401k Plan data: RIVERGATE KW MANAGEMENT LIFE, STD, LTD AND ADD INSURANCE PLAN plan

RIVERGATE KW MANAGEMENT LIFE, STD, LTD AND ADD INSURANCE PLAN 401k Plan overview

Plan Name	RIVERGATE KW MANAGEMENT LIFE, STD, LTD AND ADD INSURANCE PLAN
Plan identification number	503

RIVERGATE KW MANAGEMENT LIFE, STD, LTD AND ADD INSURANCE PLAN Benefits

401k Plan Type	Welfare Benefit
Plan Features/Benefits	Life insurance Temporary disability (accident and sickness) Long-term disability cover Death benefits (include travel accident but not life insurance) Other welfare benefit cover

401k Sponsoring company profile

RIVERGATE KW MANAGEMENT LLC has sponsored the creation of one or more 401k plans.

Company Name: RIVERGATE KW MANAGEMENT LLC

Employer identification number (EIN): 471241858

NAIC Classification: 531310

Form 5500 Filing Information

Submission information for form 5500 for 401k plan RIVERGATE KW MANAGEMENT LIFE, STD, LTD AND ADD INSURANCE PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
503 2021-08-01 MIGLIDE GARCON 2023-03-09
503 2020-08-01 MIGLIDE GARCON 2022-04-13
503 2019-08-01 MIGLIDE GARCON 2021-12-16

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed
503	2021-08-01	MIGLIDE GARCON	2023-03-09
503	2020-08-01	MIGLIDE GARCON	2022-04-13
503	2019-08-01	MIGLIDE GARCON	2021-12-16

Plan Statistics for RIVERGATE KW MANAGEMENT LIFE, STD, LTD AND ADD INSURANCE PLAN

401k plan membership statisitcs for RIVERGATE KW MANAGEMENT LIFE, STD, LTD AND ADD INSURANCE PLAN

Measure Date Value
2021: RIVERGATE KW MANAGEMENT LIFE, STD, LTD AND ADD INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year 2021-08-01 348
Total number of active participants reported on line 7a of the Form 5500 2021-08-01 0
Number of retired or separated participants receiving benefits 2021-08-01 0
Number of other retired or separated participants entitled to future benefits 2021-08-01 0
Total of all active and inactive participants 2021-08-01 0
Number of employers contributing to the scheme 2021-08-01 0
2020: RIVERGATE KW MANAGEMENT LIFE, STD, LTD AND ADD INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year 2020-08-01 100
Total number of active participants reported on line 7a of the Form 5500 2020-08-01 100
Number of retired or separated participants receiving benefits 2020-08-01 0
Number of other retired or separated participants entitled to future benefits 2020-08-01 0
Total of all active and inactive participants 2020-08-01 100
Number of employers contributing to the scheme 2020-08-01 0
2019: RIVERGATE KW MANAGEMENT LIFE, STD, LTD AND ADD INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year 2019-08-01 100
Total number of active participants reported on line 7a of the Form 5500 2019-08-01 100
Number of retired or separated participants receiving benefits 2019-08-01 0
Number of other retired or separated participants entitled to future benefits 2019-08-01 0
Total of all active and inactive participants 2019-08-01 100
Number of employers contributing to the scheme 2019-08-01 0

Measure	Date	Value
2021: RIVERGATE KW MANAGEMENT LIFE, STD, LTD AND ADD INSURANCE PLAN 2021 401k membership
Total participants, beginning-of-year	2021-08-01	348
Total number of active participants reported on line 7a of the Form 5500	2021-08-01	0
Number of retired or separated participants receiving benefits	2021-08-01	0
Number of other retired or separated participants entitled to future benefits	2021-08-01	0
Total of all active and inactive participants	2021-08-01	0
Number of employers contributing to the scheme	2021-08-01	0
2020: RIVERGATE KW MANAGEMENT LIFE, STD, LTD AND ADD INSURANCE PLAN 2020 401k membership
Total participants, beginning-of-year	2020-08-01	100
Total number of active participants reported on line 7a of the Form 5500	2020-08-01	100
Number of retired or separated participants receiving benefits	2020-08-01	0
Number of other retired or separated participants entitled to future benefits	2020-08-01	0
Total of all active and inactive participants	2020-08-01	100
Number of employers contributing to the scheme	2020-08-01	0
2019: RIVERGATE KW MANAGEMENT LIFE, STD, LTD AND ADD INSURANCE PLAN 2019 401k membership
Total participants, beginning-of-year	2019-08-01	100
Total number of active participants reported on line 7a of the Form 5500	2019-08-01	100
Number of retired or separated participants receiving benefits	2019-08-01	0
Number of other retired or separated participants entitled to future benefits	2019-08-01	0
Total of all active and inactive participants	2019-08-01	100
Number of employers contributing to the scheme	2019-08-01	0

Form 5500 Responses for RIVERGATE KW MANAGEMENT LIFE, STD, LTD AND ADD INSURANCE PLAN

2021: RIVERGATE KW MANAGEMENT LIFE, STD, LTD AND ADD INSURANCE PLAN 2021 form 5500 responses
2021-08-01	Type of plan entity	Single employer plan
2021-08-01	This submission is the final filing	Yes
2021-08-01	Plan funding arrangement – Insurance	Yes
2021-08-01	Plan benefit arrangement – Insurance	Yes
2020: RIVERGATE KW MANAGEMENT LIFE, STD, LTD AND ADD INSURANCE PLAN 2020 form 5500 responses
2020-08-01	Type of plan entity	Single employer plan
2020-08-01	Plan funding arrangement – Insurance	Yes
2020-08-01	Plan benefit arrangement – Insurance	Yes
2019: RIVERGATE KW MANAGEMENT LIFE, STD, LTD AND ADD INSURANCE PLAN 2019 form 5500 responses
2019-08-01	Type of plan entity	Single employer plan
2019-08-01	First time form 5500 has been submitted	Yes
2019-08-01	Plan funding arrangement – Insurance	Yes
2019-08-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

EAP CONSULTANTS, LLC (National Association of Insurance Commissioners NAIC id number: 62419 )

Policy contract number

8917

Policy instance

Insurance contract or identification number	8917
Number of Individuals Covered	335
Insurance policy start date	2021-08-01
Insurance policy end date	2022-07-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $0
Other welfare benefits provided	EMPLOYEE ASSISTANCE PROGRAM
Welfare Benefit Premiums Paid to Carrier	USD $4,350
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No

MUTUAL OF OMAHA (National Association of Insurance Commissioners NAIC id number: 69868 )

Policy contract number

GLUG0BXZX

Policy instance

Insurance contract or identification number	GLUG0BXZX
Number of Individuals Covered	335
Insurance policy start date	2021-08-01
Insurance policy end date	2022-07-31
Total amount of commissions paid to insurance broker	USD $6,910
Total amount of fees paid to insurance company	USD $1,971
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $77,115
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $5,933
Amount paid for insurance broker fees	0
Insurance broker organization code?	3
Additional information about fees paid to insurance broker	OTHER COMPENSATION

LIFE INSURANCE COMPANY OF NORTH AMERICA (National Association of Insurance Commissioners NAIC id number: 65498 )

Policy contract number

FLX969058

Policy instance

Insurance contract or identification number	FLX969058
Number of Individuals Covered	100
Insurance policy start date	2020-08-01
Insurance policy end date	2021-07-31
Total amount of commissions paid to insurance broker	USD $3,516
Total amount of fees paid to insurance company	USD $0
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	Yes
Temporary Disability Insurance Welfare Benefit	Yes
Long Term Disability Insurance Welfare Benefit	Yes
Unemployment Insurance Welfare Benefit	No
Other welfare benefits provided	ACCIDENTAL DEATH AND DISMEMBERMENT
Welfare Benefit Premiums Paid to Carrier	USD $25,049
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	Yes
Commission paid to Insurance Broker	USD $3,516
Amount paid for insurance broker fees	0
Insurance broker organization code?	3

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Company Name:	RIVERGATE KW MANAGEMENT LLC
Employer identification number (EIN):	471241858
NAIC Classification:	531310