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GRUBE, INC. HEALTH AND WELFARE BENEFIT PLAN 401k Plan overview

Plan NameGRUBE, INC. HEALTH AND WELFARE BENEFIT PLAN
Plan identification number 501

GRUBE, INC. HEALTH AND WELFARE BENEFIT 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)
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that will not file a Form 5500 for next plan year pursuant to 29 CFR 2520.104-20.
  • Unfunded, fully insured, or combination unfunded/insured welfare plan that stopped filing form 5500s in an earlier plan year pursuant to 29 CFR 2520.104-20.

401k Sponsoring company profile

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

Company Name:GRUBE, INC.
Employer identification number (EIN):383824895
NAIC Classification:722511
NAIC Description:Full-Service Restaurants

Additional information about GRUBE, INC.

Jurisdiction of Incorporation: Ohio Secretary of State Business Services Division
Incorporation Date: 2010-08-06
Company Identification Number: 1954158
Legal Registered Office Address: 8329 FOX CHASE LANE
-
DEFIANCE
United States of America (USA)
43512

More information about GRUBE, INC.

Form 5500 Filing Information

Submission information for form 5500 for 401k plan GRUBE, INC. HEALTH AND WELFARE BENEFIT PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5012022-09-01TINA STELLHORN2023-11-01
5012021-09-01TINA STELLHORN2023-02-07
5012018-09-01TINA STELLHORN2023-02-07

Plan Statistics for GRUBE, INC. HEALTH AND WELFARE BENEFIT PLAN

401k plan membership statisitcs for GRUBE, INC. HEALTH AND WELFARE BENEFIT PLAN

Measure Date Value
2022: GRUBE, INC. HEALTH AND WELFARE BENEFIT PLAN 2022 401k membership
Total participants, beginning-of-year2022-09-01167
Total number of active participants reported on line 7a of the Form 55002022-09-01163
Number of retired or separated participants receiving benefits2022-09-010
Number of other retired or separated participants entitled to future benefits2022-09-010
Total of all active and inactive participants2022-09-01163
Number of employers contributing to the scheme2022-09-010
2021: GRUBE, INC. HEALTH AND WELFARE BENEFIT PLAN 2021 401k membership
Total participants, beginning-of-year2021-09-01125
Total number of active participants reported on line 7a of the Form 55002021-09-01167
Number of retired or separated participants receiving benefits2021-09-010
Number of other retired or separated participants entitled to future benefits2021-09-010
Total of all active and inactive participants2021-09-01167
Number of employers contributing to the scheme2021-09-010
2018: GRUBE, INC. HEALTH AND WELFARE BENEFIT PLAN 2018 401k membership
Total participants, beginning-of-year2018-09-01112
Total number of active participants reported on line 7a of the Form 55002018-09-01101
Number of retired or separated participants receiving benefits2018-09-010
Number of other retired or separated participants entitled to future benefits2018-09-010
Total of all active and inactive participants2018-09-01101
Number of employers contributing to the scheme2018-09-010

Form 5500 Responses for GRUBE, INC. HEALTH AND WELFARE BENEFIT PLAN

2022: GRUBE, INC. HEALTH AND WELFARE BENEFIT PLAN 2022 form 5500 responses
2022-09-01Type of plan entitySingle employer plan
2022-09-01Plan funding arrangement – InsuranceYes
2022-09-01Plan benefit arrangement – InsuranceYes
2021: GRUBE, INC. HEALTH AND WELFARE BENEFIT PLAN 2021 form 5500 responses
2021-09-01Type of plan entitySingle employer plan
2021-09-01Plan funding arrangement – InsuranceYes
2021-09-01Plan benefit arrangement – InsuranceYes
2018: GRUBE, INC. HEALTH AND WELFARE BENEFIT PLAN 2018 form 5500 responses
2018-09-01Type of plan entitySingle employer plan
2018-09-01First time form 5500 has been submittedYes
2018-09-01Plan funding arrangement – InsuranceYes
2018-09-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number97888
Policy instance 1
Insurance contract or identification number97888
Number of Individuals Covered188
Insurance policy start date2022-09-01
Insurance policy end date2023-08-31
Total amount of commissions paid to insurance brokerUSD $71,264
Total amount of fees paid to insurance companyUSD $13,770
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $11,319
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $71,264
Amount paid for insurance broker fees13770
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number491798
Policy instance 2
Insurance contract or identification number491798
Number of Individuals Covered163
Insurance policy start date2022-09-01
Insurance policy end date2023-08-31
Total amount of commissions paid to insurance brokerUSD $8,502
Total amount of fees paid to insurance companyUSD $3,812
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitYes
Life Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $130,838
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $8,502
Amount paid for insurance broker fees3812
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number97888
Policy instance 1
Insurance contract or identification number97888
Number of Individuals Covered167
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $63,100
Total amount of fees paid to insurance companyUSD $9,717
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $10,008
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $63,100
Amount paid for insurance broker fees9717
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 64246 )
Policy contract number491798
Policy instance 2
Insurance contract or identification number491798
Number of Individuals Covered156
Insurance policy start date2021-09-01
Insurance policy end date2022-08-31
Total amount of commissions paid to insurance brokerUSD $6,793
Total amount of fees paid to insurance companyUSD $3,653
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 $108,430
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $6,793
Amount paid for insurance broker fees3653
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3
MEDICAL MUTUAL OF OHIO (National Association of Insurance Commissioners NAIC id number: 29076 )
Policy contract number97888
Policy instance 1
Insurance contract or identification number97888
Number of Individuals Covered101
Insurance policy start date2018-09-01
Insurance policy end date2019-08-31
Total amount of commissions paid to insurance brokerUSD $40,665
Total amount of fees paid to insurance companyUSD $6,904
Health Insurance Welfare BenefitYes
Welfare Benefit Premiums Paid to CarrierUSD $528,766
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
Commission paid to Insurance BrokerUSD $40,665
Amount paid for insurance broker fees6904
Additional information about fees paid to insurance brokerFEES
Insurance broker organization code?3

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