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SERVUS, INC. LIFESTYLE LIFE, LIFESTYLE AD&D 401k Plan overview

Plan NameSERVUS, INC. LIFESTYLE LIFE, LIFESTYLE AD&D
Plan identification number 505

SERVUS, INC. LIFESTYLE LIFE, LIFESTYLE AD&D Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Long-term disability cover

401k Sponsoring company profile

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

Company Name:SERVUS, INC.
Employer identification number (EIN):351279978
NAIC Classification:722511
NAIC Description:Full-Service Restaurants

Form 5500 Filing Information

Submission information for form 5500 for 401k plan SERVUS, INC. LIFESTYLE LIFE, LIFESTYLE AD&D

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5052020-03-01
5052019-03-01
5052018-03-01KRISTI MEHRINGER KRISTI MEHRINGER2019-07-25
5052017-03-01JASON KELLY JASON KELLY2018-07-26
5052016-03-01JASON KELLY JASON KELLY2017-07-28
5052015-03-01JASON KELLY JASON KELLY2016-07-20
5052014-03-01JASON KELLY JASON KELLY2015-07-15
5052013-03-01JASON KELLY JASON KELLY2014-06-26
5052012-03-01JASON KELLY JASON KELLY2013-07-11
5052011-03-01JASON KELLY JASON KELLY2012-07-18
5052010-03-01JASON KELLY JASON KELLY2011-07-11
5052009-03-01JASON KELLY JASON KELLY2010-07-26

Plan Statistics for SERVUS, INC. LIFESTYLE LIFE, LIFESTYLE AD&D

401k plan membership statisitcs for SERVUS, INC. LIFESTYLE LIFE, LIFESTYLE AD&D

Measure Date Value
2020: SERVUS, INC. LIFESTYLE LIFE, LIFESTYLE AD&D 2020 401k membership
Total participants, beginning-of-year2020-03-01145
Total number of active participants reported on line 7a of the Form 55002020-03-016
Number of retired or separated participants receiving benefits2020-03-010
Number of other retired or separated participants entitled to future benefits2020-03-010
Total of all active and inactive participants2020-03-016
2019: SERVUS, INC. LIFESTYLE LIFE, LIFESTYLE AD&D 2019 401k membership
Total participants, beginning-of-year2019-03-01179
Total number of active participants reported on line 7a of the Form 55002019-03-01145
Number of retired or separated participants receiving benefits2019-03-010
Number of other retired or separated participants entitled to future benefits2019-03-010
Total of all active and inactive participants2019-03-01145
2018: SERVUS, INC. LIFESTYLE LIFE, LIFESTYLE AD&D 2018 401k membership
Total participants, beginning-of-year2018-03-01311
Total number of active participants reported on line 7a of the Form 55002018-03-01179
Number of retired or separated participants receiving benefits2018-03-010
Number of other retired or separated participants entitled to future benefits2018-03-010
Total of all active and inactive participants2018-03-01179
2017: SERVUS, INC. LIFESTYLE LIFE, LIFESTYLE AD&D 2017 401k membership
Total participants, beginning-of-year2017-03-01361
Total number of active participants reported on line 7a of the Form 55002017-03-01311
Number of retired or separated participants receiving benefits2017-03-010
Number of other retired or separated participants entitled to future benefits2017-03-010
Total of all active and inactive participants2017-03-01311
2016: SERVUS, INC. LIFESTYLE LIFE, LIFESTYLE AD&D 2016 401k membership
Total participants, beginning-of-year2016-03-01359
Total number of active participants reported on line 7a of the Form 55002016-03-01361
Number of retired or separated participants receiving benefits2016-03-010
Number of other retired or separated participants entitled to future benefits2016-03-010
Total of all active and inactive participants2016-03-01361
2015: SERVUS, INC. LIFESTYLE LIFE, LIFESTYLE AD&D 2015 401k membership
Total participants, beginning-of-year2015-03-01146
Total number of active participants reported on line 7a of the Form 55002015-03-01359
Number of retired or separated participants receiving benefits2015-03-010
Number of other retired or separated participants entitled to future benefits2015-03-010
Total of all active and inactive participants2015-03-01359
2014: SERVUS, INC. LIFESTYLE LIFE, LIFESTYLE AD&D 2014 401k membership
Total participants, beginning-of-year2014-03-0184
Total number of active participants reported on line 7a of the Form 55002014-03-01146
Number of retired or separated participants receiving benefits2014-03-010
Number of other retired or separated participants entitled to future benefits2014-03-010
Total of all active and inactive participants2014-03-01146
2013: SERVUS, INC. LIFESTYLE LIFE, LIFESTYLE AD&D 2013 401k membership
Total participants, beginning-of-year2013-03-01676
Total number of active participants reported on line 7a of the Form 55002013-03-0184
Total of all active and inactive participants2013-03-0184
2012: SERVUS, INC. LIFESTYLE LIFE, LIFESTYLE AD&D 2012 401k membership
Total participants, beginning-of-year2012-03-01592
Total number of active participants reported on line 7a of the Form 55002012-03-01676
Total of all active and inactive participants2012-03-01676
2011: SERVUS, INC. LIFESTYLE LIFE, LIFESTYLE AD&D 2011 401k membership
Total participants, beginning-of-year2011-03-01417
Total number of active participants reported on line 7a of the Form 55002011-03-01592
Total of all active and inactive participants2011-03-01592
2010: SERVUS, INC. LIFESTYLE LIFE, LIFESTYLE AD&D 2010 401k membership
Total participants, beginning-of-year2010-03-01200
Total number of active participants reported on line 7a of the Form 55002010-03-01417
Total of all active and inactive participants2010-03-01417
2009: SERVUS, INC. LIFESTYLE LIFE, LIFESTYLE AD&D 2009 401k membership
Total participants, beginning-of-year2009-03-01213
Total number of active participants reported on line 7a of the Form 55002009-03-01200
Total of all active and inactive participants2009-03-01200

Form 5500 Responses for SERVUS, INC. LIFESTYLE LIFE, LIFESTYLE AD&D

2020: SERVUS, INC. LIFESTYLE LIFE, LIFESTYLE AD&D 2020 form 5500 responses
2020-03-01Type of plan entitySingle employer plan
2020-03-01Plan funding arrangement – InsuranceYes
2020-03-01Plan benefit arrangement – InsuranceYes
2019: SERVUS, INC. LIFESTYLE LIFE, LIFESTYLE AD&D 2019 form 5500 responses
2019-03-01Type of plan entitySingle employer plan
2019-03-01Plan funding arrangement – InsuranceYes
2019-03-01Plan benefit arrangement – InsuranceYes
2018: SERVUS, INC. LIFESTYLE LIFE, LIFESTYLE AD&D 2018 form 5500 responses
2018-03-01Type of plan entitySingle employer plan
2018-03-01Plan funding arrangement – InsuranceYes
2018-03-01Plan benefit arrangement – InsuranceYes
2017: SERVUS, INC. LIFESTYLE LIFE, LIFESTYLE AD&D 2017 form 5500 responses
2017-03-01Type of plan entitySingle employer plan
2017-03-01Plan funding arrangement – InsuranceYes
2017-03-01Plan benefit arrangement – InsuranceYes
2016: SERVUS, INC. LIFESTYLE LIFE, LIFESTYLE AD&D 2016 form 5500 responses
2016-03-01Type of plan entitySingle employer plan
2016-03-01Plan funding arrangement – InsuranceYes
2016-03-01Plan benefit arrangement – InsuranceYes
2015: SERVUS, INC. LIFESTYLE LIFE, LIFESTYLE AD&D 2015 form 5500 responses
2015-03-01Type of plan entitySingle employer plan
2015-03-01Plan funding arrangement – InsuranceYes
2015-03-01Plan benefit arrangement – InsuranceYes
2014: SERVUS, INC. LIFESTYLE LIFE, LIFESTYLE AD&D 2014 form 5500 responses
2014-03-01Type of plan entitySingle employer plan
2014-03-01Plan funding arrangement – InsuranceYes
2014-03-01Plan benefit arrangement – InsuranceYes
2013: SERVUS, INC. LIFESTYLE LIFE, LIFESTYLE AD&D 2013 form 5500 responses
2013-03-01Type of plan entitySingle employer plan
2013-03-01Submission has been amendedYes
2013-03-01Plan funding arrangement – InsuranceYes
2013-03-01Plan benefit arrangement – InsuranceYes
2012: SERVUS, INC. LIFESTYLE LIFE, LIFESTYLE AD&D 2012 form 5500 responses
2012-03-01Type of plan entitySingle employer plan
2012-03-01Plan funding arrangement – InsuranceYes
2012-03-01Plan benefit arrangement – InsuranceYes
2011: SERVUS, INC. LIFESTYLE LIFE, LIFESTYLE AD&D 2011 form 5500 responses
2011-03-01Type of plan entitySingle employer plan
2011-03-01Plan funding arrangement – InsuranceYes
2011-03-01Plan benefit arrangement – InsuranceYes
2010: SERVUS, INC. LIFESTYLE LIFE, LIFESTYLE AD&D 2010 form 5500 responses
2010-03-01Type of plan entitySingle employer plan
2010-03-01Plan funding arrangement – InsuranceYes
2010-03-01Plan benefit arrangement – InsuranceYes
2009: SERVUS, INC. LIFESTYLE LIFE, LIFESTYLE AD&D 2009 form 5500 responses
2009-03-01Type of plan entitySingle employer plan
2009-03-01Plan funding arrangement – InsuranceYes
2009-03-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010237492 00
Policy instance 1
Insurance contract or identification number000010237492 00
Number of Individuals Covered6
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Total amount of commissions paid to insurance brokerUSD $1,942
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $12,946
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,942
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010237492 00
Policy instance 1
Insurance contract or identification number000010237492 00
Number of Individuals Covered145
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $2,002
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $13,344
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,002
Insurance broker organization code?3
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 65676 )
Policy contract number000010237492 00
Policy instance 1
Insurance contract or identification number000010237492 00
Number of Individuals Covered179
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $2,335
Total amount of fees paid to insurance companyUSD $642
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $15,566
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $2,335
Amount paid for insurance broker fees642
Additional information about fees paid to insurance brokerBROKER BONUS
Insurance broker organization code?3
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-016264-00
Policy instance 1
Insurance contract or identification number01-016264-00
Number of Individuals Covered311
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $1,861
Total amount of fees paid to insurance companyUSD $561
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $19,341
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $1,861
Amount paid for insurance broker fees561
Additional information about fees paid to insurance brokerGROUP VOLUME DISCOUNT
Insurance broker organization code?3
Insurance broker nameJA BENEFITS LLC
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-016264-00
Policy instance 1
Insurance contract or identification number01-016264-00
Number of Individuals Covered359
Insurance policy start date2015-03-01
Insurance policy end date2016-02-29
Total amount of commissions paid to insurance brokerUSD $3,013
Total amount of fees paid to insurance companyUSD $149
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $20,141
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,013
Amount paid for insurance broker fees149
Insurance broker organization code?3
Insurance broker nameJA BENEFITS LLC
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-016264-00
Policy instance 1
Insurance contract or identification number01-016264-00
Number of Individuals Covered146
Insurance policy start date2014-03-01
Insurance policy end date2015-02-28
Total amount of commissions paid to insurance brokerUSD $3,599
Life Insurance Welfare BenefitYes
Other welfare benefits providedAD&D
Welfare Benefit Premiums Paid to CarrierUSD $30,448
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $3,599
Insurance broker organization code?3
Insurance broker nameJA BENEFITS LLC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX961796
Policy instance 1
Insurance contract or identification numberFLX961796
Number of Individuals Covered611
Insurance policy start date2012-03-01
Insurance policy end date2013-03-01
Total amount of commissions paid to insurance brokerUSD $8,986
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $61,120
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,986
Additional information about fees paid to insurance brokerSALES & SERVICE
Insurance broker organization code?3
Insurance broker nameASSURED PARTNERS OF INDIANA
SYMETRA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68608 )
Policy contract number01-016264-00
Policy instance 2
Insurance contract or identification number01-016264-00
Number of Individuals Covered84
Insurance policy start date2013-03-01
Insurance policy end date2014-02-28
Total amount of commissions paid to insurance brokerUSD $4,153
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $27,689
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $4,153
Additional information about fees paid to insurance brokerSALES & SERVICE
Insurance broker organization code?3
Insurance broker nameJ A BENEFITS LLC
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX961796
Policy instance 1
Insurance contract or identification numberFLX961796
Number of Individuals Covered676
Insurance policy start date2011-03-01
Insurance policy end date2012-03-01
Total amount of commissions paid to insurance brokerUSD $9,258
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $63,029
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $9,258
Additional information about fees paid to insurance brokerSALES & SERVICE
Insurance broker organization code?3
Insurance broker nameTOBIAS INSURANCE GROUP
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX961796
Policy instance 1
Insurance contract or identification numberFLX961796
Number of Individuals Covered592
Insurance policy start date2010-03-01
Insurance policy end date2011-03-01
Total amount of commissions paid to insurance brokerUSD $8,317
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $56,163
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )
Policy contract numberFLX961796
Policy instance 1
Insurance contract or identification numberFLX961796
Number of Individuals Covered417
Insurance policy start date2009-03-01
Insurance policy end date2010-03-01
Total amount of commissions paid to insurance brokerUSD $10,529
Long Term Disability Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $71,522
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $10,529
Additional information about fees paid to insurance brokerSALES SERVICE
Insurance broker organization code?3
Insurance broker nameTOBIAS INSURANCE GROUP

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