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SHANGRI LA CONSTRUCTION HEALTH AND WELFARE PLAN 401k Plan overview

Plan NameSHANGRI LA CONSTRUCTION HEALTH AND WELFARE PLAN
Plan identification number 501

SHANGRI LA CONSTRUCTION HEALTH AND WELFARE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Health (other than dental or vision)
  • Life insurance
  • Dental
  • Vision
  • Death benefits (include travel accident but not life insurance)

401k Sponsoring company profile

SHANGRI-LA CONSTRUCTION LP has sponsored the creation of one or more 401k plans.

Company Name:SHANGRI-LA CONSTRUCTION LP
Employer identification number (EIN):263250243
NAIC Classification:721199
NAIC Description:All Other Traveler Accommodation

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SHANGRI LA CONSTRUCTION HEALTH AND WELFARE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012023-04-01AMILCAR PAYAN2024-02-22
5012022-04-01AMILCAR PAYAN2024-01-16

Plan Statistics for SHANGRI LA CONSTRUCTION HEALTH AND WELFARE PLAN

401k plan membership statisitcs for SHANGRI LA CONSTRUCTION HEALTH AND WELFARE PLAN

Measure Date Value
2023: SHANGRI LA CONSTRUCTION HEALTH AND WELFARE PLAN 2023 401k membership
Total participants, beginning-of-year2023-04-01144
Total number of active participants reported on line 7a of the Form 55002023-04-010
Number of retired or separated participants receiving benefits2023-04-010
Number of other retired or separated participants entitled to future benefits2023-04-010
Total of all active and inactive participants2023-04-010
Number of employers contributing to the scheme2023-04-010
2022: SHANGRI LA CONSTRUCTION HEALTH AND WELFARE PLAN 2022 401k membership
Total participants, beginning-of-year2022-04-01130
Total number of active participants reported on line 7a of the Form 55002022-04-01135
Number of retired or separated participants receiving benefits2022-04-010
Number of other retired or separated participants entitled to future benefits2022-04-010
Total of all active and inactive participants2022-04-01135
Number of employers contributing to the scheme2022-04-010

Form 5500 Responses for SHANGRI LA CONSTRUCTION HEALTH AND WELFARE PLAN

2023: SHANGRI LA CONSTRUCTION HEALTH AND WELFARE PLAN 2023 form 5500 responses
2023-04-01Type of plan entitySingle employer plan
2023-04-01This submission is the final filingYes
2023-04-01This return/report is a short plan year return/report (less than 12 months)Yes
2023-04-01Plan funding arrangement – InsuranceYes
2023-04-01Plan benefit arrangement – InsuranceYes
2022: SHANGRI LA CONSTRUCTION HEALTH AND WELFARE PLAN 2022 form 5500 responses
2022-04-01Type of plan entitySingle employer plan
2022-04-01First time form 5500 has been submittedYes
2022-04-01Plan funding arrangement – InsuranceYes
2022-04-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberL05512
Policy instance 1
Insurance contract or identification numberL05512
Number of Individuals Covered132
Insurance policy start date2023-04-01
Insurance policy end date2023-11-30
Total amount of commissions paid to insurance brokerUSD $29,641
Total amount of fees paid to insurance companyUSD $12,629
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $539,912
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
BLUE CROSS OF CALIFORNIA (National Association of Insurance Commissioners NAIC id number: 00000 )
Policy contract numberL05512
Policy instance 1
Insurance contract or identification numberL05512
Number of Individuals Covered302
Insurance policy start date2022-04-01
Insurance policy end date2023-03-31
Total amount of commissions paid to insurance brokerUSD $40,865
Total amount of fees paid to insurance companyUSD $7,120
Health Insurance Welfare BenefitYes
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Other welfare benefits providedACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to CarrierUSD $843,804
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $40,865
Amount paid for insurance broker fees7120
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3

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