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FULL-TIME MEDICAL 401k Plan overview

Plan NameFULL-TIME MEDICAL
Plan identification number 509

FULL-TIME MEDICAL Benefits

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

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 FULL-TIME MEDICAL

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5092020-10-01
5092019-10-01
5092018-10-01
5092017-10-01
5092016-10-01JASON KELLY JASON KELLY2017-12-12
5092015-10-01JASON KELLY JASON KELLY2017-05-01
5092014-10-01JASON KELLY JASON KELLY2016-05-02
5092013-10-01JASON KELLY JASON KELLY2015-07-15
5092012-10-01JASON KELLY JASON KELLY2014-06-26
5092011-10-01JASON KELLY JASON KELLY2013-04-29
5092009-10-01JASON KELLY JASON KELLY2011-07-11

Plan Statistics for FULL-TIME MEDICAL

401k plan membership statisitcs for FULL-TIME MEDICAL

Measure Date Value
2020: FULL-TIME MEDICAL 2020 401k membership
Total participants, beginning-of-year2020-10-01112
Total number of active participants reported on line 7a of the Form 55002020-10-017
Number of retired or separated participants receiving benefits2020-10-010
Number of other retired or separated participants entitled to future benefits2020-10-010
Total of all active and inactive participants2020-10-017
2019: FULL-TIME MEDICAL 2019 401k membership
Total participants, beginning-of-year2019-10-01122
Total number of active participants reported on line 7a of the Form 55002019-10-01112
Number of retired or separated participants receiving benefits2019-10-010
Number of other retired or separated participants entitled to future benefits2019-10-010
Total of all active and inactive participants2019-10-01112
2018: FULL-TIME MEDICAL 2018 401k membership
Total participants, beginning-of-year2018-10-01250
Total number of active participants reported on line 7a of the Form 55002018-10-01122
Number of retired or separated participants receiving benefits2018-10-010
Number of other retired or separated participants entitled to future benefits2018-10-010
Total of all active and inactive participants2018-10-01122
2017: FULL-TIME MEDICAL 2017 401k membership
Total participants, beginning-of-year2017-10-01300
Total number of active participants reported on line 7a of the Form 55002017-10-01250
Number of retired or separated participants receiving benefits2017-10-010
Number of other retired or separated participants entitled to future benefits2017-10-010
Total of all active and inactive participants2017-10-01250
2016: FULL-TIME MEDICAL 2016 401k membership
Total participants, beginning-of-year2016-10-01348
Total number of active participants reported on line 7a of the Form 55002016-10-01300
Number of retired or separated participants receiving benefits2016-10-010
Number of other retired or separated participants entitled to future benefits2016-10-010
Total of all active and inactive participants2016-10-01300
2015: FULL-TIME MEDICAL 2015 401k membership
Total participants, beginning-of-year2015-10-01255
Total number of active participants reported on line 7a of the Form 55002015-10-01348
Number of retired or separated participants receiving benefits2015-10-010
Number of other retired or separated participants entitled to future benefits2015-10-010
Total of all active and inactive participants2015-10-01348
2014: FULL-TIME MEDICAL 2014 401k membership
Total participants, beginning-of-year2014-10-01259
Total number of active participants reported on line 7a of the Form 55002014-10-01255
Number of retired or separated participants receiving benefits2014-10-010
Number of other retired or separated participants entitled to future benefits2014-10-010
Total of all active and inactive participants2014-10-01255
2013: FULL-TIME MEDICAL 2013 401k membership
Total participants, beginning-of-year2013-10-01259
Total number of active participants reported on line 7a of the Form 55002013-10-01259
Total of all active and inactive participants2013-10-01259
2012: FULL-TIME MEDICAL 2012 401k membership
Total participants, beginning-of-year2012-10-01300
Total number of active participants reported on line 7a of the Form 55002012-10-01259
Total of all active and inactive participants2012-10-01259
2011: FULL-TIME MEDICAL 2011 401k membership
Total participants, beginning-of-year2011-10-01746
Total number of active participants reported on line 7a of the Form 55002011-10-01300
Total of all active and inactive participants2011-10-01300
2009: FULL-TIME MEDICAL 2009 401k membership
Total participants, beginning-of-year2009-10-01808
Total number of active participants reported on line 7a of the Form 55002009-10-01829
Total of all active and inactive participants2009-10-01829

Form 5500 Responses for FULL-TIME MEDICAL

2020: FULL-TIME MEDICAL 2020 form 5500 responses
2020-10-01Type of plan entitySingle employer plan
2020-10-01Plan funding arrangement – InsuranceYes
2020-10-01Plan benefit arrangement – InsuranceYes
2019: FULL-TIME MEDICAL 2019 form 5500 responses
2019-10-01Type of plan entitySingle employer plan
2019-10-01Plan funding arrangement – InsuranceYes
2019-10-01Plan benefit arrangement – InsuranceYes
2018: FULL-TIME MEDICAL 2018 form 5500 responses
2018-10-01Type of plan entitySingle employer plan
2018-10-01Plan funding arrangement – InsuranceYes
2018-10-01Plan benefit arrangement – InsuranceYes
2017: FULL-TIME MEDICAL 2017 form 5500 responses
2017-10-01Type of plan entitySingle employer plan
2017-10-01Plan funding arrangement – InsuranceYes
2017-10-01Plan benefit arrangement – InsuranceYes
2016: FULL-TIME MEDICAL 2016 form 5500 responses
2016-10-01Type of plan entitySingle employer plan
2016-10-01Plan funding arrangement – InsuranceYes
2016-10-01Plan benefit arrangement – InsuranceYes
2015: FULL-TIME MEDICAL 2015 form 5500 responses
2015-10-01Type of plan entitySingle employer plan
2015-10-01Plan funding arrangement – InsuranceYes
2015-10-01Plan benefit arrangement – InsuranceYes
2014: FULL-TIME MEDICAL 2014 form 5500 responses
2014-10-01Type of plan entitySingle employer plan
2014-10-01Plan funding arrangement – InsuranceYes
2014-10-01Plan benefit arrangement – InsuranceYes
2013: FULL-TIME MEDICAL 2013 form 5500 responses
2013-10-01Type of plan entitySingle employer plan
2013-10-01Plan funding arrangement – InsuranceYes
2013-10-01Plan benefit arrangement – InsuranceYes
2012: FULL-TIME MEDICAL 2012 form 5500 responses
2012-10-01Type of plan entitySingle employer plan
2012-10-01Plan funding arrangement – InsuranceYes
2012-10-01Plan benefit arrangement – InsuranceYes
2011: FULL-TIME MEDICAL 2011 form 5500 responses
2011-10-01Type of plan entitySingle employer plan
2011-10-01Plan funding arrangement – InsuranceYes
2011-10-01Plan benefit arrangement – InsuranceYes
2009: FULL-TIME MEDICAL 2009 form 5500 responses
2009-10-01Type of plan entitySingle employer plan
2009-10-01Plan funding arrangement – InsuranceYes
2009-10-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

SIHO (National Association of Insurance Commissioners NAIC id number: 95812 )
Policy contract number101185
Policy instance 1
Insurance contract or identification number101185
Number of Individuals Covered14
Insurance policy start date2020-01-01
Insurance policy end date2020-12-31
Health Insurance Welfare BenefitYes
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
STHEALTH/CHARTIS (National Association of Insurance Commissioners NAIC id number: 77828 )
Policy contract number417008411071
Policy instance 1
Insurance contract or identification number417008411071
Number of Individuals Covered112
Insurance policy start date2019-01-01
Insurance policy end date2019-12-31
Total amount of commissions paid to insurance brokerUSD $201,280
Total amount of fees paid to insurance companyUSD $2,051
Welfare Benefit Premiums Paid to CarrierUSD $156,722
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $140,999
Amount paid for insurance broker fees2051
Additional information about fees paid to insurance brokerCLAIMS PROCESSING
Insurance broker organization code?5
US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 )
Policy contract number417006411071
Policy instance 1
Insurance contract or identification number417006411071
Number of Individuals Covered122
Insurance policy start date2018-01-01
Insurance policy end date2018-12-31
Total amount of commissions paid to insurance brokerUSD $8,129
Welfare Benefit Premiums Paid to CarrierUSD $127,163
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,643
Additional information about fees paid to insurance brokerCLAIMS PROCESSING
Insurance broker organization code?5
US FIRE (National Association of Insurance Commissioners NAIC id number: 21113 )
Policy contract number417006411071
Policy instance 1
Insurance contract or identification number417006411071
Number of Individuals Covered250
Insurance policy start date2017-01-01
Insurance policy end date2017-12-31
Total amount of commissions paid to insurance brokerUSD $13,275
Welfare Benefit Premiums Paid to CarrierUSD $175,585
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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