, LLC CRITICAL ILLNESS AND HOSPITAL INDEMNITY PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5022022-01-01JASON HALEVA2023-09-18
5022021-01-01JASON HALEVA2023-06-21
5022019-01-01JASON HALEVA2023-06-21

Plan Statistics for MOD SUPER FAST PIZZA, LLC CRITICAL ILLNESS AND HOSPITAL INDEMNITY PLAN

401k plan membership statisitcs for MOD SUPER FAST PIZZA, LLC CRITICAL ILLNESS AND HOSPITAL INDEMNITY PLAN

Measure Date Value
2022: MOD SUPER FAST PIZZA, LLC CRITICAL ILLNESS AND HOSPITAL INDEMNITY PLAN 2022 401k membership
Total participants, beginning-of-year2022-01-01279
Total number of active participants reported on line 7a of the Form 55002022-01-010
Number of retired or separated participants receiving benefits2022-01-010
Number of other retired or separated participants entitled to future benefits2022-01-010
Total of all active and inactive participants2022-01-010
Number of employers contributing to the scheme2022-01-010
2021: MOD SUPER FAST PIZZA, LLC CRITICAL ILLNESS AND HOSPITAL INDEMNITY PLAN 2021 401k membership
Total participants, beginning-of-year2021-01-01260
Total number of active participants reported on line 7a of the Form 55002021-01-01279
Number of retired or separated participants receiving benefits2021-01-010
Number of other retired or separated participants entitled to future benefits2021-01-010
Total of all active and inactive participants2021-01-01279
Number of employers contributing to the scheme2021-01-010
2019: MOD SUPER FAST PIZZA, LLC CRITICAL ILLNESS AND HOSPITAL INDEMNITY PLAN 2019 401k membership
Total participants, beginning-of-year2019-01-01214
Total number of active participants reported on line 7a of the Form 55002019-01-01283
Number of retired or separated participants receiving benefits2019-01-010
Number of other retired or separated participants entitled to future benefits2019-01-010
Total of all active and inactive participants2019-01-01283
Number of employers contributing to the scheme2019-01-010

Form 5500 Responses for MOD SUPER FAST PIZZA, LLC CRITICAL ILLNESS AND HOSPITAL INDEMNITY PLAN

2022: MOD SUPER FAST PIZZA, LLC CRITICAL ILLNESS AND HOSPITAL INDEMNITY PLAN 2022 form 5500 responses
2022-01-01Type of plan entitySingle employer plan
2022-01-01This submission is the final filingYes
2022-01-01Plan funding arrangement – InsuranceYes
2022-01-01Plan benefit arrangement – InsuranceYes
2021: MOD SUPER FAST PIZZA, LLC CRITICAL ILLNESS AND HOSPITAL INDEMNITY PLAN 2021 form 5500 responses
2021-01-01Type of plan entitySingle employer plan
2021-01-01Plan funding arrangement – InsuranceYes
2021-01-01Plan benefit arrangement – InsuranceYes
2019: MOD SUPER FAST PIZZA, LLC CRITICAL ILLNESS AND HOSPITAL INDEMNITY PLAN 2019 form 5500 responses
2019-01-01Type of plan entitySingle employer plan
2019-01-01First time form 5500 has been submittedYes
2019-01-01Plan funding arrangement – InsuranceYes
2019-01-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number802448
Policy instance 1
Insurance contract or identification number802448
Number of Individuals Covered335
Insurance policy start date2022-01-01
Insurance policy end date2022-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedCRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $82,167
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number802448
Policy instance 1
Insurance contract or identification number802448
Number of Individuals Covered279
Insurance policy start date2021-01-01
Insurance policy end date2021-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedCRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $96,064
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
AETNA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 60054 )
Policy contract number802448
Policy instance 1
Insurance contract or identification number802448
Number of Individuals Covered283
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $0
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedCRITICAL ILLNESS, HOSPITAL
Welfare Benefit Premiums Paid to CarrierUSD $54,475
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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