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CUCINA CUCINA EMPLOYEE LIFE PLAN 401k Plan overview

Plan NameCUCINA CUCINA EMPLOYEE LIFE PLAN
Plan identification number 503

CUCINA CUCINA EMPLOYEE LIFE PLAN Benefits

401k Plan TypeWelfare Benefit
Plan Features/Benefits
  • Life insurance
  • Dental
  • Other welfare benefit cover

401k Sponsoring company profile

CUCINA CUCINA ACQUISITION LLC has sponsored the creation of one or more 401k plans.

Company Name:CUCINA CUCINA ACQUISITION LLC
Employer identification number (EIN):421614028
NAIC Classification:722110
NAIC Description: Full-Service Restaurants

Additional information about CUCINA CUCINA ACQUISITION LLC

Jurisdiction of Incorporation: Washington Secretary of State Corporations Division
Incorporation Date: 2003-12-10
Company Identification Number: 602349371
Legal Registered Office Address: 3400 CAPITOL BLVD. SE SUITE 101

TUMWATER
United States of America (USA)
98501

More information about CUCINA CUCINA ACQUISITION LLC

Form 5500 Filing Information

Submission information for form 5500 for 401k plan CUCINA CUCINA EMPLOYEE LIFE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator SignedName of Company SponsorDate Sponsor Signed
5032020-02-01
5032020-02-01
5032020-02-01
5032019-02-01
5032019-02-01
5032019-02-01
5032018-02-01
5032018-02-01
5032018-02-01
5032017-02-01
5032017-02-01
5032017-02-01
5032016-02-01
5032016-02-01
5032016-02-01
5032016-02-01
5032016-02-01
5032016-02-01

Plan Statistics for CUCINA CUCINA EMPLOYEE LIFE PLAN

401k plan membership statisitcs for CUCINA CUCINA EMPLOYEE LIFE PLAN

Measure Date Value
2020: CUCINA CUCINA EMPLOYEE LIFE PLAN 2020 401k membership
Total participants, beginning-of-year2020-02-01173
Total number of active participants reported on line 7a of the Form 55002020-02-01188
Number of retired or separated participants receiving benefits2020-02-010
Number of other retired or separated participants entitled to future benefits2020-02-010
Total of all active and inactive participants2020-02-01188
2019: CUCINA CUCINA EMPLOYEE LIFE PLAN 2019 401k membership
Total participants, beginning-of-year2019-02-01153
Total number of active participants reported on line 7a of the Form 55002019-02-01173
Number of retired or separated participants receiving benefits2019-02-010
Number of other retired or separated participants entitled to future benefits2019-02-010
Total of all active and inactive participants2019-02-01173
2018: CUCINA CUCINA EMPLOYEE LIFE PLAN 2018 401k membership
Total participants, beginning-of-year2018-02-01165
Total number of active participants reported on line 7a of the Form 55002018-02-01153
Number of retired or separated participants receiving benefits2018-02-010
Number of other retired or separated participants entitled to future benefits2018-02-010
Total of all active and inactive participants2018-02-01153
2017: CUCINA CUCINA EMPLOYEE LIFE PLAN 2017 401k membership
Total participants, beginning-of-year2017-02-01141
Total number of active participants reported on line 7a of the Form 55002017-02-01165
Number of retired or separated participants receiving benefits2017-02-010
Number of other retired or separated participants entitled to future benefits2017-02-010
Total of all active and inactive participants2017-02-01165
2016: CUCINA CUCINA EMPLOYEE LIFE PLAN 2016 401k membership
Total participants, beginning-of-year2016-02-01126
Total number of active participants reported on line 7a of the Form 55002016-02-01144
Number of retired or separated participants receiving benefits2016-02-010
Number of other retired or separated participants entitled to future benefits2016-02-010
Total of all active and inactive participants2016-02-01144

Form 5500 Responses for CUCINA CUCINA EMPLOYEE LIFE PLAN

2020: CUCINA CUCINA EMPLOYEE LIFE PLAN 2020 form 5500 responses
2020-02-01Type of plan entitySingle employer plan
2020-02-01Submission has been amendedNo
2020-02-01This submission is the final filingNo
2020-02-01This return/report is a short plan year return/report (less than 12 months)No
2020-02-01Plan is a collectively bargained planNo
2020-02-01Plan funding arrangement – General assets of the sponsorYes
2020-02-01Plan benefit arrangement – InsuranceYes
2019: CUCINA CUCINA EMPLOYEE LIFE PLAN 2019 form 5500 responses
2019-02-01Type of plan entitySingle employer plan
2019-02-01Submission has been amendedNo
2019-02-01This submission is the final filingNo
2019-02-01This return/report is a short plan year return/report (less than 12 months)No
2019-02-01Plan is a collectively bargained planNo
2019-02-01Plan funding arrangement – General assets of the sponsorYes
2019-02-01Plan benefit arrangement – InsuranceYes
2018: CUCINA CUCINA EMPLOYEE LIFE PLAN 2018 form 5500 responses
2018-02-01Type of plan entitySingle employer plan
2018-02-01Submission has been amendedNo
2018-02-01This submission is the final filingNo
2018-02-01This return/report is a short plan year return/report (less than 12 months)No
2018-02-01Plan is a collectively bargained planNo
2018-02-01Plan funding arrangement – General assets of the sponsorYes
2018-02-01Plan benefit arrangement – InsuranceYes
2017: CUCINA CUCINA EMPLOYEE LIFE PLAN 2017 form 5500 responses
2017-02-01Type of plan entitySingle employer plan
2017-02-01Submission has been amendedNo
2017-02-01This submission is the final filingNo
2017-02-01This return/report is a short plan year return/report (less than 12 months)No
2017-02-01Plan is a collectively bargained planNo
2017-02-01Plan funding arrangement – General assets of the sponsorYes
2017-02-01Plan benefit arrangement – InsuranceYes
2016: CUCINA CUCINA EMPLOYEE LIFE PLAN 2016 form 5500 responses
2016-02-01Type of plan entitySingle employer plan
2016-02-01First time form 5500 has been submittedYes
2016-02-01Submission has been amendedNo
2016-02-01This submission is the final filingNo
2016-02-01This return/report is a short plan year return/report (less than 12 months)No
2016-02-01Plan is a collectively bargained planNo
2016-02-01Plan funding arrangement – General assets of the sponsorYes
2016-02-01Plan benefit arrangement – InsuranceYes

Insurance Providers Used on plan

CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number0606378
Policy instance 1
Insurance contract or identification number0606378
Number of Individuals Covered188
Insurance policy start date2020-02-01
Insurance policy end date2021-01-31
Total amount of commissions paid to insurance brokerUSD $5,524
Total amount of fees paid to insurance companyUSD $832
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $111,986
Commission paid to Insurance BrokerUSD $5,524
Amount paid for insurance broker fees832
Additional information about fees paid to insurance brokerBROKER
Insurance broker organization code?3
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number0606378
Policy instance 1
Insurance contract or identification number0606378
Number of Individuals Covered173
Insurance policy start date2019-02-01
Insurance policy end date2020-01-31
Total amount of commissions paid to insurance brokerUSD $5,524
Total amount of fees paid to insurance companyUSD $205
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $111,986
Commission paid to Insurance BrokerUSD $5,524
Amount paid for insurance broker fees205
Additional information about fees paid to insurance brokerBROKER
Insurance broker organization code?3
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number0606378
Policy instance 1
Insurance contract or identification number0606378
Number of Individuals Covered153
Insurance policy start date2018-02-01
Insurance policy end date2019-01-31
Total amount of commissions paid to insurance brokerUSD $4,959
Total amount of fees paid to insurance companyUSD $205
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $101,890
Commission paid to Insurance BrokerUSD $4,959
Amount paid for insurance broker fees205
Additional information about fees paid to insurance brokerBROKER
Insurance broker organization code?3
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 67369 )
Policy contract number0606378
Policy instance 1
Insurance contract or identification number0606378
Number of Individuals Covered165
Insurance policy start date2017-02-01
Insurance policy end date2018-01-31
Total amount of commissions paid to insurance brokerUSD $4,718
Total amount of fees paid to insurance companyUSD $0
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $95,656
Commission paid to Insurance BrokerUSD $4,718
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerBROKER
Insurance broker organization code?3
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
RELIANCE STANDARD LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 68381 )
Policy contract numberGL 148284
Policy instance 1
Insurance contract or identification numberGL 148284
Number of Individuals Covered144
Insurance policy start date2016-02-01
Insurance policy end date2017-01-31
Total amount of commissions paid to insurance brokerUSD $746
Total amount of fees paid to insurance companyUSD $0
Other welfare benefits providedAD&D
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $6,780
Commission paid to Insurance BrokerUSD $746
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerBROKER
Insurance broker organization code?3
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitNo
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitYes
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No
CONNECTICUT GENERAL LIFE INSURANCE COMPANY AND AFFILIATES (National Association of Insurance Commissioners NAIC id number: 62308 )
Policy contract number0606378
Policy instance 1
Insurance contract or identification number0606378
Number of Individuals Covered141
Insurance policy start date2016-02-01
Insurance policy end date2017-01-31
Total amount of commissions paid to insurance brokerUSD $3,936
Total amount of fees paid to insurance companyUSD $0
Health Insurance Welfare BenefitNo
Dental Insurance Welfare BenefitYes
Vision Insurance Welfare BenefitNo
Life Insurance Welfare BenefitNo
Temporary Disability Insurance Welfare BenefitNo
Long Term Disability Insurance Welfare BenefitNo
Unemployment Insurance Welfare BenefitNo
Were dividends or retroactive rate refunds paid in cash?No
Were dividends or retroactive rate refunds paid as a credit?No
Welfare Benefit Premiums Paid to CarrierUSD $83,626
Commission paid to Insurance BrokerUSD $3,936
Amount paid for insurance broker fees0
Additional information about fees paid to insurance brokerBROKER
Insurance broker organization code?3
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?No

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